National Supervised Toothbrushing Programme Across Early Years Settings in England
Evaluation in progress, expected completion date December 2026
At a glance
In 2025, the government announced it was providing funding to 147 local authorities in England to implement a national targeted supervised toothbrushing (STB) programme. The programme is targeted at children aged 3-5-years living in the 20% most deprived areas in England. The aim is to ensure the continuation of existing STB programmes and expand provision where needed. A total of £11M of additional funding has been allocated for the programme in 2025/2026, with plans to provide further funding in subsequent years.
This research is an early-phase evaluation of the national STB programme. The evaluation will focus on how the government programme is being implemented and received. It aims to gain insight into how the funding is being used to target particular groups, how it adds to any existing and ongoing local STB schemes, and to highlight barriers and facilitators to implementation. The findings of the evaluation will feed into a longer term evaluation of the government STB programme and will help to shape the approach to delivering STB programmes at the national and local governmental levels.
How are the public involved in the evaluation?
We have established advisory groups which include early years practitioners and parents of young children. We are consulting with these groups to gain their advice on recruitment procedures and data collection materials (e.g. topic guides)
We have convened an external Project Steering Group to provide advice and guidance to the research team, ensuring the study is robust, ethical and aligns with the agreed objectives. The Project Steering Group includes early years practitioner and parent representation.
We will meet with these groups at key stages throughout the project.
Evaluation Details
Tooth decay is the most common reason for hospital admissions in children aged 5-9 years in England. Toothbrushing with fluoride toothpaste is one of the most effective ways to prevent poor oral health. Most children brush their teeth regularly. However, those from poorer backgrounds are less likely to brush their teeth twice daily and are at higher risk of tooth decay.
In England, the government has announced a new national programme to improve children’s dental health. They are providing £11 million additional funding in 2025/26 to local authorities to support supervised toothbrushing in nurseries and schools. Further funding will be made available to local authorities in future years. The programme will target children aged 3-5 years who live in the most deprived areas of England.
This early evaluation aims to understand how local authorities in England are using the funding to deliver supervised toothbrushing in their area.
What will we do?
Our study aims to understand
- how the government funding is being delivered to target children aged 3-5 years in the most deprived area
- how the funding is being used where there is existing supervised toothbrushing schemes
- the factors that help and hinder local authorities delivering the scheme.
How will we do it?
We will:
- Analyse data provided by each local authority to the government. These data include the number of schools and nurseries approached to deliver supervised toothbrushing, those delivering supervised toothbrushing and the number of children attending those schools and nurseries.
- Collect data from a survey with local authorities about how they are delivering the programme. This will include how they are targeting children in the most deprived areas, how they monitor the programme, training of nursery and school staff, plans to continue delivering the programme and the uptake of the programme with schools, nurseries and families, including why they might decide to decline.
- Talk to a smaller group of people who commission and provide supervised toothbrushing in local authorities from different areas of England, with different population characteristics and at different stages of delivering supervised toothbrushing.
- Talk to staff, families and children at early years settings to understand their experiences of supervised toothbrushing
What will we do with the results
We will write a briefing to share the results of the study with the Department of Health and Social Care (DHSC) and the Department for Education (DfE) policy teams. We plan to share our findings with a range of other people such as professionals working in dental public health and early years education and care, and families. We will also present the findings to other researchers and people working in this area at conferences and meetings.
National Government / Partner(s)
Department for Health and Social Care
PHIRST PHRESH Research Team
University of Birmingham: Dr Marie Murphy, Professor Miranda Pallan, Dr Vahid Ravaghi, Dr Kate Garrott, Dr Joanne Clarke, Kate Howson, Helen Griggs
University of Keele: Dr Opeyemi Babatunde
Contact details: phirstphresh@contacts.bham.ac.uk
NIHR Funding Award: NIHR177628
Image Credit: Photo by Atlantic Ambience