Children’s Oral Health Specialist Service

Descriptions

Local authorities in England hold a statutory responsibility for improving the oral health of their populations, with a particular focus on children and reducing health inequalities. Under the Health and Social Care Act 2012, councils are responsible for assessing local oral health needs, commissioning preventive programmes such as supervised toothbrushing and fluoride varnish schemes, and delivering community-based education and interventions.

Up to 40% of 5-year-olds in Tower Hamlets have tooth decay, with children in deprived areas and Asian/Asian British communities disproportionately affected. Poor oral health affects children's wellbeing, learning, and school readiness, and is a common cause of hospital admissions for children under ten. Dental decay is preventable and effective health promotion programmes in early childhood can reduce inequities supporting children to develop healthy lifelong habits.

Tower Hamlets' children's oral health programme has been reviewed, in advance of end of the current contract for children's oral health services (Healthy Teeth in Schools) in 31st August 2026. This review recommended that the local children's oral health programme needed to strengthen specialist oral health leadership, introduce supervised toothbrushing, increase prevention activities in the early years and provide poverty-sensitive interventions (e.g. free toothbrushing packs). Evidence shows these interventions offer a strong return on investment, reduce inequities, and improve lifelong health outcomes.

Public Health currently commission 'Healthy Teeth in Schools', a service that delivers oral health checks and fluoride varnish for 3-6 year olds in schools. In March 2025, the Department of Health and Social Care (DHSC) announced funding for a new, targeted, supervised toothbrushing programme for 3-5-year-olds to be delivered in September 2025 in early years settings. This is being mobilised in the borough through a 1-year contract. Both these contracts will be end in August 2026 and be placed by this new contract.

Scope of contract

The contract will replace two existing contracts: 1) Healthy Teeth in Schools 2) Targeted supervised toothbrushing. It will bring together other activities that improve oral health into one contract to improve integration and efficiency.

The service will deliver the following:

All children attending schools aged 3-6 years (Nursery, Reception, Year 1) will have an oral health check and protective fluoride varnish applied to their teeth, every 6 months.

All children attending early years settings, including childminders and reception classes, aged 3-5 years will benefit from supervised toothbrushing. This will involve training staff, organising delivery of resources, auditing settings and evaluation of the programme. This programme has been shown to create healthy habits, improve toothbrushing practice at home (through children better accepting the practice and teaching their parents), as well as ensuring children from all backgrounds brush their teeth regularly.

All children will be offered age-appropriate Brush for Life packs (toothbrushes, toothpaste, information leaflet) at the following universal health visiting contacts: 3-4 months, 6 months, 12 months and 2 years. The service will procure these packs but delivery of resources to families has been included in the Health Visiting specification.

Training and system leadership: The service will provide oral health promotion training and resources to partners across Tower Hamlets. This includes the school nursing service, health visiting, midwifery, paediatrics, Family Hubs and Early Help, Children's Social Care, early years settings, schools, voluntary and community organisations, faith organisations, Healthy Lives, Healthy Early Years London. Training and resources must be flexible and meet the needs of different families, for example, accessible online and available in a variety of community languages.