Information, advice and guidance on dental health in schools.
Tooth decay in childhood
Government data Go to https://www.gov.uk/government/statistics/oral-health-survey-of-5-year-old-children-2019 (opens new window) shows that almost a quarter of five year olds in England have tooth decay. It's the most common reason that children aged between five and nine need treatment in hospital.
Poor oral health affects children and families' wellbeing and is almost totally preventable. The effects of tooth decay on children include:
- low self-esteem
- speech problems
- having to have multiple tooth extraction procedures, which may mean missing school
Schools have an important role to promote oral health by giving children, young people and their families information to help them make healthy choices.
How to promote oral health
Schools can promote oral health by telling children, young people and families about:
- regular tooth brushing twice a day and using a fluoride toothpaste
- registering with a dentist, which they can find on the NHS website
- having dental checks every six months
- limiting the number of sugary drinks and snacks, as advised on the NHS website
- eating a healthy diet that reflects the government Eatwell guide Go to https://www.gov.uk/government/publications/the-eatwell-guide (opens new window)
- the effect of smoking and drinking alcohol on oral health, including cancers, and referring them to quit smoking support
Dental health resources
You can find resources on promoting oral health, and organisations that can help, on our Dental health resources page.
Tooth brushing advice
Children should brush their teeth:
- for around two minutes
- twice a day, ideally last thing before bed and at least one other time during the day
- with fluoride toothpaste, as this helps prevent and control tooth decay
Parents or carers should supervise tooth brushing until a child is seven or eight years old, either by brushing their teeth themselves or, if they brush their own teeth, by watching how they do it.
From the age of seven or eight, they should be able to brush their own teeth. It's still a good idea for parents or carers to watch them now and again, to make sure they brush properly and for about two minutes.
You can find more information on how to clean teeth Go to http://www.nhs.uk/Livewell/dentalhealth/Pages/Teethcleaningguide.aspx (opens new window) on the NHS Choices website.
Supervised tooth brushing in nurseries and schools
According to Public Health England Go to https://www.gov.uk/government/publications/health-matters-child-dental-health/health-matters-child-dental-health#effective-interventions-for-improving-dental-health (opens new window), brushing with fluoride toothpaste every day makes tooth decay less likely and less serious when it does happen.
Nurseries and schools can support children to take part in a supervised tooth brushing programme. They can teach them to brush their teeth from a young age and encourage children to brush their teeth at home.
You can find more information on supervised tooth brushing Go to https://www.gov.uk/government/publications/health-matters-child-dental-health/health-matters-child-dental-health#effective-interventions-for-improving-dental-health (opens new window) on GOV.UK.
Tooth brushing facts
- You don't need to buy special children's toothpastes. In fact, some of them don't have enough fluoride in them to help prevent tooth decay.
- Children up to the age of six who don't have tooth decay can use a lower-strength toothpaste, but make sure it contains at least 1,000ppm fluoride.
- Children from the age of seven can use family toothpaste, as long as it contains 1,350-1,500 parts per million (ppm) fluoride. If you're not sure, check the toothpaste packet or ask your dentist.
- Children under three years old should use just a smear of toothpaste.
- Children over three years old and adults should use a pea-sized blob of toothpaste.
- Make sure children don't eat or lick toothpaste from the tube.
- Encourage children to spit out excess toothpaste.
- Don't rinse with lots of water, as rinsing with water after tooth brushing will wash away the fluoride and make it less effective.
Register with and visit a dentist
NHS dental treatment for children under 18 years old is free.
Having dental check-ups every six months can prevent or lower the risk of having serious and painful problems in the future.
You can find a local NHS dentist on the NHS choices website Go to http://www.nhs.uk/Service-Search/Dentist/LocationSearch/3 (opens new window) or by calling the NHS 111 service.
Limit the number of sugary drinks and snacks
Tooth decay is caused by how frequently we have sugar containing food and drink and poor dental health practices. The more often a child has sugary or acidic foods or drinks, the more likely they are to have tooth decay.
- reduce the amount of food and drinks that contain sugar, for example sweets, chocolates, cakes, biscuits, sugary breakfast cereals, jams, honey, fruit smoothies and dried fruit, and only have them at mealtimes
- avoid squashes, fizzy drinks, and juice drinks as these contain sugar and are low in vitamins, minerals and fibre
- encourage children to drink milk and water instead of sugary drinks and juices
- dilute one part juice to one part water and have it with a meal, if you do have it
- avoid drinks that are low sugar, no sugar added, or sugar free as, although these have less sugar, they have citric acid which is equally bad for children's teeth
Most sugars in the diet are in processed and manufactured foods and drinks. You should check labels to find out how much sugar is in a food or drink.
The NHS Choices website has advice about food labels Go to https://www.nhs.uk/Livewell/Goodfood/Pages/sugars.aspx (opens new window).
Have a healthy diet
Eating a varied diet that's rich in vitamins, minerals, and fresh fruit and vegetables can help to prevent gum disease.
The Eatwell Guide Go to https://www.gov.uk/government/publications/the-eatwell-guide (opens new window) on GOV.UK shows the proportions of different types of foods you need for a well-balanced and healthy diet.
The effect of tobacco and alcohol on oral health
- Information on the impact of smoking Go to https://www.dentalhealth.org/smoking-and-oral-health (opens new window) and alcohol Go to https://www.dentalhealth.org/drugs-alcohol-and-your-oral-health (opens new window) on oral health, on the website of independent dental charity Dental Health.
- Local stop smoking support in Bristol, for anyone aged 16 and over who'd like some advice about local stop smoking services, on the Live Well Bristol website
- Information for support to stop smoking Go to http://www.nhs.uk/livewell/smoking/Pages/stopsmokingnewhome.aspx (opens new window), on NHS Choices
Groups at higher risk of poor oral health
Looked after children
This group is likely to have less access to dental care, if they're moved between different carers.
People in deprived communities
People living in deprived communities consistently have poorer oral health than people living in more affluent communities. This includes:
- tooth decay
- tooth loss
- oral cancer
- gum disease
- periodontal disease
Children in deprived areas are less likely to brush their teeth at least twice a day.
People with disabilities
In general, people with disabilities:
- get more oral disease
- have fewer teeth than the general population
- have more difficulty accessing dental care
Some conditions and syndromes which people are born with may also have a negative impact on dental development and oral health.
Help with identifying a dental health issue
NHS advice on:
- symptoms of tooth decay Go to https://www.nhs.uk/conditions/tooth-decay/ (opens new window)
- symptoms of gum disease Go to https://www.nhs.uk/conditions/gum-disease/symptoms/ (opens new window)
- symptoms of a dental abscess Go to https://www.nhs.uk/conditions/dental-abscess/ (opens new window)
- symptoms of bad breath (halitosis) Go to https://www.nhs.uk/conditions/bad-breath/ (opens new window)
- treating toothache Go to https://www.nhs.uk/conditions/toothache/ (opens new window)
Dental services in Bristol
People without complex needs can find dentists on the NHS Choices website Go to http://www.nhs.uk/Service-Search/Dentist/LocationSearch/3 (opens new window).
University Hospitals Bristol (UHB) NHS Foundation Trust
The Primary Care Dental Service (PCDS) Go to http://www.uhbristol.nhs.uk/patients-and-visitors/your-hospitals/university-of-bristol-dental-hospital/what-we-do/primary-care-dental-service-(pcds)/ (opens new window) provides a range of dental services for people with complex needs. People need to be referred via their GP or dentist to use it. Health visitors, nursing home managers, key workers and CLDT staff can also refer people to this service. Services include:
- Community Dental Service, for people who can't get treatment from a general dental practitioner because of special needs or disabilities
- Dental Access Centre (DAC), for patients who have had difficulty being accepted by an NHS dentist, for example people who can't find a local NHS dentist accepting new patients or who aren't registered at all
- Dental Out of Hours Emergency Service (OOH), at clinics in Easton in Bristol (Charlotte Keel), Bath City Centre (Riverside) and Weston General Hospital, the service provides emergency treatment to all patients, whether NHS or private, who don't have access to regular dental care, or are just visiting the area
To access the DAC or OOH Service, phone 111.
The cost of the treatment in each of the services is the same as any other NHS dental practice. It's free for children under 18.