Dental health in children

Improving dental health: acceptability and feasibility of intervention

Contact | Peter Day |

Improving dental health: qualitative interviews with parents
Contact | Peter Day |

Improving dental health: systematic review of parental supervised brushing
Contact | Peter Day |

Supporting dental teams to undertake effective behaviour change conversation with parents of young children. 
Contact | Peter Day |

Brushing reminder 4 Good oral HealTH: the clinical and cost-effectiveness of a short messaging service behaviour change programme to improve the oral health of young people living in deprived areas. 
Contact Professor Nicola Innes |

A new research project funded by the NIHR HTA Programme will investigate ways of improving the oral health of young people living in deprived areas. 
The researchers from the Universities of Dundee and Sheffield will work with 48 schools and nearly 6000 young people in Scotland, England and Wales on the four-year Brushing Reminder 4 Good Oral Health (BRIGHT) initiative.
BRIGHT will investigate whether a classroom-based lesson about dental health followed by a series of text messages could increase how often and how well children aged 11-16 brush their teeth – and ultimately reduce levels of tooth decay.
In each school, one class will receive the talk and a series of text messages, while another will not. The team will collect information on tooth decay, frequency of brushing, and the impact decay has on the children’s lives to determine whether those in the programme develop better oral health habits than those who don’t participate.
Professor Nicola Innes, from Dundee’s School of Dentistry, said, “Dental decay is preventable and, in some ways, that should be simple. Just brush with a toothbrush and fluoride toothpaste. However, enacting that prevention at the level of the individual person isn’t always so simple.
“We are looking forward to taking up the challenge in this often overlooked group – young people living in deprived areas – who suffer a disproportionate amount of dental disease, toothache, and subsequent loss of sleep and time at school.”
The classroom-based teaching session has been created by Dundee’s School of Education and Social Work, while the text messages will be delivered via TextApp, a software tool devised by the School of Medicine’s Health Informatics Centre.
The Dundee and Sheffield researchers will work with colleagues from the Universities of Leeds and Cardiff and the York Trials Unit on the project.
Dr Zoe Marshman, Reader in Dental Public Health at the University of Sheffield, said, “We welcome the opportunity to help children in secondary schools in deprived areas achieve good dental health which can then be maintained throughout their lives.” 
“To do this we are working with children, parents and school staff together with an expert team of researchers in dentistry, health economics, psychology, education, digital technology and trials.

Development of Parental supervised brushing (PSB) intervention with health visitors.
Contact | Peter Day |

Background: 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.

Aims: This project aims to design and evaluat 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. 

Plans: 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.