Bradford: Promoting good oral health

Bradford council commissioned a specialist team to promote good oral health in children by working in primary schools, community events and private nurseries.


A quarter of children in England have tooth decay by the age of five, but in Bradford this rises to around 40 per cent. To tackle the issue the council has commissioned a specialist team to promote good oral health. It works in primary schools, runs community events and, thanks to an innovative project during the lockdown, now offers support to private nurseries.

From schools to community ‘Brushathons’

Bradford’s oral health improvement team - provided by Bradford District Care NHS Foundation Trust (BDCFT) – has a long history of working in the community.

The team of dental nurses and oral health improvement practitioners delivers a rolling programme of fluoride varnish aimed at children aged two to four. Children have fluoride varnish applied to their teeth twice a year between their second and fourth birthdays. Over 18,000 fluoride varnish applications are applied each year with over 90 per cent of parents engaging with the programme.

For older children there is a supervised toothbrushing programme in schools. The oral health improvement team work with children aged four to six. The programme is targeted in the areas with the worst rates of dental decay and covers about a third of the district’s schools.

Oral Health Improvement Lead Sharon Walker said: “We go in and train the staff to run a supervised session, provide support on request and then go back twice a year to observe the quality of the session delivered, providing advice if necessary. But we do give the schools flexibility to build the toothbrushing programme into the school day, so it is delivered when it suits them best.”

The team also run community events. For example, during the summer of 2019 the team ran the Big Bradford Brushathon. The oral health team went out to deliver community events, including street parties and park fun days, to provide oral health advice to families.

Residents were encouraged to come along by bringing their old toothbrushes and exchanging them for a new one as well as carrying out toothbrushing events for the children.

“It proved to be very popular,” Sharon said. “We ended up engaging with around 2,700 people. The hook of exchanging toothbrushes was a fantastic way to get engage children and families. It is good to look at fresh ways to get families thinking about good oral health.”

Bradford Babies Brush scheme

The pandemic meant these activities had to stop with some of Sharon’s team redeployed to other parts of the NHS including the vaccination programme. But the remaining team still tried to offer oral health improvement support by delivering toothbrushes and brushing packs to food banks.

Then, in early 2021, the team launched a scheme targeting private day nurseries. During that lockdown private day nurseries were one of the few places allowed to open so the team offered staff virtual toothbrushing training sessions like they had been doing for primary schools.

The initiative – called Bradford Babies Brush Let’s Talk Teeth – saw 16 staff across 11 nurseries trained to become oral health champions. As well as training the staff on how to show young children to brush their teeth properly, they learned about how much sugar there is in everyday food and drinks so they could get into good habits in the nurseries and relay the key oral health messages to parents.

Following the training, settings were provided with resources to commence the supervised toothbrushing. This included a three-month supply of toothbrushes and toothpaste. Over 400 children benefited in total.

Feedback from the nursery staff who took part was extremely positive. One said: “All of the sessions were very informative and definitely increased my knowledge.”

The success of the programme has led to the council funding this programme over the coming years. A total of 99 private nurseries have been identified for the programme and 36 of them will be recruited by August 2022.

Sharon said: “Targeting early years providers like this plays an important part in helping address tooth decay in young children. It is almost entirely preventable with appropriate interventions. On top of this, we are now back in primary schools delivering supervised toothbrushing and fluoride varnish programmes.”

Contact details

Sharon Walker, Health Improvement Lead, Bradford District Care NHS Trust: sharon.walker@bdct.nhs.uk