Parental Supervised Toothbrushing for young children project

Contact: Peter Day -


Tooth decay is the most prevalent preventable condition in children and is a significant public health problem. Improving the dental health of children is a national priority. Yorkshire and the Humber have amongst the highest rates of tooth decay in England.  UK guidelines strongly advocate the importance of twice-daily Parental Supervised Brushing (PSB) with fluoride toothpaste for children up to seven years old.  However, there is clear gap in the translation of this guidance into practice. There is a paucity of evidence on how to promote PSB skills and no interventions that have been developed based on models of behaviour change.


This project aims to design and evaluate evidence-based behaviour change interventions to improve PSB for children up to 3 years old.



1) A systematic review of the prevalence, barriers and facilitators to PSB, and of interventions to improve child oral health has been conducted


2) Qualitative research with local stakeholders and interviews with parents have been undertaken to explore experiences of tooth brushing with children; the results of this have been published:


3) A theory-based behaviour change intervention tailored to local populations living in areas of high deprivation has been developed using the process of intervention mapping, the process has been published here: There are three delivery vehicles for intervention delivery that we are currently exploring: (1) a universal intervention delivered through health visitors; (2) a targeted intervention delivered through parenting programmes (HENRY); and (3) educating the wider early years workforce through 'edutainment'.


4) The project group has secured funding from MRC PHIND to co-produce training and supporting materials with health visitors and parents to maximise PSB adoption.  Suitable objective measures of PSB adoption will be developed and the acceptability and feasibility of the PSB intervention will be tested.




The next step is to conduct an evaluation of the intervention. This will firstly entail the co-production of intervention materials with each organisation to ensure compatibility.  Secondly an early phase study will be conducted to assess the acceptability and feasibility of the intervention to parents and practitioners.





  • Kara Gray-Burrows Peter Day, Rosie McEachan, Zoe Marshman, Stephanie Prady , Elnaz Aliakbari. Mapping to develop a home-based parental supervised toothbrushing intervention for young children Implement Sci. 2016 May 6;11:61. doi: 10.1186/s13012-016-0416-4
  • Zoe Marshman, Sarah Ahern, Rosie McEachan, H Rogers, Kara Gray-Burrows, Peter Day.  Parents’ Experiences of Toothbrushing with Children: A Qualitative Study. JDR Clinical & Translational Research 2016; 1 (2):122-130


  • Gray-Burrows KA, Owen J, Day PF. Learning from good practice: a review of current oral health promotion materials for parents of young children. Br Dent J. 2017 Jun 23;222(12):937-943. doi: 10.1038/sj.bdj.2017.543.