Oral Health

To nurture the skills of resilience is key to providing young people with the ability to cope with stress, adversity, failure and challenges. Resilience is evident when young people have a greater ability to “bounce back” when faced with difficulties and achieve positive outcomes.

Resilience is required to resist the temptation of sugary food and drinks and to pursue healthier alternatives.

24% of 5 year olds in Peterborough and 13% in Cambridgeshire were reported to have tooth decay (Oral health survey 2017).

A Public Health England survey of 224 five-year-olds in Peterborough found tooth decay in 38 per cent of children in the 2018-19 academic year. The latest population estimates from the Office for National Statistics show there are 3,347 five-year-olds in the area, meaning 1,260 may be suffering with dental problems.

In 2016-17, 32 per cent of children surveyed had tooth decay, suggesting that Peterborough children have poorer oral health now than they did two years ago.

The rate in 2018-19 was higher than that across the rest of the East of England, with 19% of five-year-olds in the region experiencing tooth decay – either present at the time of the dental exam, or evident because of missing or filled teeth. Affected children in Peterborough often had widespread issues, with multiple teeth affected showing signs of decay.  Of the children that were surveyed in Peterborough, six (3 per cent) had to have a tooth out – suggesting that around 90 children in Peterborough had required an extraction, aged five or younger. As high-street dentists are unable to administer a general anaesthetic, this normally requires a hospital visit.

And with hospital tooth extractions for children aged five and under costing £836 on average, extractions in Peterborough may have cost the NHS around £75,200 in 2018-19.

Nationally, 18,400 five-year-olds (23%) had tooth decay, and more than 1,700 children had teeth extracted

In a report, Public Health England said dental decay among young children “remains an important public health issue.”

“It leads to pain and distress, sleepless nights for children and parents, and time off school and work.

“Dental decay is largely a preventable disease. Further work to improve oral health and reduce inequalities is needed as nearly a quarter of five-year-olds had experience of dental decay, and the inequalities gap remains unacceptably high.” the report said.

In 2019, 23.4% of 5-year olds in England start school with tooth decay. There are significant inequalities in tooth decay levels between the most deprived (34.3%) versus the least deprived (13.7%) five- year-old children. Prevalence varied at regional level, ranging from 17.6% in the South East to 31.7% in the North West.

In 2013, 32% of 12-year olds and 44% of 15-year olds had tooth decay. 35% of 12-year-old children are too embarrassed to smile or laugh.

12% of 12-year olds have trauma to their permanent incisors

66% of 12-year olds and 75% of 15-year olds said that their dental health was good or very good


Raising awareness of the importance of oral health, as part of a ‘whole-school’ approach in all primary schools.

Introducing specific schemes to improve and protect oral health in primary schools in areas where children are at high risk of poor oral health.

Supervised tooth brushing schemes for primary schools in areas where children are at high risk of poor oral health.


  • Identify school staff who could be trained to provide advice and support to promote and protect pupils’ oral health. Train these staff to give:
    • Age-appropriate information adapted to meet local needs and based on the ‘advice for patients’ in Delivering better oral health.
    • Advice and information about where to get routine and emergency dental treatment, including advice about costs (for example, transport costs).
    • Advice and help to access local community networks offering information, advice and support about general child health and development.
    • Ensure trained staff set up and run tooth brushing schemes and support fluoride varnish programmes commissioned by local authorities (see recommendations 19 and 20).
    • Provide opportunities for staff to talk with parents or carers about, and involve them in, improving their children’s oral health. For example, opportunities might arise at parent-teacher evenings, open days or by encouraging parents and carers to get involved in developing the school food and drinks policy.
  • Promote a ‘whole-school’ approach to oral health by:
    • Ensuring, wherever possible, that all school policies and procedures promote and protect oral health (for example, policies on diet and nutrition, health and safety and anti-bullying should include oral health; see Standards for school food in England, Department for Education 2016).
    • Making plain drinking water available for free and encouraging children to bring refillable water bottles to school.
    • Providing a choice of sugar-free food, drinks (water and milk) and snacks (for example, fresh fruit). These should also be provided in any vending machines.
    • Displaying and promoting evidence-based, age-appropriate oral health information for parents, carers and children (this should be relevant to local needs and include details of how to access local dental services).
    • Ensuring opportunities are found in the curriculum to teach the importance of maintaining good oral health and highlighting how it links with appearance and self-esteem. This should use age-appropriate information, adapted to meet local needs and based on the ‘advice for patients’ in Delivering better oral health.
    • Identifying and linking with relevant local partners to promote oral health (see the NICE guideline on community engagement: improving health and wellbeing and reducing health inequalities). This could include oral health promotion schemes commissioned by the local authority and local community networks (see recommendation 3).


Dental problems such as tooth decay and gum disease are wholly preventable, but when present, can have a wide range of effects, not only causing pain and the need to remove decayed teeth, but affecting the ability to speak, eat, smile and socialise.

In 2018/19 there were 59,011 episodes of tooth extraction in hospital for children aged 0 to 19 years in England, a decrease of 303 from the previous year. In children aged 6 -10 years extractions due to tooth decay were particularly high – 23,709. The proportion of children aged 0 to 19 years having tooth extraction in hospital has remained at approximately 0.5% of the population since 2014/15.

An average of 3 days of school missed due to dental problems

Pupils should have the opportunity to learn at school what constitutes, and how to maintain, a healthy lifestyle, including the benefits of healthy eating and dental health and to recognise opportunities and develop the skills to make their own choices about food, and understand what might influence their choices and the benefits of eating a balanced diet.


  • Understand how sugary drinks can affect teeth.
  • Name ways to keep teeth healthy.
  • Understand that eating or drinking too much sugar causes tooth decay.



  • Design an experiment to show how sugary drinks can affect teeth.
  • Describe ways to keep their teeth healthy.
  • Understand that eating or drinking too much sugar causes tooth decay.


Source: PHE December 2020

Local Support

Awesome Smiles September Stations

Awesome Smiles September Stations is a new event funded by Cambridgeshire County Council to offer a whole school approach to Oral Health promotion, with free access to a resource pack.  All primary schools throughout Cambridgeshire and Peterborough are encouraged to set a date in September and have fun with a circuit of activity stations to encourage

Read More About Awesome Smiles September Stations

Raisin Awareness Project

The Raisin Awareness Project offers a whole school approach to promoting Oral Health covering many aspects as suggested in the NICE pathway Improving oral health in primary schools – NICE Pathways . The Raisin Awareness Project, set up by the not-for profit company Awesome Oral Health CIC, aims to link primary schools in Cambridgeshire and

Read More About Raisin Awareness Project