This vodcast explores insights into the national Supervised Toothbrushing programme in early years. Seb Thorpe (Begin Bright) is joined by Laura Lindon (Department for Education) who will discuss the programme and wider early years priorities; and Claire Stevens (Department for Health and Social Care) who will provide an overview of the health outcomes the programme aims to achieve.
This vodcast is also supported by a Q&A with David Yates, Nursery Lead at Tinsley Meadows Primary School to discuss his experience with supervised toothbrushing. You can find this Q&A below the vodcast.
Supervised Toothbrushing Q&A with David Yates
We spoke to David Yates, Nursery Lead at Tinsley Meadows Primary School about his experience with supervised toothbrushing.
How did you start running supervised toothbrushing sessions in your setting?
My involvement with toothbrushing began when I was originally signposted to the NHS Oral Health Team when I worked on the ‘Every Child a Talker’ initiative, supporting children’s language and communication skills, during my time working in a children’s centre nursery.
It was easy to get up and running with fantastic support in terms of advice, quality assurance and free resources from the oral health team.
Tooth brushes are individually labelled and stored in purpose made racks to prevent cross contamination. Each child’s toothbrush is always returned to the same labelled slot in the holder to add a further layer of infection control. A small amount of toothpaste is dispensed on to an individual piece of paper towel, which is handed out to each child along with their toothbrush.
Very broadly, how does it work?
We use a toothbrushing song (which lasts for 2 minutes) during which children brush their teeth, ensuring they brush for the full duration. Afterwards, they put their tissue in their bin, rinse their own brush and are supported by an adult to return their brush to their slot in the rack.
Why do you think supervised toothbrushing is worth doing?
Children enjoy brushing their teeth at nursery, and some parents report that they have noticed a difference at home where they previously found it a challenge to encourage their children to brush their teeth.
We also see visible benefits in children’s oral hygiene, particularly as they move up school, parents report improvements in children’s willingness to brush at home and children become more independent with their self-help skills, they can talk about keeping their teeth clean and healthy, linking to the learning and development requirements of the EYFS statutory framework.
Is it difficult to fit supervised toothbrushing sessions into the day?
Not at all! Toothbrushing is embedded in our daily nursery routine. We don’t find it obtrusive, or a chore, because it’s something that we do, similar to snack time, tidy up time etc. Our toothbrushing sessions take place at the beginning of the nursery session, during the short whole class ‘welcome’ group time. All the toothbrushes and toothpaste are prepared prior to this, before the beginning of the school day and during the lunch time period prior to the afternoon session.
The toothbrushes are brought to the carpet and stored on a shelf where they are easily accessible as soon as they are needed. Toothpaste is dispensed on to individual pieces of paper towel which is then handed individually to each child along with their toothbrush before brushing starts. We find it fits into the nursery routine well at this time and the children know that it always happens then. The whole process takes maybe around just 5-10 minutes. The children rinse their own toothbrushes afterwards and put their tissues in the bin.
Did you find it more difficult to fit supervised toothbrushing into reception classes?
When I taught in Reception, I didn’t find it to be more difficult to fit in. In nursery we have a morning and an afternoon brushing session because the majority of children attend part time, but in Reception, every child attends all day, so we could choose when to incorporate toothbrushing into the daily routine. We brushed at the beginning of the day, before lunch or immediately after lunch, depending on the routine of the day or the class cohort and all seemed to work well.
How do you ensure that supervised toothbrushing is done hygienically? Is there cross contamination from spitting?
Organisation is key, storing everything neatly and making sure it’s easily accessible. We have 60 children per session in our nursery, all of whom have a toothbrush. Our current system has colour-coded racks for children who attend mornings, afternoons or full days.
There are different ways to deliver supervised toothbrushing and they don’t necessarily involve spitting into sinks! We use the dry method which means that children spit out excess toothpaste into a paper towel, which goes straight in the bin. Both methods are described in the toolkit and again, our oral health promotion team were really helpful in showing us how to run a session when it was new to us. It’s become an integral part of our day the children know when we brush, just like they know when to fill their water bottles and wash their hands.
How do you keep parents and carers informed of supervised toothbrushing and encourage them to continue the practice at home?
We answer any queries from parents as they arise. Any parents who may initially have doubts are usually reassured after a quick conversation and explanation. They may feel that they are brushing sufficiently at home or there is a judgement made because their child is expected to brush additionally at school, but as soon as the purpose and benefits are explained, a shared understanding is achieved.
The Oral Health Promotion Team in our area visit every year to launch toothbrushing with the children and offer a parent information/advice session where parents are given advice around safe snacks, sugary food and drink and the correct way to support toothbrushing. Parents are always invited to watch to watch toothbrushing sessions if they wish, and brushes and pastes are regularly gifted for children to use at home.
How do you support children with SEND to participate?
No child is excluded – every child has a toothbrush and is encouraged to participate, but they are not forced to do so if they become upset or are unable to take part. Sometimes, children are provided with more than one toothbrush to hold, if this helps them, or they have even been given nursery toothpaste to use at home where families have continued to have difficulties with toothbrushing at home that we may not have been experienced at nursery.