England's supervised toothbrushing schemes expand despite funding uncertainty
New research on implementing supervised toothbrushing schemes identifies funding and partnership requirements for England's public health expansion.
Supervised toothbrushing programmes for young children are expanding rapidly across England, with participation more than doubling since 2022. A new national survey published in the British Dental Journal on 1 May 2026 found that local authorities increasingly recognise these schemes as cost-effective tools to prevent caries, particularly in deprived communities where decay rates are highest.
Barriers to expansion and implementation
The study identified two major obstacles slowing growth: uncertain funding and difficulty engaging early years settings. Many commissioners reported that short-term financial support discouraged organisations from investing staff and resources without long-term guarantees. Schools and nurseries sometimes resisted participation, citing competing priorities and concerns that toothbrushing fell outside their educational remit. The settings most in need of support were often the hardest to engage.
Building partnerships to strengthen delivery
Researchers found that relationship building between public health teams, schools, health visitors and community organisations was critical to successful delivery. Sharing knowledge between areas, including practical examples of working schemes, helped improve uptake and overcome resistance. The study highlighted targeted communication, trusted local intermediaries and senior leadership support as ways to strengthen implementation and engagement.
The government announced funding last year to support local authorities in scaling up schemes in England's most deprived areas. However, researchers warned that one-off investment alone would not ensure sustainable delivery. Programmes require sustained support for local partnerships, workforce capacity and shared learning to succeed long-term.
Frequently asked questions
How much has participation in supervised toothbrushing programmes grown since 2022?
Participation has more than doubled since 2022, according to the national survey of local authorities published in the British Dental Journal. Most schemes target children in deprived communities where caries rates are highest.
What are the main barriers to expanding supervised toothbrushing programmes?
The study identified uncertain funding and difficulty engaging early years settings as major barriers. Short-term financial support discouraged organisations from committing staff, and schools and nurseries were sometimes reluctant to participate due to competing priorities and concerns about toothbrushing falling outside their educational role.
What factors help supervised toothbrushing schemes succeed?
Relationship building between public health teams, schools, health visitors and community organisations was critical. Sharing knowledge between areas, targeted communication, trusted local intermediaries and senior leadership support all improved uptake and overcome resistance.
Why is one-off government funding not enough for sustainable schemes?
Researchers warned that programmes need sustained support for local partnerships, workforce capacity and shared learning beyond initial investment. One-off funding alone cannot ensure long-term delivery without ongoing commitment to these elements.
