Oral Health Promotion Team

Meet the team

  • Oral Health Team Manager: Vikki Tennison
  • Oral Health Practitioner: Bridie Shann
  • Oral Health Practitioner: Ruth Harrison

Contact us

Email: [email protected]

Supervised toothbrushing programme

The Supervised Toothbrushing programme is a tooth brushing activity which takes place daily in many schools and nurseries across Hull, North Yorkshire, Sunderland & York.

The programme is an innovative and award winning oral health initiative aimed at reducing the prevalence of tooth decay by increasing exposure to fluoride for children.

It is well recognised that oral health is an important part of general health and wellbeing. Whilst there have been improvements in the oral health of children in England, significant inequalities remain.

Tooth decay is the most common oral disease affecting children and young people in England, yet it is largely preventable. Recent reports found that almost a quarter (23.4%, 2020) of five year olds and 10.7% (2021) of three year olds had experience of dental decay.

Poor oral health can affect children and young people’s ability to sleep, eat, speak, play and socialise with other children. The impacts can be seen educationally with children missing school and this can impact on parents and carers who may need time off work to take children to dental appointments.

Studies have shown that daily application of fluoride toothpaste to teeth reduces the incidence and severity of tooth decay in children3. At a population, school or Early Years level, the evidence tells us that brushing each day at school over a two-year period is effective for preventing tooth decay and can establish life-long behaviour to promote oral health3. It is also important that school based toothbrushing activity should promote and support toothbrushing in the home as well as the school or early years setting4.

Additional information regarding supervised brushing can be found here


Supervised toothbrushing supplies and resources can be found at a number of suppliers including:

How the supervised toothbrushing programme works

The supervised toothbrushing programme is an evidence-based oral health initiative designed to:

  • Improve children’s oral health
  • Increase exposure to fluoride
  • Promote behavioural and self-care skills

Requirements for settings wishing to implement supervised brushing:

  • Identify a member of staff who will be the toothbrushing champion
  • Ensure all members of staff engage with training, watch the supporting videos and read the standards and guidelines
  • Gain consent from parents/carers for all children taking part
  • Ensure cross infection procedures are followed
  • Carry out daily and weekly quality assurance checks


  • Should be organised in a safe and effective way which is integrated with nursery, school and home routines
  • Can be carried out individually or in groups
  • Children are seated or standing while brushing teeth
  • Children should brush their own teeth
  • The toothbrushing method should be appropriate for the age and ability of the child
  • Toothbrushes are appropriate for the age and ability of the child
  • Toothbrushes are replaced each term
  • Toothbrushes are individually identifiable for each child
  • Toothbrushes DO NOT need to be wet before toothpaste is applied


  • Toothpaste must contain 1,350-1,500ppm fluoride
  • A pea-sized amount for children over the age of three
  • Children should be discouraged from rinsing
  • Any excess toothpaste after brushing is wiped on a paper towel and the paper towel placed in the bin

Cross infection procedures:

  • Toothpaste MUST NOT be applied directly onto the brush
  • Toothpaste to be applied to paper towel or a clean plastic plate
  • Each child scoops a blob of toothpaste onto their brush
  • Toothbrushes MUST NOT be soaked in bleach, cleaner or disinfectant
  • Toothbrushes must be stored in storage racks so that they do not touch
  • Toothbrushes and racks have corresponding symbols allowing for individual identification
  • Storage systems must not be kept in toilet areas and must be kept out of reach of children
  • Storage system lids must be used

Cleaning procedures

  • Storage systems to be wiped daily to remove visible drips
  • Storage systems should be washed weekly with warm water and household detergent
  • Household gloves to be worn during cleaning procedures and all cuts and abrasions to be covered with a waterproof dressing

All venues taking part in supervised brushing must follow the guidelines and run the scheme as directed and not implement their own systems.

Supervised toothbrushing training for venues funded by Harrogate and District NHS Foundation Trust

Supervised toothbrushing training for special schools

Supervised toothbrushing training for self-funded venues (schools and nurseries)

Supervised toothbrushing training fact sheet for staff

Guidelines for supervised toothbrushing programme

Supervised toothbrushing programme hygiene check list

Consent Form

Oral Health Training

The Oral Health Team facilitate a wide range of FREE oral health training packages to health and social care professionals including: health visitors, school nurses, nursery nurses, childminders, Children Centre staff, residential care staff (Hull only) and staff caring for vulnerable groups and patients with special care needs.

The Oral Health Promotion Team provide training for many vulnerable groups including care support groups and day centres.

To book your training please email us at [email protected]


The Oral Health team attend regular events, interacting with a variety of population groups to educate on the importance of good oral health.

We also participate in national campaigns.

  • 16 May – 16th June 2023: National Smile Month
  • 16 May: Hull North Point Shopping Centre, 10.00am – 4.00pm
  • 26 May: Scarborough breastfeeding group, 30 – 11.30am
  • 5 June: Filey Library, story time, 11.30am-12.30pm
  • 5 June: Sunderland, Rainbow Centre, 1030am-11.30am
  • 13 June: Hull St Stephens Shopping Centre, 9.30am – 4.00pm

Oral Health Advice 0-3

Baby teeth

Babies will usually start to develop teeth from around six months, but this can vary for each child. Eventually, they will have 20 baby teeth, and these will have all come through by the time your baby is three years old. For some babies, teething does not cause any problems, but some may experience discomfort, increased drooling and waking more through the night.

Things that may help your child when teething:

  • Chilled (not frozen) teething rings
  • Fresh fruit/vegetable sticks
  • Comfort and distraction
  • Teething gel
  • Sugar free medicines

Brushing your child’s teeth

It is important to care for your child’s teeth as poor oral health can affect the teeth and gum. The deciduous (baby) teeth act as a guide for the adult teeth so they need to be looked after to ensure they are not lost early as this can cause the adult teeth to be crooked.

Start brushing your babies’ teeth as soon as they appear using a small soft toothbrush so that your baby gets used to it. Build this into your child’s daily routine and brush in the morning and at night. Use a smear of toothpaste containing at least 1,000ppm fluoride.

Visiting the dentist

As soon as your child gets their first teeth, and certainly by their first birthday, take them to the dentist so they can become familiar with the experience. Don’t worry if they won’t open their mouth at the first visit, repeat exposures will help them to acclimatize.

Bottle to Beaker

For good dental health and to reduce the risk of dental decay, children should be drinking from a free-flow or open cup from the age of one.

Drinking from a bottle can increase the risk of dental decay because drinks flow much slower through a bottle. This causes the liquid inside to be in contact with the teeth for longer, which can damage the enamel and create cavities in the teeth.

Using a bottle beyond 12 months of age can also affect the positioning of the teeth and impact on speech and development.

Drinking from a free-flow or open cup allows children to learn how to sip, rather than suck.

While non-spill beakers will be less messy, they require children to suck the liquid out, which can be damaging to teeth.

Free-flow beakers allow the liquid to come out easily, without the need for sucking, therefore preventing damage to the front teeth.

Top tips to help move from bottle to beaker:

  • Offer drinks in a cup at every mealtime
  • Put water in the bottle and milk in the cup
  • Do not give sugary drinks or juice
  • It may get messy so only put a small amount in the cup at first
  • Keep children sat upright when drinking
  • The key is consistency, once you’ve made the change, do not go back to the bottle

Oral Health Advice 3+

Brushing your child’s teeth

Keep brushing your child’s teeth every morning and evening. Your child may be becoming more independent at this age and want to brush their teeth themselves. This can be encouraged but at this age, they will not have the full dexterity to brush their teeth effectively and they miss some of the back teeth, so it is important that they let you brush as well.

Now that they have all their baby teeth, children should be using a pea-sized amount of toothpaste. The toothpaste should contain 1,350-1,500ppm fluoride, and we recommend that children spit out after brushing and don’t rinse. This keeps some of the fluoride on the teeth which can help to strengthen the enamel and prevent dental decay.

Visiting the dentist

Children should be attending the dentist regularly, usually every six months, but your dentist will choose the most appropriate recall for your child based on their needs.

Oral Health Advice 7+

At this age, your child will start to lose some of their baby teeth and the permanent teeth (adult) teeth will begin to erupt. The first teeth to come through are usually the front teeth and the first molar tooth (at the back). Most of the adult teeth should have come through by the time your child is 12-14, with the wisdom teeth erupting from the age of 17-21 years. If all the teeth are present, adults will have 32 teeth in total.

From this age, children should now have enough dexterity to brush their teeth effectively. This can be with a manual or electric toothbrush but should be for two minutes, twice a day, using a pea-sized amount of toothpaste containing 1,350-1,500ppm fluoride. Spit don’t rinse after brushing to keep some of the fluoride on the teeth.

Children should be visiting the dentist regularly (every six months or at least once a year).

Oral Health for Teenagers

As your child gets older, they will become more independent and begin to take responsibility for their own oral health.

At this age, it is still essential to brush twice a day, for two minutes with a toothpaste containing 1350-1500ppm fluoride and to spit don’t rinse after brushing. Brushing can be with a manual or electric toothbrush. It is also important to encourage interdental cleaning with floss or interdental brushes to help remove plaque and food deposits from between the teeth and help maintain healthy gum.

If your child plays contact sports, it is recommended to get a mouthguard to optimize protection against dental trauma. These should be custom made at the dental practice to ensure the correct fit.

Visit the dentist every six months or at least once a year.

Oral Health For Adults

Brush teeth twice a day, last thing at night and one other time during the day. This can be done with either a manual or electric toothbrush for two minutes, with a toothpaste containing 1,350-1,500ppm fluoride. Spit don’t rinse after brushing and do not use mouthwash after brushing as this can wash away the fluoride in the toothpaste. If you choose to use mouthwash, this should be at a different time to brushing and should not replace toothbrushing.

Daily interdental cleaning is important to remove plaque and food deposits from between the teeth as this can help prevent decay and gum disease. This doesn’t take long but can make a huge difference to your oral health. Good oral health is associated with good general health. There are a variety of options to use,

  • Dental floss
  • Superfloss
  • Interdental brushes
  • Single tufted brushes
  • Interspace head for electric toothbrush
  • Waterflosser
  • Airfloss

Visit the dentist every six months and the hygienist every 3-6 months.

Oral health training

Interdental cleaning

Oral Health for SEN/learning difficulties

Good oral health is extremely important for this group but there can be challenges achieving this. Sometimes it may be necessary for adaptations to be made to oral hygiene aids and there are a variety of products available which may be useful.

Toothbrushes – Collis curve, Dr Barman’s Superbrush, Triple Bristle sonic toothbrush.

Toothpaste can sometimes be a barrier for SEN children when brushing their teeth, either due to the taste or the foaming effect. OraNurse toothpaste may be beneficial for some as it is non-foaming and flavourless.

Visit the dentist regularly, it may be necessary to attend every three months if at high risk of tooth decay.

Oral Health Advice for the Elderly

Due to advances in oral health care, we are seeing more people keep their teeth for longer and it is important that these teeth are kept healthy. Teeth are essential to allow us to continue to eat the foods we enjoy; however, some people may start to experience mobility and tooth loss. Keeping teeth as clean as possible can help to maintain gum support around the teeth, keeping them in the mouth for longer.

It is vital to keep brushing twice a day for two minutes with a toothpaste containing 1,350-1,500ppm fluoride. If you are at a high risk of dental caries, your dentist may prescribe a high-strength fluoride toothpaste to use.

Cleaning between the teeth can help remove plaque and food deposits, reducing the risk of dental caries and gum disease but if dexterity is an issue, it may be necessary for adaptations to be made.

Electric toothbrushes may help improve access.

U-shaped toothbrushes may also be useful as these have a wider handle.

Wearing dentures may make it harder to keep teeth clean as plaque can gather where the denture sits against the natural teeth. Always remove dentures when brushing teeth and make sure to brush the sides of the teeth where the denture sits. It may help to move the lip out of the way so that you can see if the toothbrush is cleaning along the gum margin effectively. Using a magnifier and a light may help improve visibility when brushing.

Some medications can cause a dry mouth and reduce the amount of saliva in the mouth. Saliva helps protect teeth from dental decay so speak to your dental team about saliva substitutes.

Visit the dentist regularly, every six months or at least once a year.

Oral Health Advice during Pregnancy

Some women experience sore and swollen gums during their pregnancy. Bleeding gums are caused by plaque build up but hormonal changes during pregnancy can make gum more prone to plaque, leading to inflammation and bleeding. This is called pregnancy gingivitis or gum disease.

It is important to continue with your normal oral hygiene routine during pregnancy, brushing twice a day for two minutes with a toothpaste containing 1,350-1,500ppm fluoride. This may feel like a challenge, especially in the first trimester if you are experiencing morning sickness but keeping your mouth healthy during pregnancy will help your gum health settle quickly after your baby has been born.

If you have morning sickness (nausea and vomiting), rinse your mouth with plain water after each time you are sick. This will help prevent the acid in your vomit from damaging your teeth.

Do not brush your teeth straight away as they will be softened by the acid from your stomach. Wait for around one hour before brushing your teeth.

Regular consumption of sweet food and drinks can increase the risk of dental decay, therefore avoid having too often and keep to mealtimes only. If you’re hungry between meals, snack on vegetables, fresh fruit or plain yoghurt, avoid sugary or acidic foods.

Oral Health & Smoking

Smoking can cause several negative side effects in the mouth including staining of the teeth, gum disease, tooth loss and in some severe cases, oral cancer.

Staining is caused by nicotine and tar in the tobacco. At first this can make the teeth appear yellow, but over time and with heavy smoking, this can make the teeth brown.

Smoking increases the risk of gum disease as the amount of oxygen in the bloodstream is reduced, limiting how much can get to the teeth and gum, slowing down healing in the gum. Overtime, this causes the bone holding the teeth in place to shrink and the teeth can become loose. Another side effect of smoking is a dry mouth, this can cause increased plaque build-up, speeding up the progression of gum disease more quickly for smokers than in non-smokers.

While many people are aware that smoking can cause lung cancer, it can also cause cancer in the throat, mouth, tongue and lip. Mouth cancer can appear as a painless mouth ulcer that does not heal normally. White or red patches in the mouth can also develop into cancer. Check for any unusual lumps in your mouth or jaw area and any persistent hoarseness in your throat. If you notice anything in your mouth that doesn’t heal within three weeks, visit your dentist to get it checked.

Keeping your mouth healthy:

  • Stop smoking, and if you drink, reduce your alcohol intake.
  • Eat a balanced healthy diet, aim for at least five portions of fruit and vegetables per day.
  • Keep sweet food and drinks to mealtimes.
  • Brush teeth twice a day for two minutes with a toothpaste containing 1,350-1,500ppm fluoride.
  • Clean between your teeth daily.
  • Visit the dentist regularly (at least every six months).

Gum disease

Gum disease is a condition where the gums become red, swollen, sore and bleed.

There are two main forms of gum disease:

Gingivitis is a mild form of gum disease and is caused by poor oral hygiene. Plaque deposits around the gingival tissues cause swelling, inflammation and bleeding gum. Gingivitis can be reversed by improving oral hygiene techniques. If oral hygiene does not improve, gingivitis can progress to periodontitis.

Periodontitis is a chronic inflammation involving the supporting tissues around the teeth with largely irreversible tissue damage and if left untreated can lead to tooth loss and impact on a patient’s quality of life.

Local risk factors for gum disease:

  • Plaque and calculus
  • Tooth position
  • Partial dentures
  • Overhanging restorations

Systemic risk factors:

  • Smoking
  • Diabetes
  • Poor diet
  • Certain medications
  • Stress
  • Genetics
  • Pregnancy

There is emerging evidence that alcohol, nutrition and obesity may also play a role.

Symptoms of gum disease include:

  • Bleeding gums
  • Swollen, red and sore gum
  • Bad breath

You should visit a dentist if you notice any of these.

You can also help prevent gum disease by:

  • Brushing teeth twice a day for two minutes with toothpaste containing 1,350-1,500ppm fluoride
  • Spit after brushing and do not rinse
  • Clean between the teeth daily with floss or interdental brushes
  • Change your toothbrush or toothbrush head every three months
  • Visit the dentist or hygienist every 3-6 months
  • Minimise alcohol consumption
  • Stop smoking
  • Eat a balanced diet, include at least five portions of fruit and vegetables per day
  • Keep sugary food and drink to mealtimes


Anyone can suffer from sensitive teeth at any time in their life. Symptoms may vary from mild twinges to discomfort that lasts for several hours.

Why do we get sensitivity?

Our teeth are covered in a layer of enamel which protects a softer layer called dentine underneath. Enamel is very thin and can easily wear away, exposing the dentine, causing sensitivity. This can often happen where the tooth meets the gum as this is where enamel is at its thinnest.

What causes sensitivity?

  • Brushing too hard
  • Acidic foods and drinks
  • Gum recession
  • Gum disease
  • Grinding teeth
  • Cracked or broken teeth
  • Broken filling
  • Teeth whitening

There are toothpastes available designed to treat the symptoms of sensitivity, if these do not ease your symptoms, visit the dentist who may be able to provide treatment options to help. This may include applying high strength fluoride gel to the teeth or replacing fillings.

How to prevent sensitive teeth:

Check your toothbrushing technique. Aggressive brushing can cause the enamel to wear away, use a circular brushing technique and avoid scrubbing the teeth. Some electric toothbrushes have pressure sensors, and these can help prevent overbrushing.

Spit don’t rinse after brushing. This keeps the fluoride on the teeth for longer which can help strengthen the teeth.

Consider your diet, especially what you are drinking. Fruit juice, fizzy drinks and wine are all very acidic so regular consumption may cause the enamel to erode. This is the same for sugar free drinks. Some people recommend hot water and lemon drinks first thing in the morning to help aid digestion, but this is also very acidic and long-term use will cause enamel erosion which could increase sensitivity. (Learn more about how food and drink can affect teeth on our diet page).

Do not brush your teeth straight after eating. When we eat, we create an acid environment in our mouths, brushing after food can cause the enamel to wear away. It is recommended to wait an hour before brushing.

Keep sugary food and drinks to mealtimes.

If you grind your teeth, speak to your dentist about having a mouthguard made.

Visit the dentist regularly.

Tooth Decay

Tooth decay is the breakdown of tooth tissue, and it is caused when plaque bacteria combine with dietary sugars, producing acids which demineralise the tooth surface, causing cavities.

Tooth decay may not cause any symptoms initially but over time, may cause pain, sensitivity and discolouration of the tooth. A hole may also develop in the tooth which may lead to an infection.

It is important to have regular dental check ups so that tooth decay can be detected early.

The following can help prevent tooth decay:

  • Brush teeth for two minutes twice a day with a toothpaste containing 1,350-1,500ppm fluoride
  • Spit don’t rinse after brushing; this will keep the fluoride on the teeth for longer and help protect the teeth from decay
  • Clean between your teeth every day with floss or interdental brushes
  • Keep sugary food and drinks to mealtimes only
  • Eat a balanced diet, include at least five portions of fruit and vegetables per day
  • Visit the dentist regularly, every six months or at least once a year

(See our diet page to learn more about how food and drink can affect the teeth)

Diet and oral health

A balanced diet is important for general health and the Eatwell Guide shows how to achieve this by recommending how much of each food group we should be consuming. The majority of our diet should come from fruit, vegetables and starchy carbohydrates. We should also consume protein, dairy and a small amount of fat. Foods such as crisps, biscuits, cake, and chocolate are not included within the Eatwell Guide as they are not needed in our diet, and for this reason, they should be eaten less often.

Not only does what we eat and drink affect our bodies, it also affects our teeth. This is because every time sugary foods and drinks are consumed, the sugar reacts with bacteria in the mouth and produces acids. Over time, these acids attack the enamel on the tooth surface causing holes to develop, eventually creating cavities. Regularly consuming food and drink containing sugars increases the number of acid attacks and therefore, increasing the risk of tooth decay.

Sugar can be found in many everyday foods and drinks and all sugar can cause tooth decay. Sugar also has many names, ingredients that end in ‘ose’ are sugars and these include glucose, fructose, and sucrose. Other names for sugar are honey, maple syrup, agave syrup, treacle, caramel and many more.

To find out how much sugar is in a product, we can read the ingredients list or see if that item has traffic light labelling on the front of the packet. Traffic light labelling shows whether a product is high (red), medium (amber), or low (green) in fat, saturated fat, salt and sugars, and how much energy (calories and kilojoules) it provides.

The traffic light labelling can help compare between products and help to make healthier choices, when choosing items, it is recommended to opt for more greens and ambers and less reds.

So how much sugar should we be having?

The government recommend that the amount of free sugars, (those added to food and drinks, and sugars found naturally in honey, syrups, unsweetened fruit and vegetable juices, smoothies and purees), should not make up more than 5% of the energy we get from food and drink. Public Health England have the following recommendations to keep our bodies and mouths healthy.

Adults should have no more than 30g of free sugars a day (7 cubes of sugar)

Children aged 7 to 10 should have no more than 24g of free sugars a day (6 cubes of sugar)

Children aged 4 to 6 should have no more than 19g of free sugars a day (5 cubes of sugar)

Children under 4 are recommended to avoid food and drinks containing sugar.

What about the sugar in fruit?

Fruit is recommended as part of a healthy diet, and while it does contain some naturally occurring sugars, having a couple of portions of whole fruit each day will not be damaging to teeth. Fruit has many benefits as it contains fibre and a variety of vitamins which can keep our body and gum healthy.

However, having too much fruit or having it in juices and smoothies, can be harmful to teeth. This is because fruit contains acid so if it is consumed in excess, it can cause erosion of the teeth. Also, when fruit is blended, the sugars are then classed as free sugars. Therefore, it is better to ‘eat fruit, don’t drink it’.


Fizzy drinks and juice should be limited due to the sugar content and acidity. Regularly consuming sweetened beverages will increase the risk of tooth decay and cause acid erosion. Sugar free drinks can also cause acid erosion. Drinks including hot water and lemon, or apple cider vinegar should also be avoided as these are very acidic and will erode the enamel on teeth.

To keep teeth healthy, stick to water, milk, unsweetened tea or coffee.

While it may not be possible to cut out all sweetened drinks from your diet, if you do have any, keep them to mealtimes.

Making healthy choices

The NHS food scanner app is a great way to help keep us healthy. Scanning the barcodes of food and drink items can help check if they are a healthy option or if there is a better alternative to have.

Download the NHS Food Scanner app


  • Eat a balanced diet
  • Get your 5-a-day
  • Reduce the amount and frequency of food and drinks containing sugar
  • Eat your fruit, don’t drink it
  • Drink water, milk, unsweetened tea and coffee