‘I’m an NHS dentist – some five-year-olds have never owned a toothbrush’  (2025)

In England’s most deprived areas, school and nursery staff will soon be tasked with supervising young children as they brush their teeth, as part of a new national toothbrushing programme.

While similar schemes already exist in some schools, this initiative will now provide dedicated funding to the poorest regions, where children face the highest risk of tooth decay. Alarmingly, one in four five-year-olds in England suffer from tooth decay – rising to one in three in the most disadvantaged areas.

It is also the leading cause of hospital admissions for children aged five to nine, with many communities struggling with increasingly limited access to NHS dental care.

Dr Fazeela Khan-Osborne, a former paediatric dentist and school dental inspector in Kensington and Chelsea, believes the toothbrushing scheme is long overdue. Having carried out statutory dental inspections in schools for many years, she stresses the urgency of its implementation.

“I’ve witnessed first hand significant neglect and severe dental disease in young children – and the NHS sees children with multiple severe cavities every day,” says Dr Khan-Osborne, now principal dentist at One to One Dental. “I’ve had to send children to hospital for the extraction of five, six, seven, or even eight teeth at once. The only way to do that is under gas and air, which can create lasting dental phobias.

“Tooth decay is closely tied to socio-economic factors – rising food prices mean more children rely on processed foods. Even though awareness has improved, many families are struggling, and something as simple as owning a toothbrush becomes a luxury. But it’s not just an issue in lower-income groups – even among my private clients, I still see children with serious tooth decay.”

While Dr Laura Geige, who sees both private and NHS clients, agrees that the issue is more widespread than many realise.

“Childhood tooth decay is one of the most distressing issues I encounter,” adds Dr Geige, who runs It’s Me & You clinic in Kingston upon Thames. “I regularly see children under five with multiple decayed teeth, often in severe pain, unable to eat or sleep – and some don’t even own a toothbrush. I’ve treated children with abscesses so severe their faces were swollen, and had to send children to A&E for emergency extractions. In rare cases the decay has been so severe the child has required a full-mouth extraction under general anaesthesia.

“Nearly all of these cases are entirely preventable, but by the time a child sits in my chair with severe decay, the damage has already been done.”

Thankfully, starting in April, local authorities will receive £11m in funding to identify the schools and nurseries most in need of support.

The initiative aims to reach around 600,000 three- to five-year-olds annually. According to government estimates, for every £1 spent on the programme, £3 in treatment costs will be saved – amounting to more than £34m over the next five years.

Some children will also benefit from the 23 million toothbrushes and tubes of toothpaste donated by Colgate. The British Dental Association has welcomed the initiative, however they’ve emphasised the need for stronger action on food marketing and labeling.

And Dr Giege agrees.

“The deeper issue is inequality. I’ve seen children in deprived areas who have never owned a toothbrush,” she admits. “Providing basic equipment like this to all children in the UK would be a great start, but we also need to stop normalising excessive sugar consumption.

“Food prices are rising, and children from poorer families are relying on diets filled with cheap, processed foods packed with hidden sugars.

“Alongside toothbrushing schemes, we should be restricting the marketing of high-sugar products to children and ensuring that all families have access to regular dental checkups. Until that time, young children will continue to suffer needlessly from a disease that should be almost non-existent in a developed country.”