England's supervised toothbrushing programmes expand to 238,636 children
Dental public health leads should review barriers and facilitators to STP implementation before scaling programmes under the new national funding.
STP participation more than doubles since 2022
Supervised toothbrushing programmes (STPs) in England have grown substantially, with 81% of local authorities running a programme in 2025, up from 48% in 2022 and 59% in 2024. The number of children participating more than doubled from 106,273 in 2022 to 238,636 in 2025. In March 2025, the Department for Education and Department of Health and Social Care allocated £11 million for 2025/26 to support local authorities in reaching 600,000 children aged 3–5 years in the most deprived areas, alongside a partnership with Colgate-Palmolive providing 23 million toothbrushes and toothpastes over five years.
Key barriers to scaling supervised toothbrushing programmes
Research combining a national survey of 152 local authorities with interviews at four case study sites identified two major barriers. First, infrastructure limitations including uncertain funding, workforce capacity constraints, and logistical challenges with supply distribution. Stakeholders emphasised that short-term funding cycles discourage early years settings from investing time and effort in implementation. Second, engaging early years settings proved difficult, particularly those in the most deprived areas where the need is greatest. Staff shortages, competing priorities, and beliefs that toothbrushing falls outside schools' remit hindered participation.
Building relationships and knowledge sharing enable expansion
Two key facilitators emerged from the case study analysis. Building relationships across local authorities, providers, health visiting teams, and school leaders created trust and opened communication channels, helping overcome engagement obstacles. Trusted intermediaries such as multi-academy trust leads and health visitors were particularly effective at reframing STPs as aligned with school readiness and child wellbeing. Knowledge sharing through national resources, local networks, and peer-to-peer support also accelerated implementation. Participants highlighted that informal information-sharing about successes and lessons from pilot projects helped change perceptions and enabled effective scaling in areas adopting STPs for the first time.
| Year | Local authorities with STP | Participating children | Number of settings |
|---|---|---|---|
| 2022 | 48% (68 of 141) | 106,273 | 2,325 |
| 2024 | 59% (90 of 152) | 143,200 | 2,978 |
| 2025 | 81% (123 of 152) | 238,636 | Not specified |
Frequently asked questions
What percentage of English local authorities now have supervised toothbrushing programmes?
In 2025, 81% of local authorities in England (123 of 152) have a supervised toothbrushing programme, compared to 48% in 2022 and 59% in 2024. The government allocated £11 million for 2025/26 to expand programmes to reach 600,000 children aged 3–5 years in the most deprived areas.
How many children are now participating in supervised toothbrushing programmes in England?
Participation more than doubled from 106,273 children in 2022 to 238,636 in 2025. This represents significant expansion, though the national target is 600,000 children, indicating further scaling is required.
What is the main barrier to expanding supervised toothbrushing programmes?
Uncertain and short-term funding is the primary infrastructure barrier. Stakeholders reported reluctance to invest effort in programmes lacking sustainable funding. Workforce instability and logistical challenges with supply distribution also constrain expansion, particularly in high-need areas.
Which early years settings are hardest to engage in supervised toothbrushing programmes?
Settings in the most deprived areas, where the need is greatest, are often the hardest to engage. Barriers include heavy staff workloads, competing priorities, and some headteachers viewing toothbrushing as outside schools' remit. Research shows that trusted intermediaries, such as multi-academy trust leads and health visitors, can shift perspectives through reframing STPs as aligned with child wellbeing.
What strategies help local authorities successfully implement supervised toothbrushing programmes at scale?
Building relationships across local authorities, providers, health teams, and school leaders helps overcome engagement barriers. Knowledge sharing through national resources, local networks, and peer-to-peer learning about successes accelerates adoption. Involving trusted intermediaries and securing early logistical planning are also essential.
