Ealing Smiles Daily Supervised Tooth brushing programme for Early Years Settings and Primary Schools (3-5 years old)

Aims of Ealing Smiles Daily To develop good oral health behaviours during the early years of life which can establish prevention for life To promote Supervised Toothbrushing and develop good oral health practices from a young age in early years settings across Ealing

Highest proportion of 5 year olds with tooth decay in London

Risks of poor oral health on children School absence Severe decay in baby teeth can have serious consequences for a child’s speech and jaw development Untreated dental disease compromises the child’s ability to eat well, sleep well, and function well at home and at school. Loss of time at school, impact on education learning and development Parental Stress More complicated and expensive treatment Sleepless nights and anxiety A&E and hospital visits Pain The longer tooth decay is left untreated, the more a child will experience Pain and discomfort A higher risk of new decay in neighbouring teeth and future adult teeth

Before getting started Staff at the EY setting must be trained in carrying out Supervised brushing Each participating child must have signed consent by their parent/ carer for them to brush at nursery/school .Consent letters to include information and FAQs These letters must be kept on file on location No consent = No participation

Equipment required for Supervised Toothbrushing Toothbrushes and corresponding racks with lids to be provided by Ealing Public Health /Whittington Health CDS Oral Health Promotion 1450 ppm Fluoride toothpaste-to be provided by Ealing Public Health /Whittington Health CDS Oral Health Promotion Additional equipment Paper towels /paper plates Hand wash soap Cleaning detergent Gloves for staff (to wear whilst cleaning during the session)

Resources

Getting Started Only trained Staff should be “supervising” Ensure supervision of children at all times during the brushing activity Supervisor should cover any cuts or abrasions or breaks in their skin with waterproof dressing Supervisor must wash their hands before and after session

Toothbrushes Toothbrushes MUST NOT be shared! Toothbrushes are NOT to be handled by the children unless during a session Toothbrushes are changed every 2-3 months or per term unless splayed, a log must be kept in the replacement log form

Toothpaste For children aged 3 years and above use a pea-sized amount of fluoride tooth paste provided For children 0-3 years use a smear of fluoride toothpaste

Toothpaste To be dispensed by a supervisor Where toothpaste is shared a supervisor dispenses it onto a clean surface such as a paper towel or plate Ensure there is sufficient spacing between quantities of dispensed toothpaste to allow collection without cross contamination Toothpaste must be dispensed at the time the child is ready to brush Children should SPIT toothpaste out, NOT Rinse or swallow

Toothbrushing

Toothbrushing Ensure all Tooth surfaces are being brushed. Time the brushing for 2 minutes either using a 2 minute timer, a 2minute brushing app or 2 minute brushing song/video Prompt during session All children must be encouraged to brush however if a child is uncooperative, they should not be forced.

After brushing Thoroughly rinse each toothbrush individually under cold running water right after the brushing activity ends i.e. toothpaste must not be allowed to dry on the toothbrush Shake to remove excess water, avoid contact with the sink Toothbrush racks should be cleaned weekly with household detergent and warm water to remove any contamination (ensure the racks are dry before replacing any toothbrushes Tooth brushes should be stored appropriately

Storage and Replacement Toothbrushes should be placed in correct place holders to avoid cross contamination Contact WH if the storage racks become cracked / damaged for a replacement Keep out of reach of children Store in a dry clean cupboard or room Storage racks should not be placed next to the child whilst they are brushing their teeth – may become contaminated

Replacement of toothbrushes Each participating child must have a replacement brush ,in case of loss or compromise on hygiene All brushes should be replaced on a termly (2-3 monthly) basis regardless of their condition Once the bristles are bent/splayed, the brush must be replaced - keep an eye out for chewing, focus on those children to improve their brushing technique If a toothbrush gets accidentally dirty it will need to be replaced Keep a log for audit purpose

Cross Infection Control Supervisors MUST wash hands before and after session Supervisors MUST cover all cuts/abrasions If a toothbrush gets accidentally dirty it will need to be replaced DO NOT allow children to handle tooth brushes (when not in use) and racks Store appropriately All staff must read through the guidelines in the Protocol document

Toothbrushing in a DRY Area The Supervisor should dispense toothpaste onto a clean surface such as a plate or paper towel right before the activity is to take place Ensure there is sufficient spacing between quantities of dispensed tooth paste Brush for two minutes ensuring all tooth surfaces are brushed Children must not rinse the toothpaste and should be discouraged from swallowing Ideally children should not eat or drink for 30 minutes in order to get the maximum benefit from the fluoride

Any Questions