Information, advice and guidance on dental health in schools.

Tooth decay in childhood

Government data Go to (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
  • pain
  • 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:

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 (opens new window) on the NHS Choices website.

Supervised tooth brushing in nurseries and schools

According to Public Health England Go to (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 (opens new window) on GOV.UK.

Tooth brushing facts

According to the NHS choices website Go to (opens new window):

  • 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 (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.

You should:

  • 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 (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 (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

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:

Dental services in Bristol

NHS dentists

People without complex needs can find dentists on the NHS Choices website Go to (opens new window).

You can also access an NHS dentist in an emergency or out of hours Go to (opens new window), on the NHS website.

University Hospitals Bristol (UHB) NHS Foundation Trust

The Primary Care Dental Service (PCDS) Go to (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. 

You can find more details on the NHS website Go to (opens new window).