{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T04:34:04Z","timestamp":1777696444295,"version":"3.51.4"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Br Dent J"],"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:p>\n            <jats:bold>Introduction<\/jats:bold> Supervised toothbrushing programmes (STPs) in nurseries and schools are effective at reducing inequalities in caries when targeted to areas of dental disease. Recent changes to government education and health policy have increased interest in STPs in England. This study aimed to establish the current level of provision of STPs in England, describe changes over time, understand associations with predictor variables, and summarise key barriers and facilitators to their implementation.<\/jats:p>\n          <jats:p>\n            <jats:bold>Methods<\/jats:bold> A national survey was conducted at upper tier local authority level about the extent of a STP across England between December 2023 and April 2024. Quantitative data were analysed using descriptive statistics, with regression analyses examining associations with key predictor variables. Barriers and facilitators to implementation were analysed and summarised based on the Consolidated Framework for Implementation Research.<\/jats:p>\n          <jats:p>\n            <jats:bold>Results<\/jats:bold> Data were received from 152 local authorities. Around 60% implemented a STP. Nearly one-third of programmes were commissioned by local authorities (28.9%) and most adopted a targeted approach (77.8%). Statistical analyses demonstrated significant and positive associations between dental caries prevalence and the number of children in STPs. Barriers to implementation included: 1) funding; 2) capacity; 3) pressures at settings; 4) logistics; and 5) lack of engagement. Facilitators included: 1) partnerships and connections; 2) available resources; 3) oral health expertise; 4) external policy and incentives; 5) shared knowledge; and 6) engagement.<\/jats:p>\n          <jats:p>\n            <jats:bold>Conclusions<\/jats:bold> Provision of STPs in England has increased since 2022. Any future expansion of STPs should consider the barriers and facilitators identified to enable smooth implementation.<\/jats:p>","DOI":"10.1038\/s41415-024-7782-0","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T15:26:05Z","timestamp":1737127565000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Supervised toothbrushing programmes in England: a national survey of current provision and factors influencing their implementation"],"prefix":"10.1038","author":[{"given":"Tom","family":"Broomhead","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samantha","family":"Watt","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarab","family":"El-Yousfi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kara A.","family":"Gray-Burrows","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanin","family":"El Shuwihdi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristian","family":"Hudson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter F.","family":"Day","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zoe","family":"Marshman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"7782_CR6163","unstructured":"UK Government. National Dental Epidemiology Programme (NDEP) for England: oral health survey of 5-year-old children 2022. 2023. Available at https:\/\/www.gov.uk\/government\/statistics\/oral-health-survey-of-5-year-old-children-2022\/national-dental-epidemiology-programme-ndep-for-england-oral-health-survey-of-5-year-old-children-2022 (accessed June 2023)."},{"key":"7782_CR6166","doi-asserted-by":"crossref","unstructured":"Sheiham A. Dental caries affects body weight, growth and quality of life in pre-school children. Br Dent J 2006; 201: 625-626.","DOI":"10.1038\/sj.bdj.4814259"},{"key":"7782_CR6168","doi-asserted-by":"crossref","unstructured":"Watt S, Dyer T A, Marshman Z, Jones K. Does poor oral health impact on young children's development? A rapid review. Br Dent J 2024; 237: 255-260.","DOI":"10.1038\/s41415-024-7738-4"},{"key":"7782_CR6170","doi-asserted-by":"crossref","unstructured":"Giles E, Relins S, Gray-Burrows K, Baker S R, Day P F. Dental caries and school readiness in 5-year-olds: a birth cohort data linkage study. Community Dent Oral 2024; 52: 723-730.","DOI":"10.1111\/cdoe.12968"},{"key":"7782_CR6173","doi-asserted-by":"crossref","unstructured":"Broadbent J M, Thomson W M, Poulton R. Trajectory Patterns of Dental Caries Experience in the Permanent Dentition to the Fourth Decade of Life. J Dent Res 2008; 87: 69-72.","DOI":"10.1177\/154405910808700112"},{"key":"7782_CR6175","doi-asserted-by":"crossref","unstructured":"Walsh T, Worthington H V, Glenny A-M, Marinho V C, Jeroncic A. Fluoride toothpastes of different concentrations for preventing dental caries. Cochrane Database Syst Rev 2019; DOI: 10.1002\/14651858.CD007868.pub3.","DOI":"10.1002\/14651858.CD007868.pub3"},{"key":"7782_CR6177","doi-asserted-by":"crossref","unstructured":"Aliakbari E, Gray-Burrows K A, Vinall-Collier K A et al. Facilitators and barriers to home-based toothbrushing practices by parents of young children to reduce tooth decay: a systematic review. Clin Oral Investig 2021; 25: 3383-3393.","DOI":"10.1007\/s00784-021-03890-z"},{"key":"7782_CR6180","doi-asserted-by":"crossref","unstructured":"Anopa Y, McMahon A D, Conway D I, Ball G E, McIntosh E, Macpherson L M D. Improving Child Oral Health: Cost Analysis of a National Nursery Toothbrushing Programme. PLoS One 2015; DOI: 10.1371\/journal.pone.0136211.","DOI":"10.1371\/journal.pone.0136211"},{"key":"7782_CR6182","doi-asserted-by":"crossref","unstructured":"Kidd J B R, McMahon A D, Sherriff A et al. Evaluation of a national complex oral health improvement programme: a population data linkage cohort study in Scotland. BMJ Open 2020; DOI: 10.1136\/Bmjopen-2020-038116.","DOI":"10.1136\/bmjopen-2020-038116"},{"key":"7782_CR6185","doi-asserted-by":"crossref","unstructured":"Gray-Burrows K A, Day P F, El-Yousfi S, Lloyd E, Hudson K, Marshman Z. A national survey of Supervised Toothbrushing Programmes in England. Br Dent J 2023; DOI: 10.1038\/s41415-023-6182-1.","DOI":"10.1038\/s41415-023-6182-1"},{"key":"7782_CR6187","unstructured":"UK Government. Advancing our health: prevention in the 2020s - consultation document. 2019. Available at https:\/\/www.gov.uk\/government\/consultations\/advancing-our-health-prevention-in-the-2020s\/advancing-our-health-prevention-in-the-2020s-consultation-document (accessed May 2024)."},{"key":"7782_CR6190","unstructured":"NHS England. Core20PLUS5 - an approach to reducing health inequalities for children and young people. Available at https:\/\/www.england.nhs.uk\/about\/equality\/equality-hub\/national-healthcare-inequalities-improvement-programme\/core20plus5\/core20plus5-cyp\/ (accessed July 2024)."},{"key":"7782_CR6193","unstructured":"UK Government. Early years foundation stage statutory framework for group and school-based providers: setting the standards for learning, development and care for children from birth to five. 2023. Available at https:\/\/assets.publishing.service.gov.uk\/media\/65aa5e42ed27ca001327b2c7\/EYFS_statutory_framework_for_group_and_school_based_providers.pdf (accessed July 2024)."},{"key":"7782_CR6196","unstructured":"House of Commons. Local government in England: structures. 2024. Available at https:\/\/researchbriefings.files.parliament.uk\/documents\/SN07104\/SN07104.pdf (accessed July 2024)."},{"key":"7782_CR6199","unstructured":"UK Government. Local government structure and elections. 2023. Available at https:\/\/www.gov.uk\/guidance\/local-government-structure-and-elections (accessed July 2024)."},{"key":"7782_CR6202","unstructured":"Public Health England. Oral health survey of 5-year-old children 2019. 2020. Available at https:\/\/www.gov.uk\/government\/statistics\/oral-health-survey-of-5-year-old-children-2019 (accessed June 2023)."},{"key":"7782_CR6205","unstructured":"Public Health England. Oral health survey of 5-year-old children 2017. 2018. Available at https:\/\/www.gov.uk\/government\/statistics\/oral-health-survey-of-5-year-old-children-2017 (accessed June 2023)."},{"key":"7782_CR6208","unstructured":"Public Health England. Oral health survey of 5-year-old children 2015. 2016. Available at https:\/\/www.gov.uk\/government\/statistics\/oral-health-survey-of-5-year-old-children-2014-to-2015 (accessed June 2023)."},{"key":"7782_CR6211","unstructured":"UK Government. English indices of deprivation 2019. 2019. Available at https:\/\/www.gov.uk\/government\/statistics\/english-indices-of-deprivation-2019 (accessed June 2023)."},{"key":"7782_CR6215","unstructured":"IBM Corp. IBM SPSS Statistics for Windows, Version 290.2.0. Armonk: IBM Corp, 2023."},{"key":"7782_CR6218","doi-asserted-by":"crossref","unstructured":"Damschroder L J, Reardon C M, Widerquist M A O, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci 2022; 17: 1-16.","DOI":"10.1186\/s13012-022-01245-0"},{"key":"7782_CR6220","unstructured":"Public Health England. Improving oral health: supervised tooth brushing programme toolkit. 2016. Available at https:\/\/www.gov.uk\/government\/publications\/improving-oral-health-supervised-tooth-brushing-programme-toolkit (accessed May 2024)."},{"key":"7782_CR6223","unstructured":"NHS England. What are integrated care systems? 2022. Available at https:\/\/www.england.nhs.uk\/integratedcare\/what-is-integrated-care\/ (accessed July 2024)."}],"container-title":["British Dental Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41415-024-7782-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41415-024-7782-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41415-024-7782-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T15:26:15Z","timestamp":1737127575000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41415-024-7782-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,17]]},"references-count":23,"alternative-id":["7782"],"URL":"https:\/\/doi.org\/10.1038\/s41415-024-7782-0","relation":{},"ISSN":["0007-0610","1476-5373"],"issn-type":[{"value":"0007-0610","type":"print"},{"value":"1476-5373","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,17]]},"assertion":[{"value":"13 June 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 July 2024","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 July 2024","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 January 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare no conflicts of interest.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics declaration"}},{"value":"Ethical approval was provided by the University of Leeds Dental Research Ethics Committee (301121\/KGB\/338). Consent to participate was implied by completion of the survey.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics declaration"}}]}}