As part of the programme, participating settings attended two days of training talking them through techniques and ‘implementation’ ideas. Most nurseries nominated a ‘programme champion’ to support the practitioners through the programme rollout and act as a point of contact for parents.

Prior to the programme, 27 per cent of both parents and practitioners were unaware of the suggested amount of time for toothbrushing; while 67 per cent didn’t know that you should not rinse your mouth after brushing.

A feasibility study revealed that as a result of the programme, children who took part are less reluctant to brush their teeth at home. Also, the number of parents either attending or planning to attend a dentist with their child has increased significantly.

Both practitioners and parents learnt a great deal through the programme, including tooth paste portions and length of time children should be brushing. According to guidelines, children from birth to three should use a ‘smear’ of toothpaste, while three to six year olds should used a ‘pea sized’ amount.

Early years settings also learnt how to safely store children’s toothbrushes and found creative ways of storing, cleaning and labelling toothbrushes to reduce the risk of cross-infection. Nursery managers and practitioners were very positive about the experience, stating that the introduction of daily toothbrushing was not seen as an additional burden, either financially or practically. 42% of settings found it ‘very easy’ to incorporate brushing into their daily routine.

The annual costs of delivering the supervised toothbrushing programme in the study were £204.06 per year or £4.09 per child. These costs only included purchasing tooth brushes and toothpaste, paper towels and for printing the information booklet. This is based on a full daycare setting with 50 children operating 51 weeks per year. Staff costs are not indicated as there is only a small additional impact on staff time as toothbrushing can be incorporated into daily routines.

Following publication of the feasibility study, Public Health England has published a toolkit to support supervised toothbrushing programme in early years settings and schools.