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Solent Family Assist Guidance on Dummies

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Solent Family Assist Guidance on Dummies

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Dummies can be used for calming and comforting little ones.

They certainly have their uses in the first year of life, however we advise to try and ditch the dummy by the age of one. After this age, dummies can begin to create problems for your growing baby.

It certainly becomes more difficult to convince your child to part with their dummy as they move into and through toddlerhood, and the dummy can negatively impact speech and language as well as your child's teeth.

The longer your baby uses a dummy, the more chance there is that the structure of their mouth will be affected. This means it will affect how their teeth meet when they close their mouth or when they bite. This can not only affect their baby teeth, but their adult teeth later on too. Read more about how to make sure your baby's teeth are looked after here.

It is completely normal to feel a little worried about how your baby will react and cope when you first take their dummy away. Although they may show their unhappiness in no uncertain terms at first, it's good to remember that babies and children are very adaptable and it should only take a few days until they adjust to life without a dummy!

How to ditch the dummy

There are different ways to approach stopping dummy use and it is your decision which way you go about it, however once you have decided, it is important to remain firm and consistent with your decision in order for your baby to adjust to the change without getting confused.

Some parents prefer to gradually wean their baby off of the dummy; this can be done by beginning to offer the dummy at nap and bed time only, before eventually removing it completely. Other parents feel that the gradual approach may confuse their baby and so decide to remove it completely.

Here are some general tips you can follow:

Offer something else as a comforter in place of the dummy; this can be a specific teddy or a small blanket.

If your baby wakes in the night try to comfort them without giving them back the dummy

Remove dummies from the home or keep them out of sight.

Never let your baby babble or talk with the dummy in their mouth, this will stop them from learning to speak clearly

Depending on their age and level of understanding you can prepare your child for what's going to happen. For example, you might say: "Tomorrow we're going to say bye-bye to dummy because you're a big boy/girl now"

You can ask your child to collect all their dummies into a bag and then leave them out for the fairies/Easter bunny/Santa to collect. You can leave a small gift to replace the dummies

Give your child praise and encouragement, and if they haven't mentioned the dummy, try not to remind them

You may want to use an incentive such as a sticker chart to show your child how well they're doing.

If your child asks for the dummy you can either explain to them that they can only have it at sleep times or that we don't have the dummy anymore. You can also use distraction by quickly diverting their attention to playing and having fun.

Consistency really is key. Once you have decided to ditch the dummy, you and all those who care for your little one must stay consistent.

Useful links

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Tips for ditching the dummy | Toddler | Health for Under 5s

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Dummies can be used for calming and comforting little ones. They certainly have their uses in the first year of life, however we advise to try and ditch the dummy by the age of one. After this age, dummies can begin to create problems for your growing baby.

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Dummies and Pacifiers: Essential Tips and Benefits for Newborns and Babies

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Dummies and Pacifiers: Essential Tips and Benefits for Newborns and Babies

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Dummies and Pacifiers: Essential Tips and Benefits for Newborns and Babies

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Health visitor Kerry Bennett has advice for parents around the use of dummies, including possible benefits and risks.

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When should babies lose the dummy and how do I wean baby off it?

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When should babies lose the dummy and how do I wean baby off it?

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There are all sorts of reasons babies might be crying, so you could try and meet these needs without resorting to the dummy.

Equally, sometimes babies will cry and cry and a dummy might be a way of helping you cope with it. But before reaching for the dummy, see if there's another way of soothing them.

2. Try giving them an alternative comforting object.

This could be a favourite soft toy.

As they get older, try praising them and giving them stickers as a reward for not reaching for their dummy.

3. Set limits and stick to them to gradually wean them off.

Limit dummy use to key times like bedtime or when they're ill.

Be consistent and be strong - there may be tricky moments, but it will pass.

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When should babies lose the dummy and how do I wean baby off it?

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We chatted to experts to get tips for why, when and how you should wean babies off the dummy. Dummies can help calm babies but they can also delay speech development.

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Hi I'm Charlie, your virtual assistant. I will explain how to use this online noticeboard (Padlet). 

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Hi I'm Charlie, your virtual assistant. I will explain how to use this online noticeboard (Padlet). 

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Please use the column headings to find the information you need

Then scroll down the column to see the information

Click on the links to view the information

To find other headings please scroll right

If you are using a mobile you can click on the 3 dots on this post and choose start slide show. This makes it easier to look through the information on a smaller screen.

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Welcome To Isle Of Wight Family Centres : Isle Of Wight Family Centres

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Drinking juice or squash from a bottle may cause the sugar to stay on your child's teeth increasing the risk of tooth decay and impacting on speech and language development.

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A quick watch of when and what to use when changing from bottle to beaker/cup.

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From 6 months you can introduce beakers and cups to your child. Using an open cup or free flow beaker ensures that any sugary drink doesn't remain on your child's teeth, reducing the risk of tooth decay.

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Drinks for babies and young children

Not all drinks are suitable for babies and young children. Here's what to give to your child and when.

Breast milk

Breast milk is the only food or drink babies need in the first 6 months of their life.

It should continue to be given alongside an increasingly varied diet once you introduce solid foods from around 6 months.

The World Health Organization recommends that all babies are breastfed for up to 2 years or longer.

Breastfeeding up to 12 months is associated with a lower risk of tooth decay.

Formula milk

First infant formula is usually based on cows' milk and is the only suitable alternative to breast milk in the first 12 months of your baby's life.

Follow-on formula is not suitable for babies under 6 months, and you do not need to introduce it after 6 months.

First infant formula, follow-on formula or growing-up milks are not needed once your baby is 12 months old.

Cows' milk can be introduced as a main drink from 12 months.

Read more about the types of infant formula.

Non-cows' milk formula

Goats' milk formula is available and produced to the same nutritional standards as cows' milk formula.

Goats' milk formula is not suitable for babies with cows' milk protein allergy. It's no less likely to cause allergies in babies than cows' milk formula as the proteins they contain are very similar.

You should only give your baby soya formula if a health professional advises you to.

'Goodnight' milk

"Goodnight" milk is not suitable for babies under 6 months old. This type of formula is not needed, and there's no evidence that babies settle better or sleep longer after having it.

Water

Once your baby has started to eat solid foods (from around 6 months) you can offer them sips of water from a cup or beaker with meals. Drinking water for babies over 6 months does not need to be boiled first.

Fully breastfed babies do not need any water until they've started eating solid foods. During hot weather they may want to breastfeed more than usual.

Formula fed babies under 6 months of age may need small sips of cooled boiled water during hot weather as well as their usual milk feeds.

Find out how to make up baby formula safely using water.

Cows' milk

Cows' milk can be used in cooking or mixed with food from around 6 months but should not be given as a drink to babies until they're 12 months old. This is because cows' milk does not contain enough iron to meet your baby's needs.

Whole milk should be given to children until they're 2 years old because they need the extra energy and vitamins it contains.

Semi-skimmed milk can be introduced once your child is 2 years old, as long as they're a good eater and they have a varied diet.

Skimmed and 1% milk are not suitable for children under 5 years old because they do not contain enough calories.

Lower-fat milks can be used in cooking from 1 year old.

Unpasteurised milk

Young children should not be given unpasteurised milk because of the higher risk of food poisoning.

Goats' and sheep's milk

Goats' and sheep's milk are not suitable as drinks for babies under 1 year old as, like cows' milk, they do not contain enough iron and other nutrients babies this age need. As long as they're pasteurised, they can be used once your baby is 1 year old.

Soya drinks and other milk alternatives

You can give your child unsweetened calcium-fortified milk alternatives, such as soya, oat or almond drinks, from the age of 1 as part of a healthy balanced diet.

Babies and young children under 5 years old should not be given rice drinks, because of the levels of arsenic in these products.

If your child has an allergy or intolerance to milk, talk to your health visitor or GP. They can advise you about suitable milk alternatives.

Rice drinks

Children under 5 years old should not have rice drinks as a substitute for breast milk, infant formula or cows' milk as they may contain too much arsenic.

Arsenic is found naturally in the environment and can find its way into our food and water.

Rice tends to take up more arsenic than other grains, but this does not mean that your baby cannot eat rice.

In the UK, there are maximum levels of inorganic arsenic allowed in rice and rice products, and even stricter levels are set for foods intended for young children.

Do not worry if your child has already had rice drinks. There's no immediate risk to them, but it's best to switch to a different kind of milk.

Fruit juice and smoothies

Fruit juices, such as orange juice, are a good source of vitamin C. However, they also contain natural sugars and acids, which can cause tooth decay.

Babies under 12 months do not need fruit juice or smoothies. If you choose to give these to your baby, dilute the juices and smoothies (one part juice to 10 parts water) and limit them to mealtimes.

Giving fruit juice and smoothies at mealtimes (rather than between meals) helps reduce the risk of tooth decay.

From 5 years old, you can give your child undiluted fruit juice or smoothies. Stick to no more than 1 glass (about 150 ml) a day, served with meals.

Squashes, flavoured milk, 'fruit' or 'juice' drinks and fizzy drinks

Squashes, flavoured milk, "fruit" or "juice" drinks and fizzy drinks are not suitable for young babies. They contain sugar and can cause tooth decay, even when diluted.

For older babies and young children, these drinks can fill your child up so they're not hungry for healthier food. Instead, offer sips of water from a cup with meals.

Fizzy drinks are acidic and can damage tooth enamel so they should not be given to babies and young children.

Diet or reduced-sugar drinks are not recommended for babies and young children.

Even low-calorie drinks and no-added-sugar drinks can encourage children to develop a sweet tooth.

'Baby' and herbal drinks

"Baby" and herbal drinks usually contain sugars and are not recommended.

Hot drinks

Tea and coffee are not suitable for babies or young children. If sugar is added, this can lead to tooth decay.

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Drinks and cups for babies and young children

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Drinks for young children, including breast milk, infant formula, cows milk, fruit juice, water and squash, plus choosing a cup or beaker.

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Younger children only need a small amount of toothpaste. As they get older they will require slightly more on their toothbrush.

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Download the app for help with finding healthier swaps for sugary foods.

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NHS Food Scanner app - Healthier Families

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See healthier swaps and bring food labels to life with the NHS Food Scanner from Better Health. Click for download links or to find out more.

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Helpful tips and advice for helping you support your child to overcome fears and concerns about visiting a dentist and other helpful tips.

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Success with brushing in the early years is all about making it fun, so try to brush children's teeth at a time they're most happy or when they're playing and distracted. For us, it was super useful doing it in the bath, because we were cleaning their whole body, so let's clean their teeth as well. And it doesn't matter how much mess you make!

Other things you can try include getting them to brush your teeth for as long as you can brush their teeth. There's a bit of distraction there - they're so concentrated on cleaning yours, you can get in there and give theirs a good clean.

It's really important to supervise brushing up until the age of 7, but actually you should be doing it up until about age 4. That's when they really learn to control the toothbrush and you can let them have a go, but then you can go back over it yourself.

Another thing to try may be cleaning their favourite toy's teeth. Again, it's a bit of distraction that makes it a bit more playful.

The last thing is to maybe make the mouth an adventurous place. So for example, it could be a house, so 'let's clean upstairs', 'let's clean downstairs', 'let's clean the back garden' as you focus on different parts of the mouth.

So it's about making it fun, a bit of distraction and lots of positive reinforcement after they've done a good job.

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Brushing kids' teeth and visiting the dentist - your questions answered by The Singing Dentist

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The Singing Dentist Dr Milad Shadrooh answers parents' burning questions around oral health, toothbrushing and taking young children to the dentist.

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You can find some videos here from CBeebies with advice on how to care for your child's teeth.

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British Society of Paediatric Dentistry (BSPD) > Kidsvids

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The (BSPD) is the national society specifically concerned with the oral health of children in the UK it provides meetings, publications and news.

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Information about dental surgeries close to you.

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You can find a dental surgery that's convenient for you, whether it's near your home or work, and phone them to see if there are any NHS appointments available.

You can search for an NHS dentist near you on this website.

Dental surgeries will not always have the capacity to take on new NHS patients. You may have to join a waiting list, look for a different dentist who is taking on new NHS patients, or be seen privately.

Once you find a dental surgery, you may have to fill in a registration form at your first visit, which is just to add you to their patient database. But that does not mean you have guaranteed access to an NHS dental appointment in the future.

Dental emergency and out-of-hours care

If you think you need urgent care, contact your usual dentist, if you have one, as some surgeries offer emergency dental appointments and will provide care if clinically necessary.

You can also contact NHS 111, who can put you in touch with an urgent dental service.

Do not contact a GP, as they cannot offer urgent or emergency dental care.

When to contact NHS 111

You can get help from NHS 111 or NHS 111 online if you have:

severe pain

heavy bleeding

swelling of your mouth, throat, neck or eye

Call 111 or use NHS 111 online.

When to go to A&E

Only visit A&E in serious circumstances, such as:

injuries to the face, mouth or teeth

severe or increasing swelling in your mouth, throat or neck, making it difficult to breathe, swallow or speak

Find your local A&E
If you're not sure whether you should go to A&E, contact NHS 111 online.

How much will I be charged?

The emergency dentist will only deal with your current dental problem and provide clinically necessary treatment to stop any pain.

An urgent dental treatment will be charged at Band 1 (£25.80), unless you're entitled to free NHS dental treatment.

If you're asked to come back for further treatment, this will be considered a separate course of non-urgent treatment.

If you're not entitled to free NHS dental treatment, you'll have to pay the relevant charge for the new course of treatment.

Ask the dentist what the treatment will cost or ask for a treatment plan.

Find out how much you'll pay for NHS dental treatment.

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Find out how to access NHS dental services.

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The NHS recommend that for under 3's, adults should brush their child's teeth.
3-6 years, transition period of child brushing with adult supervision.
7+ years child brush but should be reminded and prompted by adults as and when needed.

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This guidance is issued jointly by the Department of Health and Social Care, the Welsh Government, the Department of Health Northern Ireland, Public Health England, NHS England and NHS Improvement, and with the support of the British Association for the Study of Community Dentistry.

Delivering Better Oral Health has been developed with the support of the 4 UK Chief Dental Officers.

Whilst this guidance seeks to ensure a consistent UK-wide approach to prevention of oral diseases, some differences in operational delivery and organisational responsibilities may apply in Wales, Northern Ireland and England. In Scotland the guidance will be used to inform oral health improvement policy.

Oral hygiene practices in the UK

Oral hygiene practices include toothbrushing and the use of other aids for cleaning teeth. Toothbrushing is widely practiced across the UK. In a 2009 national survey of adults, more women reported cleaning their teeth at least twice a day than men (82% compared with 67%). Three quarters (76%) of dentate adults reported using toothpaste with 1,350 to 1,500 parts per million level of fluoride and a further 18 per cent used a brand with a medium (1,000 to 1,350 parts per million) fluoride level. Most dentate adults (58%) used additional products as well as a standard toothpaste and brush, the most common of which were mouthwash (31%), powered toothbrushes (26%) and dental floss (21%). Women and middle-aged adults were more likely to use additional products than men, younger and very old adults (85 years and over).

A 2013 national survey found that only a quarter of children benefited from having their teeth brushed before they were 6 months of age, whereas about 50% had commenced between 6 months and one year of age. Overall about 90% of children (aged 5 to 8 years) are reported as having started toothbrushing by 2 years of age. Overall, 77% of 12-year-olds and 81% of 15-year-olds reported that they brushed their teeth twice daily or more. Mouthwash was the most common aid other than a toothbrush (manual or powered) and toothpaste. As expected, the use of mouthwashes, dental floss (the only interdental cleaning method investigated) and sugar-free gum was generally higher in older children. Approximately 40% of the school children surveyed used a powered toothbrush.

Oral hygiene principles for oral health

Toothbrushing is important throughout life. The overall goal is to achieve and maintain good oral hygiene as follows:

clean all tooth surfaces, and the gum line, thoroughly with a toothbrush and fluoride-containing toothpaste at least twice a day (last thing at night or before bed and one other time), spitting out the excess toothpaste

use additional cleaning aids to reach interproximal surfaces, as appropriate

The risk of dental caries (Chapter 4) and periodontal diseases (Chapter 5) can both be reduced by the practice of regular careful oral hygiene involving toothbrushing with fluoride toothpaste. The particular benefit in preventing dental caries, relates to the fluoride in toothpaste (Chapter 9). Good oral hygiene reduces the risk of periodontal diseases; however, periodontal health also requires effective interproximal plaque removal. Oral hygiene advice for the population in general, and specific advice for those at higher risk, are presented below for each oral condition.

Dental caries

For caries prevention, it is the application of fluoride in toothpaste that is the most important aspect of brushing, as fluoride helps prevent, control, and arrest caries ( Chapter 2: Table 1). Higher concentration of fluoride in toothpaste leads to better caries control. Family or standard fluoride toothpaste at 1,350 to 1,500 parts per million fluoride ( ppmF) is recommended, although in very young children, where the ability to control swallowing is limited, a toothpaste containing a lower amount (at least 1,000 ppmF) can be used. Frequency of brushing is important. Brushing should occur twice daily as a minimum, the guidance being to clean teeth last thing at night or before bed, and at least one other time each day. The term 'before bed' may be used as an alternative to 'last thing at night' for shift workers to sleep at another time of day.

Early introduction to the habit of toothbrushing is important. Parents should brush their children's teeth as soon as they erupt. From 3 to 6 years of age, there is a transition with the child and adult both brushing. Adult involvement ensures the correct amount of toothpaste is used, enables them to prevent children eating or licking toothpaste from the tube and that all teeth are brushed thoroughly. From 7 years of age, many children can brush their own teeth but will still require prompting, supervision, and motivation. Parents may still need to provide help with toothbrushing for some children, depending on risk and capability.

Gingivitis

Physical removal of plaque is the important element of toothbrushing for preventing or controlling periodontal (gum) diseases for the general population ( Chapter 2: Table 2). Self-care is important to maintain healthy gums and manage any gingivitis; it reduces inflammation of the gingivae. It is important to advise and instruct patients on good plaque removal from, and just into, the gingival crevice, including interdental areas, which takes around 2 minutes. There is no high-quality evidence regarding the best times of the day to brush in order to maintain healthy gums; however, it is good practice to suggest last thing at night or before bedtime and one other time in line with caries prevention.

Periodontitis

Self-care is vitally important to prevent and manage plaque-induced periodontitis ( Chapter 2: Table 2). For people with periodontal diseases this becomes vitally important throughout the rest of life and good oral hygiene may take longer than the recommended 2 minutes. The patient's existing method of brushing may need to be modified to clean all tooth surfaces systematically, maximise plaque removal and to brush the gum line carefully. No particular technique has been shown to be better than another. Disclosing tablets can help to indicate areas that are being missed. For people with extensive inflammation, it is good practice to start with toothbrushing advice, followed by interdental plaque control.

Cleaning between teeth, ideally with interdental brushes, is recommended prior to toothbrushing as a habit-forming approach, which is considered to be good practice through adult life.

Based on current evidence, no strong conclusions can be drawn concerning any specific oral hygiene devices as adjuncts to toothbrushing for patient self-care in periodontal maintenance[^10], or method of providing oral hygiene advice[footnote 11].

Tooth wear

General population advice

For the general population, advice on toothbrushing follows the generic advice on oral health for prevention of dental caries and periodontal diseases ( Chapter 2: Table 4). Although concerns have been raised, there is no strong evidence to suggest that the timing of toothbrushing is of great importance in preventing tooth wear or that all patients should delay brushing until after meals involving erosive food and drinks[footnote 12].

Higher risk of tooth wear

For those at higher risk, changing to a low abrasive toothpaste or specially reformulated toothpaste for tooth wear alone may be considered, but will not be sufficient to fully address tooth wear (Chapter 7). There have been debates over whether to recommend manual or powered toothbrushes. Many brushes now have sensors to indicate when the user is brushing too hard. However, when it comes to tooth wear, there is no evidence to suggest that powered toothbrushes are any better, or worse, than manual toothbrushes[footnote 13]. Patient preference is therefore the most important factor over whether a powered or manual toothbrush is used.

Oral hygiene advice

Effective toothbrushing with a fluoride toothpaste is important to support oral health. The physical action of brushing removes plaque, which prevents gingivitis and periodontitis, and the fluoride in toothpaste is effective against tooth decay. The following key messages for the population include when and how to brush, specific habits associated with brushing, and, where necessary, assistance with brushing. There may be adaptations of toothbrushes, such as special grip handles, that are helpful to people who have limited manual dexterity.

Advice for the population (primary prevention)

Advice to prevent oral disease in general should, therefore, focus on the following points:

brush all tooth surfaces at least twice a day (last thing at night or bedtime and on at least one other occasion), with fluoride toothpaste

ensure that every surface of each tooth and the junction between the gum and tooth (gumline) are cleaned carefully

for young people and adults, the patient's existing method of brushing may need to be modified to maximise plaque removal, emphasising the need to systematically clean all tooth surfaces

both powered and manual toothbrushes are effective for plaque control[footnote 14]

there is low-certainty evidence that medium and soft bristle brushes are less likely to cause gingival lesions than hard bristle toothbrushes[footnote 15]; for most patients, an appropriate brush will be a small-headed toothbrush with medium texture bristles

the type of toothbrush filament does not appear to be clinically important in plaque removal[footnote 15][footnote 16]

daily interproximal plaque removal should have started by age 18 years, or younger, if gingival inflammation is present

thorough cleaning may take at least 2 minutes; the main rationale for this time period is to ensure that sufficient time is taken for all tooth surfaces to be cleaned effectively[footnote 17]

timers, which range from simple 'egg-timers' to clocks incorporated into toothbrushes and downloadable 'apps', can be helpful to assist with the length of time toothbrushing[footnote 17]

disclosing agents can help to indicate areas of the mouth that are being missed and guide the person to more effective brushing

Advice for children in the population (primary prevention)

Advice should include the following:

brushing should start as soon as the first primary tooth erupts using toothpaste containing at least 1,000 ppmF

parents or carers should use no more than a smear of toothpaste (a thin film of paste covering less than three-quarters of the child's brush) for children below 3 years of age[footnote 17]

parents or carers should use no more than a pea-sized amount of toothpaste for children between 3 and 6 years[footnote 18]

parents or carers should brush their young children's teeth. In the absence of evidence from home settings, expert opinion suggests that they need to be helped and supervised by an adult, when brushing, until at least 7 years of age (based on findings from supervised brushing at schools which show significant caries reduction)[footnote 19]

parental supervision in the early years can also ensure that children do not eat or lick toothpaste from the tube (or brush), use the correct amount of toothpaste, and brush in a systematic pattern around the mouth[footnote 20]

as soon as they are able (usually around the age of 3 years), children should be encouraged to spit out excess toothpaste, and not to rinse with water after brushing

from 7 years of age, many children can brush their own teeth but will still require supervision, motivation, and possibly assistance

for children at higher risk of oral disease, a family fluoride toothpaste (1,350 to 1,500 ppmF) is indicated for maximum caries control, except where children cannot be prevented from eating toothpaste

Advice for those with evidence of periodontitis or higher risk (secondary and tertiary prevention)

Advice should include the following:

cleaning at the gum level is particularly important for people with experience of periodontitis

interdental cleaning aids help reach interproximal surfaces, and it may possibly be helpful to use them before toothbrushing

in general, people with, or treated for, periodontitis will have larger interdental spaces due to tissue loss, and should use interdental brushes, which are more effective than dental floss or tape[footnote 21]

the interdental brush should fit snuggly in the interdental space; therefore, many people with periodontitis will require different sizes for smaller and larger spaces - where the teeth are closer together, floss or tape can be used for interdental cleaning

regular re-evaluation of oral hygiene will be helpful for some patients with appropriate level of support from dental professionals[footnote 22]

Additional considerations

partially dentate older adults would particularly benefit from additional attention to oral hygiene, particularly those wearing partial dentures[footnote 23], as they increase plaque retention

good denture hygiene is important for those with partial and/or complete dentures as demonstrated in mouthcare matters

Specific oral hygiene issues for vulnerable children and adults

Vulnerable children and adults, particularly those lacking manual dexterity and mental capacity, may require assistance and support with toothbrushing as part of their daily self-care. Oral hygiene care and advice for people who have learning disabilities should be based on professional expertise and the needs and preferences of the individual and their carers[footnote 24]. They may benefit from using a powered brush[footnote 24], and some will require modifications such as a grip handle to assist with toothbrushing. The latter may also be useful for people with physical disabilities. There is low/very low certainty evidence for the effectiveness of triple-headed manual toothbrushes for reducing plaque compared to single-headed brushes[footnote 25]. Carers of people lacking the ability to undertake their personal oral hygiene may consider some of these products helpful and they are likely to require training and support from the dental team. It is worth noting that some studies reported participant difficulties with, or fears of, using the powered or the 3-headed manual toothbrushes[footnote 24]; thus, they won't be helpful for some patients.

NICE guidance on oral health for adults in care homes stresses the importance of ensuring care staff provide residents with daily support to meet their mouth care needs and preferences, as set out in their personal care plan after their oral health assessment[footnote 26].

This should include:

providing daily oral care for full or partial dentures (such as brushing, removing food debris, and removing dentures overnight)

using their choice of cleaning products for dentures if possible

using their choice of toothbrush, either manual or powered

daily use of mouth care products prescribed by dental clinicians (for example, this may include a high fluoride toothpaste or a prescribed mouthwash or rinse[footnote 27]

Powered versus manual toothbrushes

There is moderate-certainty evidence to suggest that powered toothbrushes reduce plaque and gingivitis more than manual toothbrushing in the short and long term, and supporting their safety[footnote 28]. Findings are consistent across reviews, favouring powered brushes but the clinical relevance of the results is unclear[footnote 14][footnote 29][footnote 30][footnote 31]. This is particularly important to note as many people will not be able to afford a powered toothbrush and it should be stressed that teeth can be cleaned effectively with either type of toothbrush[footnote 32]. Additionally, the evidence is insufficient to conclude that any particular mode of action of powered brush is superior (for example, sonic, rotatory)[footnote 33]. There is no evidence regarding the role of powered versus manual toothbrushes in preventing caries.

Interdental cleaning

Periodontal health

There is low to very low-certainty evidence that using some dental cleaning aids in addition to tooth cleaning (for example, interdental brushes and floss) reduce gingivitis and plaque, but the clinical importance of the effect sizes is uncertain. The findings suggest that interdental brushes may be more effective than floss and the evidence for tooth cleaning sticks and oral irrigators is limited and inconsistent. Daily cleaning is recommended between the teeth to below the gum line. Ideally this should take place throughout adult life and start earlier if there are signs of gingivitis. Since toothbrushing is a daily routine for the majority of people, carrying out interdental oral hygiene first may help to link these activities and develop regularity.

Dental caries

Recommendations relating to interdental brushing and flossing are based on trials at unclear or high risk of bias that focus on the reporting of plaque and/or gingivitis, rather than caries. Thus, there is no evidence to determine whether interdental cleaning aids reduce caries, or not, when compared with toothbrushing alone.

Sustainable toothbrushes

The sustainability agenda, which is an important aspect of public health action, has implications for the prevention or oral diseases. It is increasingly influencing the nature of new products arriving on the market, some of which have relatively little underpinning research.

For example, switching from traditional plastic toothbrushes to replaceable-head plastic or bamboo has been suggested as being environmentally more sustainable. However, all choices have trade-offs which should be considered carefully. Bamboo toothbrushes are manufactured in different parts of the world, and although they have been shown to have a reduced carbon footprint[footnote 34], they have also been shown to have high planetary harm, due to the need for land, and volume of water required to grow the product. Furthermore, there is currently little evidence on their effectiveness. On the other hand, plastic has been considered the most hygienic option for decades. Additionally, all toothbrushes, whether normal plastic, bamboo, and biodegradable plastic (PLA or polylactic acid), have brush heads containing metal and/or nylon, so it is currently not possible to recycle the heads.

Further innovative new products will emerge, and it will be important for health professionals to be aware of these changes and consider the clinical effectiveness of sustainable products. Integrating oral health and sustainability is attractive, and continually recycled plastic, rather than bioplastic or bamboo, will be the most environmentally sustainable toothbrush model[footnote 35]. Practices may wish to encourage patients to recycle toothbrushes as best as possible. As a compromise, it may be possible for people to remove or chop off the brush head and recycle the handle. Some dental practices already have an arrangement with companies to recycle any type of toothbrush and toothpaste tubes.

Resources

Oral Hygiene TIPPS video. Oral Hygiene TIPPS is a behaviour change strategy which aims to make patients feel more confident in their ability to perform effective plaque removal and help them plan how and when they will look after their teeth and gums.

HABIT resources to support oral health conversations between health visitors and parents.

eBUG toothbrushing demonstration video for 7(+) years.

Dental Check By One.

Scottish Dental Clinical Effectiveness Programme. Prevention and Management of Dental Caries in Children: SDCEP; 2018 (Second Edition).

How To Clean a Denture Animation:

Mouth Care Matters.

Wales Designed to Smile.

Scotland Childsmile.

Northern Ireland Happy Smiles.

NHS apps library. Includes Brush DJ which plays two minutes of your music so you brush your teeth for the right amount of time. The app has short videos on how to brush your teeth and how to clean in between them using an interdental brush or floss.

Public Health England: Oral health toolkit for adults in care homes.

References

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This guidance is issued jointly by the Department of Health and Social Care, the Welsh Government, the Department of Health Northern Ireland, Public Health England, NHS England and NHS Improvement, and with the support of the British Association for the Study of Community Dentistry.

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General guidelines from the NHS about how to look after your children's teeth.

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From brushing their first tooth to their first trip to the dentist, here's how to take care of your children's teeth.
A regular teeth-cleaning routine is essential for good dental health. Follow these tips and you can help keep your kids' teeth decay-free.

Toothbrushing tips

It's important to use a fluoride toothpaste, as this helps prevent and control tooth decay.
Children aged up to 3 years

Start brushing your baby's teeth as soon as the first milk tooth breaks through (usually at around 6 months, but it can be earlier or later).

Parents or carers should brush the teeth.

Brush teeth twice daily for about 2 minutes with fluoride toothpaste.

Brush last thing at night before bed and on 1 other occasion.

Use children's fluoride toothpaste containing no less than 1,000ppm of fluoride (check label) unless a dentist advises family toothpaste containing between 1,350ppm and 1,500ppm fluoride.

Use only a smear of toothpaste.

Make sure children don't eat or lick toothpaste from the tube.

Children aged 3 to 6 years

Brush at least twice daily for about 2 minutes with fluoride toothpaste.

Brush last thing at night before bed and at least on 1 other occasion.

Parents or carers should brush the teeth.

Use children's fluoride toothpaste containing no less than 1,000ppm of fluoride (check label) unless a dentist advises family toothpaste containing between 1,350ppm and 1,500ppm fluoride.

Use only a pea-sized amount of toothpaste.

Spit out after brushing and don't rinse - if you rinse, the fluoride won't work as well.

Children aged 7 and over

Brush at least twice daily for about 2 minutes with fluoride toothpaste.

Brush last thing at night before bed and at least on 1 other occasion.

Use fluoride toothpaste containing between 1,350ppm and 1,500ppm of fluoride (check label).

Spit out after brushing and don't rinse - if you rinse, the fluoride won't work as well.

Children aged 7 and over should be able to brush their own teeth, but it's still a good idea to watch them to make sure they brush properly and for about 2 minutes.

How to help children brush their teeth properly

Guide your child's hand so they can feel the correct movement.

Use a mirror to help your child see exactly where the brush is cleaning their teeth.

Make tooth brushing as fun as possible by using an egg timer to time it for about 2 minutes.

Don't let children run around with a toothbrush in their mouth, as they may have an accident and hurt themselves.

Taking your child to the dentist

NHS dental care for children is free.

Take your child to the dentist when their first milk teeth appear. This is so they become familiar with the environment and get to know the dentist. The dentist can advise you on how to prevent decay and identify any oral health problems at an early stage. Just opening up the child's mouth for the dentist to take a look at is useful practice for the future.

When you visit the dentist, be positive about it and make the trip fun. This will stop your child worrying about future visits.

Take your child for regular dental check-ups as advised by the dentist.

Find a dentist near you

Fluoride varnish and fissure sealants

Fissure sealants can be done once your child's permanent back teeth have started to come through (usually at the age of about 6 or 7) to protect them against decay. This is where the chewing surfaces of the back teeth are covered with a special thin plastic coating to keep germs and food particles out of the grooves. The sealant can last for as long as 5 to 10 years.

Fluoride varnish can be applied to both baby teeth and adult teeth. It involves painting a varnish that contains high levels of fluoride onto the surface of the tooth every 6 months to prevent decay. Some children may need this more often. It works by strengthening tooth enamel, making it more resistant to decay.

From the age of 3, children should be offered fluoride varnish application at least twice a year. Younger children may also be offered this treatment if your dentist thinks they need it.

Ask your dentist about fluoride varnish or fissure sealing.

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Find out how to look after children's teeth, including advice on brushing, toothpaste, establishing a routine and taking a child to the dentist for the first time.

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Introducing toothbrushes to your child for them to play with, helps them to become familiar with the feel, appearance and use of it.

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The Baby Club: Playing with toothbrushes... even if your baby doesn't have teeth!

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Play with toothbrushes as a game of pretend - even if your baby doesn't have teeth yet!

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Steps you can take to help prevent tooth decay.

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Find out how much sugar a child should be having, discover food swaps and suggestions for reducing sugar intake.

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The effects of too much sugar

Too much sugar is bad for children's health as it can lead to the build-up of harmful fat on the inside that we cannot see.

This fat can cause weight gain and serious diseases like type 2 diabetes, heart disease and some cancers.

Having too much sugar can also lead to painful tooth decay - every 10 minutes, a child in England has a tooth removed in hospital.

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Reducing sugar - Food facts - Healthier Families

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Help your family cut back on their sugar intake with our simple tips and guide to sugar found in your everyday food and drink.

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Find out how much sugar you may be having every day.

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Sugar calculator - Food facts - Healthier Families

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Use our interactive calculator to find out how much sugar your child might be having each day. You may be surprised at the results!

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Reducing the amount of sugary foods and drinks you have will help to prevent tooth decay. Replacing sugary drinks with water and milk will reduce the risk of tooth decay.

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Impact of oral health on school readiness

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Impact of oral health on school readiness

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Poor oral health impacts on school attendance, childrens concentration in school and caregivers employment.

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Dentists recommend you should brush for two minutes, but to children that can seem like such a long time! Brush DJ is an NHS app, that will play music for the 2 minutes you spend brushing. A great way to keep children focussed for those critical 2 minutes.