Supervised Tooth Brushing Programme

Delivering a Tooth Brushing Programme in your Nursery

As set out in the revised Early Years Foundation Stage (EYFS) Framework, early years providers are required to promote the good oral health of children. This has been included because good oral health habits need to be formed from an early age. Tooth decay is largely preventable, but it’s still a serious problem among young children, effecting around a quarter (25%) of 5 year olds!

Children who have toothache, or need treatment, may have pain or infections. This can have a wider effect and lead to problems eating, sleeping, socialising and learning. Tooth extraction is one of the most common procedures for children under 6 in hospital.

Parent helping child brush their teeth

Help for Early Years Providers has added new guidance on promoting good oral health (opens in new tab) in the early years.

The guidance:

  • explains the importance of good oral health for early years children
  • helps practitioners to meet the oral health requirement in the Early Years Foundation Stage statutory framework
  • includes practical tips and activities to use in early years settings
  • links to further reading and resources

Promoting Oral Health

You can decide how you promote oral health, based on what works best in your setting. It’s a good idea to link oral health to things you already promote, like self-care, healthy eating and physical development. Try to be creative and imaginative, for example:

  • Encourage children to brush the teeth of dolls or soft toys.
  • Use large teeth models and brushes for children to practice on.
  • Read stories about keeping teeth happy and healthy.
  • Talk about tooth friendly food and drinks that help to grow strong teeth, and those that we should limit as they’re no so tooth friendly (be mindful about the language you use and avoid labelling foods as ‘good’ and ‘bad’).
  • Roll play going to the dentist- book children and teddies in for check-ups!

Another great way to promote and support good oral health is by delivering a supervised tooth brushing programme.

Three children taking part in the supervised tooth brushing programme

What is a Supervised Tooth Brushing Programme?

Delivering a supervised tooth brushing programme in your early years setting supports children to integrate tooth brushing into their daily routines.

Once trained, practitioners will be able to support children to:

  • Correctly wash their hands
  • Brush all surfaces of the teeth for 2 minutes – front teeth, back teeth, biting surface, outside, inside, upper and lower teeth
  • Brush the tongue
  • Spit toothpaste out and not rinse.

Practitioners will also gain confidence in discussing the importance of tooth brushing and good oral health practices with families so they can continue these at home.

PHE Supervised tooth Brushing Info-graphic: Targeting supervised tooth brushing to childhood settings in areas of high levels of tooth decay will help reduce oral health inequalities. This helps to encourage children to brush their teeth from a young age and supports home brushing. Fluoride toothpaste has been shown to prevent tooth decay.

Examples of Settings Delivering the Programme

Following training and support from the Dental Wellness Trust (opens in new tab) (DWT), Susan Lawrence and Shrewsbury Nurseries have been successfully delivering a daily LiveSmart Supervised Tooth Brushing Programme. Staff at the settings are extremely positive in delivering the programme, and children look forward to brushing their teeth each day. Some parents have even reported that their child who was once a reluctant brusher, is now happily brushing their teeth at home!

Hear what they’ve got to say about the Supervised Tooth Brushing Programme in the video below:

Supervised Toothbrushing Programme in Early Years Settings Feedback

The team received feedback from eight nursery settings in the London Borough of Newham who are taking part in the LiveSmart Supervised Toothbrushing Programme (opens in new tab) from the Dental Wellness Trust.

The majority of settings (5) reported delivering the programme daily, in the morning and afternoon. This ensures all children have the opportunity to be part of the programme and learn about the importance of looking after their teeth. Three settings delivered it daily, in the afternoon only. Most settings offered the programme to all children in the baby, toddler and pre-school rooms. Three settings delivered it in the toddler and pre-school rooms only.

Supervised Toothbrushing Feedback received from Early Years settings in May 2023. Settings reported delivering the programme daily, in the morning and afternoon and in baby, toddler and preschool rooms

We received lots of top tips on how to successfully deliver the programme, lets take a look:


  • Some settings have an oral health lead to encourage and support children and staff to brush teeth together
  • Other settings get all staff involved and take the children in small groups to the bathroom
  • Staff found the Dental Wellness Trust training helped them to deliver the programme and also the Early Start Nutrition Oral Health Promotion training to support their conversation with children and families.

Consider the Room Layout

  • Have an area set up to brush teeth together. This can include a display board to motivate children and remind children of the key oral health messages. Staff use this area to talk about the importance of oral health and do other activities to help them be more encouraged
  • Toothbrushing can take place in the bathroom where you can also play songs to go with their teeth brushing.


  • Some settings have books about brushing our teeth and rotate with a dentist role play area
  • During the session staff can use the resources provided by the Dental Wellness Trust e.g. a plate to place the toothpaste on, children take the paste from the plate with their toothbrushes, in turns
  • Settings also use a 2 minute timer (e.g. sand timer) and give out stickers weekly
  • Settings love using the acrylic containers to store their toothbrushes hygienically (provided by DWT)
  • Children get an understanding of good tooth brushing by having a display board showing the importance toothbrushing, this is done alongside role play.

Image of toothbrushes in a toothbrush holder, image of a sand timer beside two toothbrushes in a glass, image of girl role playing at the dentist

There was lots of positive feedback from the children, parents and staff involved in the programme:

Children Feedback:

  • Children talk about their teeth, they know how long they should clean their teeth for, they know that healthy foods make healthy teeth, they know the sweet foods make unhealthy teeth
  • Children are very keen and like to show staff how well they have brushed them
  • During role play (dentists) the children are ensuring that every part of their teeth are covered when brushing including the back of the mouth / tongues

Parents Feedback:

  • Parents have an increased understanding about tooth-brushing. Families are able to talk to staff about difficulties they have at home and staff are confident to share how their children get on cleaning their teeth at nursery
  • Parents have said how they can see brushing teeth in nursery has helped their children at home with it and some children have asked their parents to play the 2 minute song

Staff Feedback:

Staff reported feeding confident to:

  • encourage parents to visit the dentist
  • identified children with dental decay and support parents to go to a dentist for intervention
  • raise the subject with families and support them to brush their child’s teeth at home with tips on engaging and reducing the home battle with toothbrushing

Members of staff who completed the toothbrushing/oral health training have more more knowledge on the important of the oral health and also built on their confidence to deliver the toothbrushing programme in their nursery

*Data received May 2023

How can our setting take part?

Newham early years settings

  • If you’re setting is in Newham, London and you’re interested in rolling out the LiveSmart Supervised Toothbrushing programme, please contact our team (opens in new tab) today to express your interest
  • You’ll need to attend a short training session with the DWT (around 20-30 minutes)
  • Toothbrushes and toothpaste will be provide free of charge by the DWT.

Outside of Newham early years settings

Online Oral Health Training

Oral health promotion training is another great way of ensuring your staff have a basic understanding of what good oral health is.

Our Oral Health Promotion online training (opens in new tab) explores the factors that can impact on children’s oral health, such as diet, tooth brushing and dental visits. Practitioners will also learn useful tips and strategies to help them support families in looking after their children’s teeth at home. If you are a Newham Early Years setting contact the Early Start Nutrition team today (opens in new tab) for a code to access the training for FREE!

Book now for only £30! (opens in new tab)


Oral Health Training Blurb

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