Brushing up on health — how schools play a vital role

Good oral health is an essential part of a children and young people’s overall wellbeing. Yet, many children across the UK are experiencing tooth decay, and at an early age — currently around a quarter of five-year-olds in England.

In some areas, over a third of children are affected. And those in the most deprived communities are almost three times more likely to experience decay than their peers in more affluent areas. Poor oral health can affect children’s ability to eat and socialise, and can lead to pain, missed school days, or even tooth loss and hospital treatment.

This isn’t just about teeth — it’s about children’s quality of life, their confidence, and ability to learn and play without discomfort.

Beyond dental issues, excessive sugar consumption, one of the main causes of tooth decay, also contributes to obesity. The NHS currently spends approximately £3.4 billion per year treating oral conditions, highlighting the financial burden of poor oral health.

To address these challenges, the government has committed £11 million to a national supervised toothbrushing programme for 3- to 5-year-olds, for early years settings (including nurseries and primary schools) in the most deprived areas of England. Support is also included to improve the oral health of children with special educational needs.

This initiative aims to ensure that children get a daily opportunity to brush their teeth with fluoride toothpaste and learn toothbrushing skills which will have lifelong importance. It is designed to complement home toothbrushing, with parents and school staff working together to ensure pupils know the importance of oral health.

There are already around 150,000 children brushing regularly in nurseries and schools and this new initiative will increase that to 600,000 children. More information about supervised toothbrushing can be found at: HOME | Supervised Toothbrushing Toolkit.

NHS dentistry and supervised toothbrushing was also highlighted recently in the NHS 10 year plan (see page 31).

What does this mean for primary schools?

Whilst supervised brushing will help pupils develop positive toothbrushing skills and prevent tooth decay, it’s just one piece of the puzzle.

When taught as part of the PSHE curriculum, education on dental health plays a crucial role in reducing the prevalence of tooth decay and its consequences. Teaching children and young people about the causes of tooth decay, the benefits of choosing healthy foods and drinks, and how to care for their teeth, equips them with lifelong understanding and skills to maintain their own oral health, with wider, long-term benefits for their overall health.

Dental health education is also recognised in the DfE statutory guidance on health education for both primary and secondary aged pupils. It is also included in outcomes for the Early Years Foundation Stage.

So, as we think about how to embed this new initiative, here are some top tips for teaching dental health as part of your PSHE curriculum:

• Provide opportunities to rehearse brushing skills: practical activities where children brush teeth models, or role-play brushing their teeth with real or cut-out toothbrushes can be valuable. This links well with other parts of the early years and PSHE curriculum, and helps builds pupils’ confidence in taking care of their teeth.
• Use visual aids: use videos and images to support pupils’ learning and reinforce key messages. This is especially important for children who have special educational needs or English as an additional language.
• Small changes, big impact: remind pupils of the importance of using toothpaste (with fluoride), the need to brush before bed, and to spit but not rinse — these simple steps can really make a meaningful difference towards preventing tooth decay.
• Connect to real-life scenarios: as part of lesson activities, particularly for key stage 2 pupils, draw on common situations like choosing food and drinks at lunch or snack time. These are opportunities for children to exercise choice over what they eat and can support them to make independent, healthy choices.
• Avoid shame and stigma: pupils who have experienced dental health problems may feel shame or embarrassment about their teeth or even fear of the dentist or dental treatments. As such, it’s important to avoid fear-based messages or placing the burden of dental health onto pupils themselves. Instead, focus on supporting pupils to develop good dental health skills, such as brushing twice a day and visiting the dentist regularly. Establishing ground rules at the start of lessons will help to minimise negative comments and promote a non-judgemental approach. See our guidance on Handling complex issues and creating a safe learning environment for more information.
• Build in sugar awareness: aim to teach pupils about the impact of dietary choices on dental health, and link to aspects of wider, overall health. In particular, highlighting hidden/unexpected sugars in food and drinks will give pupils more accurate knowledge to inform their choices.
• Encourage parental involvement: sharing key messages with parents/carers, for example through letters or activities to do at home, helps to reinforce good oral health habits at home and promotes a joined-up approach.

Supporting you

For quality, evidence-based dental health resources, see our dental health lesson plans, developed with support from academics at the University of Sheffield and Cardiff University.

The updated lesson pack includes a lesson each for key stage 1, key stage 2 and key stage 3. The lessons explore how diet and everyday actions affect dental health; techniques and top tips for cleaning teeth, including brushing skills; common risks to dental health and strategies to manage them.

An additional quality assured key stage 3 lesson is also available, developed by academics at the University of Sheffield, University of Dundee and Cardiff University as part of the BRIGHT trial, which aims to develop students’ understanding and knowledge about the importance of tooth brushing with fluoride toothpaste as a method to prevent tooth decay.

With the right support and resources, we can equip pupils with the knowledge, skills, and confidence to take care of their dental health now and in the future.