Your NHS dentistry and oral health update 

23 September 2025 

A focus on supervised toothbrushing

Results of the Oral health survey of 5 year old schoolchildren 2024 showed that 26.9% of children had some form of dental decay, while those living in the most deprived areas of England were more than twice as likely to experience dentinal decay as those living in the least deprived areas. Poor oral health impacts children and their families, affecting a child’s ability to eat, smile and socialise, whilst causing pain, infection and missed days of school for the child, alongside missed working days for parents or carers in attending dental services to receive care. While tooth decay is the most common oral disease affecting children and young people in England, it is still largely preventable.

Toothbrushing twice daily with a fluoride toothpaste remains one of the best defences against tooth decay and a long list of preventable oral health issues. We are therefore delighted that the government is working with local councils and the NHS to expand access to pivotal supervised toothbrushing programmes in schools.

I would like to thank Sam Watt, Zoe Marshman, Peter Day and Kara Gray-Burrows for their continued hard work with the roll out of supervised toothbrushing programmes and for contributing to this special focus bulletin. We are delighted to welcome Zoe and Peter to our next CDO webinar on 24 September. Keep reading for more details and how to register.

Finally, I would like to thank all colleagues working across dentistry and oral health for your continued hard work and diligence in providing care to our patients. 

Kind regards,
Jason Wong

Supervised toothbrushing programmes: How you can make a difference

By Dr Sam Watt, Academic Clinical Fellow in Dental Public Health, University of Sheffield; Professor Zoe Marshman, Professor of Dental Public Health, University of Sheffield; Professor Peter Day, Professor of Children's Oral Health, University of Leeds; and Dr Kara Gray-Burrows, Lecturer in Behavioural Sciences & Complex Intervention Methodology, University of Leeds.

Children in the most deprived areas of England can now access a national government-funded programme to help protect them from tooth decay. Funding of £11 million for the 2025-26 period is being made available to local councils, as the commissioners of oral health promotion programmes, to deliver supervised toothbrushing in early years settings. Additionally, Colgate-Palmolive have committed to provide 23 million toothbrushes and fluoride toothpaste over 5 years for both the supervised toothbrushing programmes and packs for children to take home.

Health Minister Stephen Kinnock visited Tinsley Meadows Primary School in Sheffield on 15 September 2025 to hear how the programme roll out is progressing.  

Launched in spring 2025, the programme aims to support up to 600,000 children in 2025-26 to undertake supervised toothbrushing. This represents a fourfold increase in current programmes from 2024, when around three-quarters of councils commissioned supervised toothbrushing programmes with over 140,000 children taking part.

The importance of supervised toothbrushing programmes has also been highlighted in the NHS 10 Year Health Plan, ‘Fit for the future’, which emphasised supervised toothbrushing in early years settings as an effective way to prevent tooth decay in young children.

Here we answer questions on supervised toothbrushing and how you can help.

What are supervised toothbrushing programmes?

These programmes are designed to complement the toothbrushing children do at home with their parents and carers, not to replace it. In early years settings, children brush their own teeth using fluoride toothpaste (1,350 to 1,500ppm) while being supervised by staff. The activity takes less than ten minutes and fits easily into the daily routine.

Dental health is already part of the statutory Early Years curriculum because poor dental health can significantly impact children’s development, school attendance and quality of life. Running a supervised toothbrushing club is one effective way primary schools can demonstrate to Ofsted that they are meeting this curriculum requirement.

There are many misconceptions about children queuing for teachers to supervise toothbrushing and schools needing extensive new facilities such as installing more sinks. Excellent resources, such as the videos below, demonstrate how quick and easy supervised toothbrushing can be in practice:

• Toothbrushing Club: Joseph Locke Primary School in Barnsley, Yorkshire
• Supervised toothbrushing with Big Brush Club - includes a motivational and educational song 

Approaches to supervised toothbrushing

There are two approaches to supervised toothbrushing:

• Dry toothbrushing: One approach is toothbrushing in a dry area, brushing either without the use of water or a sink. If the dry toothbrushing approach is being adopted, children stand or sit while toothbrushing. After brushing, children spit excess toothpaste into a tissue or paper towel.
• Wet toothbrushing: Another approach is toothbrushing at a sink. If the wet toothbrushing approach is being adopted, toothbrushing takes place at the identified sink area. Children are closely supervised and encouraged to spit excess toothpaste into the sink.

What are the benefits?

Economic analysis suggests that for every £1 spent on supervised toothbrushing programmes, there is an estimated £3 return on investment to the NHS over a 5-year period.

This short video captures testimonies from parents, children, clinicians and early years staff about the benefits of supervised toothbrushing.

Where can I learn more?

The Office for Health Improvement & Disparities (OHID) has produced an updated toolkit to support commissioners and providers of local supervised toothbrushing schemes, to ensure activities are evidence-informed, safe and have clear accountability and reporting arrangements to demonstrate impact. For oral healthcare teams, the Delivering Better Oral Health (DBOH) toolkit remains a crucial resource in the delivery of prevention and oral health improvement.

This toolkit, accessed by over 19,000 visitors since launch, is a repository of resources, step-by-step guides and top tips about supervised toothbrushing. It includes interactive maps to show which councils commission supervised toothbrushing, how many children are already participating, levels of dental caries and deprivation. The website also includes information on the effectiveness of supervised toothbrushing.

How can I promote supervised brushing?

There are many ways to help promote and advocate for this proven, evidence-based initiative:

•  Find out if there is a supervised toothbrushing programme in your area.
• If there is, talk to your patients about it – ask parents or carers with young children if they are aware of supervised toothbrushing in nurseries, schools or with childminders? Does their early years setting provide supervised toothbrushing, and if so, does their child take part? Pester power from parents can encourage nurseries and schools to participate in local supervised toothbrushing programmes.
• Advocate for the benefits of supervised toothbrushing with patients and through your networks, including:
  • Prevention of tooth decay
  • Improved oral health
  • Promoting lifelong oral health
  • Cost-effectiveness
  • Tackling dental inequalities
  • Encouraging and helping with home brushing

Parents of young children find a lot of resistance from children from brushing at home and report that when their children take part in supervised toothbrushing at school or nursery, it makes the children happier to brush at home.

When providing Oral Hygiene Instruction to children, note that there are some similarities but also some differences between supervised toothbrushing and brushing at home. Similarities include children using their own brush, using fluoride toothpaste and brushing for 2 minutes. Key differences in early years settings include children dry brushing with no mirrors or sinks (and often sitting down in front of a video clip or song); teaching staff leading the activity and helping to increase children’s confidence with toothbrushing. At home, parents need to take a more hands-on role and actively support children to brush all areas of the mouth.

Our CDO webinar on 24 September is a great opportunity to learn more about children's oral health in England, including supervised toothbrushing - registration details below.

CDO webinar: Children's oral health in England

Join us for the third in our series of CDO webinars on Wednesday 24 September 2025, 6:00pm–7:30pm BST. We aim to hold these webinars every two months.

The programme for this event will commence with an update from Jason Wong, followed by a session on children's oral health in England, supervised toothbrushing schemes and new resources for autistic children and young people. 

CDO webinar speakers:

From left to right: Jason Wong (CDO England), Zoe Marshman (Professor in Dental Public Health at the University of Sheffield), Peter Day (Professor of Paediatric Dentistry, University of Leeds)

➡️ Join us on 24 September: Register now

Dental Update webinar

Join Chief Dental Officer England Jason Wong, alongside the founders of the BREATHE wellbeing platform Rana Al-Falaki and Jackie Cooper on 14 October 2025, as they discuss the concept of Wellbeing Intelligence (WI) as part of an upcoming Dental Update webinar. They will also explore how Artificial Intelligence (AI) can support wellbeing and how AI alongside wellbeing techniques can empower oral healthcare professionals, enhance productivity, reduce burnout and improve relationships within oral healthcare teams and with patients.

➡️ Join Dr Rana Al-Falaki, Jason Wong & Jackie Cooper by completing the registration form

Word of Mouth

‘Word of Mouth’ is a CDO initiative that looks to highlight success and positive developments from across the profession. This month we highlight successes from Community Dental Services and North Central London ICB.

Community Dental Services: Showcasing innovation

Since launching the 'Word of Mouth' page on the Futures Collaboration platform, Community Dental Services (CDS) have been sharing the innovative work taking place across the sector. Their contributions showcase a range of impactful programmes, from blood pressure checks in dental clinics, to oral health accreditation schemes in residential homes. Other examples include pop-up clinics serving children in Luton and Prevention-Based Initiative (PBI) clinics specifically designed for children under four.

To explore these initiatives in more detail, or to share your own examples of innovation and best practice, visit the 'Word of Mouth' page in the Dentistry Workspace on the Futures Collaboration platform (registration required).

Tackling oral health inequalities: Success for NCL colleagues

Congratulations to North Central London Integrated Care Board (NCL ICB) on being shortlisted for the HSJ Awards 2025 in the category of 'Reducing Inequalities and Improving Outcomes for Children and Young People Award'. This recognition highlights the ICB’s pioneering work in tackling oral health inequalities and transforming access to NHS dentistry.

In 2023, NCL ICB undertook a comprehensive analysis of local oral health needs. The findings revealed significant inequalities in children’s dental health and a high demand for secondary care services, particularly hospital admissions for extractions under general anaesthetic. In response, the ICB committed recurrent and non-recurrent investment to expand access, embed prevention, and improve the patient experience.

Successful initiatives include supervised toothbrushing in early years settings, additional weekend dental clinics, and a school-based oral health prevention programme delivered by the Tottenham Hotspur Foundation. Strong governance and clinical leadership have underpinned this work, ensuring effective partnership-led transformation. These scalable, sustainable solutions lay the foundation for future equity.

Being shortlisted for this award is a significant recognition of the work that has been achieved and continues to be done. NCL ICB hopes to inspire similar approaches elsewhere, reinforcing the message that oral health is integral to overall health and to addressing wider health inequalities.

Find out more: Investing in children's teeth

Green Impact Dentistry

Green Impact Dentistry supports dental practices to transform their working practices to make environmental and social sustainability achievable for everyone, through a supported online framework. Practices can choose to work towards a Bronze, Silver or Gold award, evidencing their commitment to being a responsible healthcare business. An online toolkit, co-designed by sustainability and dentistry experts, provides a step-by-step guide to sustainability quality improvements.

Any dental practice in England, Scotland or Northern Ireland can sign up to take part. By signing up, your practice will have free access to the toolkit, support, and will be eligible for an award at the end of the year. You can register your practice at any time, and the next deadline for awards submission is 31 October 2025. 

Learn more on the Green Impact Dentistry webpage

Evolving the NHS's approach to patient safety: The future of
Never Events

NHS England has published findings from its Never Events framework consultation, with 66% of respondents finding the current framework unfit for purpose. Acting on this, NHS England’s National Patient Safety Team has committed to develop a revised Never Events framework focused on driving genuine safety improvements.

The revised framework will prioritise learning, focus on events of significant concern to patients and the NHS, align with Patient Safety Incident Response Framework (PSIRF) principles, and support a just culture for reporting.

In the interim, the existing framework remains active, and providers must continue recording Never Events via their relevant reporting system. You can also read a blog from Aidan Fowler, National Director of Patient Safety.

Never Events represent subset of patient safety incidents defined as being wholly preventable because guidance or safety recommendations that provide strong systemic protective barriers are available at a national level and should have been implemented by all healthcare providers. Project Sphere, a working group led by the Office of the Chief Dental Officer, continues to advocate for the delivery of safe oral healthcare through a union of safe culture and safe system, taking into the consideration the human factors component of patient safety management.

NHS Innovation Accelerator: Open call for assessors

The NHS Innovation Accelerator (NIA) is an award-winning initiative, funded by NHS England via the Accelerated Access Collaborative, and delivered by UCLPartners. NIA is inviting experienced clinicians, as well as system commercial, innovation and operational leaders to support the NHS Innovation Accelerator open call by becoming an assessor. 

NIA is a national programme that helps high-impact innovations spread faster and further across the NHS. Each year, the organisers run an open call to identify the most promising solutions that can benefit patients, staff, and the wider health system. 

As an assessor, you’ll play a vital role in reviewing applications, based on your area of expertise, to ensure that we recruit only the best quality and proven innovations that are clinically sound and considered as useful by clinicians working within the NHS. It’s a unique opportunity to: 

• Contribute your expertise to advancing health and care innovation. 
• Gain insights into the latest developments in digital health, medical technology, and service transformation. 
• Support innovators tackling some of the NHS’s most pressing challenges. 

Your input will directly influence which innovations are supported and scaled to improve patient care. 

Assessments are carried out online via SMApply between 23rd October and 16th November. In the final stage of assessment, we will invite applicants to interview with a panel of assessors. Interviews will take place on 7, 8, 9, 12, 13, 14, and 15 January 2026. We welcome assessors who could support with assessments and/or interview panels.  

➡️ Apply to be an assessor today by completing the registration form

Futures Platform annual survey

The Futures Collaboration Platform team will be launching their annual survey and they want to hear from you. 

The survey aims to understand Futures users' needs and feedback as to how the platform is meeting expectations, and where improvements and changes can be directed. The short survey takes no more than 5-10 minutes to complete, and the feedback will help the Futures team improve user experience for all. 

Access the survey here from Monday 22 September: Your experience with Futures 2025 - Annual Survey (registration required).

Deadline: 10 October 2025

Thank you for sharing your thoughts.

NHSmail is now NHS.net Connect

NHSmail has been renamed to NHS.net Connect. Your existing secure service, email address, and login details will stay the same, but the new service will offer a fresh look and enhanced features to support your daily work. You will continue to receive the same support from the National Administration Service. 

Over the coming months, you will move to the new Launchpad, which will replace the NHSmail portal and become your personalised homepage for:

• Managing your NHS.net profile and password
• Handling shared mailboxes and user access (via NAS)
• Accessing Outlook, Teams, OneDrive, and more in one place
• Getting fast, step-by-step support
• Using NHS.net Connect across desktop and mobile devices

You do not need to take any action right now. For more information, access support.nhs.net. 

Sign up to the Primary Care bulletin

The Primary Care bulletin provides resources on health policy and practice and we encourage you to sign up for this, too. It is aimed at teams across general practice, dentistry, community pharmacy and optometry. 

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This bulletin is a round up of all the latest news and important resources for anyone working in NHS dental services. We'll send it out as and when important news needs to come your way. If you've already signed up but didn't receive the update, then check your junk folder for the confirmation email and make sure you've followed the instructions to complete sign up.

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Recent dentistry and oral health bulletins 

Previous bulletins can be accessed by clicking on the links below:

Special focus bulletins 

The Office of the Chief Dental Officer and the NHS England team regularly produce 'special focus bulletins' on clinical priorities and key aspects of patient care. These bulletins summarise the key information dental teams need to know and act as a refresher, combining best practice, expert opinion and useful resources. If you would like to suggest a topic for a future special focus bulletin please email the CDO's team at England.CDOExecutive@nhs.net