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Supervised brushing – a key tool in decay prevention

Blog Author Sandra White

Blog Date 20/03/2019

Children brusing teeth


In England, children are being hospitalised for having rotten teeth before they are even old enough to speak. Right across England, 105 children a day have their teeth removed in hospital due to tooth decay. Today is World Oral Health Day and it's important to raise awareness of good oral health and that, among children aged 0-5 years, almost nine out of ten hospital extractions are a result of this largely preventable disease.


Despite this, the picture isn't wholly negative: children's oral health is gradually improving, with 77 per cent of five-year old children in England now free of obvious decay. But the rates are still unacceptable, particularly as tooth decay is largely – and easily – preventable.


Action is needed now

Improving child dental health is a national problem and one that needs a collective response. It requires ongoing action across the whole system – with national and local government, the food and drink industry, healthcare professionals, those working in childcare settings, and families all having a part to play.


Children are losing 60,000 crucial days of their education each year due to rotting teeth – as well as suffering from pain, sleepless nights and difficulty doing the things they enjoy most, like playing games and socialising with friends. Let's not forget about the time taken off work by parents and carers.


Significant regional inequalities remain, with children from the most deprived areas having more than twice the level of decay than those from the least deprived.

Tooth decay is largely the result of not brushing teeth twice a day with fluoride toothpaste and consuming too much sugar. Children are consuming the equivalent of around 5,500 sugar cubes per year, which is 2,800 more than recommended. For five-year olds, this is equivalent to eating their body weight in sugar alone. As they say, the lowest fruits are the easiest to pick.


Tackling decay nationally and locally

There are simple solutions and, nationally, positive action is being taken to help combat the issue. The soft drinks industry levy, implemented by the government last year, has already led to an 11 per cent sugar reduction in retailer and manufacturer drinks included in the levy.


Additionally, Public Health England's sugar reduction programme is challenging the food industry to reduce the sugar in popular foods by 20 per cent by 2020. On average, sugar has been reduced by 2 per cent so far, with some categories like yoghurts, breakfast cereals and sweet spreads meeting or exceeding the first-year ambition of 5 per cent.


These measures are a good start to addressing the excess sugar in children's diets, which, aside from tooth decay, can lead to serious health problems such as child and adult obesity and Type 2 diabetes.


But we must go further – one step is supervised tooth brushing in nurseries and schools to ensure all children have an opportunity to learn how to keep their teeth healthy. It is unacceptable that 34 per cent of children in the most deprived areas of the country have decaying teeth, compared with 14 per cent in the least deprived, but equal care during school hours, as well as reducing sugar, could help improve this.


In some areas, local authorities are leading the way in working towards healthier schools and early years settings, by running supervised tooth-brushing programmes for example. Some local authorities also have community water fluoridation schemes, which has been shown to reduce dental inequalities in children.


We all have a part to play

Acting to prevent tooth decay doesn't have to be difficult. Parents, grandparents and carers can also help by swapping their children's high sugar foods and drinks for lower-sugar alternatives, and there are tools to help here, such as Change4Life's 'Food Scanner' app and other resources. Increasing children's access to fluoride, by brushing twice a day with fluoride toothpaste as soon as the first tooth appears, will also make an invaluable impact.


Tooth decay can have a serious impact on children's physical and emotional health, and extractions at such a young age can often signal a lifetime of poor oral health ahead. If we are to set our children up for a life free from tooth decay, everyone, from government to grandparent, must recognise their role and work together to protect our children from this devastating, yet preventable disease.


Sandra White

National lead for Dental Public Health at Public Health England