Effective preventive practice

Pea sized amount of toothpaste

Statement 2(a)

Children use an appropriate and effective quantity of toothpaste whilst minimising cross-contamination.


Regular daily brushing with an appropriate fluoride toothpaste is highly effective in preventing dental decay. Good oral hygiene practice should be established at an early stage in a child’s life and become an integral part of normal daily hygiene.


2.1.6_Smear of toothpaste
  • Toothpaste provided by the programme, containing at least 1000 parts per million (ppm) fluoride is used.
  • A smear of toothpaste is used for children under 3 years and a pea-sized amount for children 3 years and over.
  • Where toothpaste is shared, a supervisor dispenses it onto a clean surface such as a plate or paper towel.
  • There is sufficient spacing between the quantities of dispensed toothpaste to allow collection without cross-contamination.
  • Toothpaste must only be dispensed at the time the child is ready to brush.
  • Where children have their own tubes of toothpaste and dispense it, they should be closely supervised.
  • Supervisors should cover any cuts, abrasions or breaks in their skin with a waterproof dressing

Statement 2(b)

Toothbrushes and brushing techniques are appropriate and are able to be used effectively by each child.


Toothbrush size and shape influences the effectiveness of brushing. Brushing programmes should work towards establishing toothbrushing techniques for the developing child.


  • Toothbrushes and brushing techniques are appropriate to the age and ability of the child.
  • Toothbrushes are replaced at least once a term, or sooner if required (for example, when the bristles become splayed).
  • Toothbrushes are individually identifiable for each child.

Statement 2(c)

Toothbrushing is organised in a safe and effective way which is integrated with nursery, school and home routines.


Children should be supervised while brushing their teeth. Toothbrushing programmes should be integrated into normal nursery and school routines to ensure maximum compliance.


  • Children are supervised when brushing their teeth.
  • Toothbrushing takes place at a time which is most suitable for each establishment.
  • Toothbrushing takes place in groups or individually with children seated or standing.
  • Children are discouraged from swallowing toothpaste during or after brushing their teeth.
  • After toothbrushing, brushes are rinsed thoroughly and individually under cold running water and replaced in the storage system to allow them to air dry.
  • The toothbrushing programme uses one of two models outlined in the appendices Nursery toothbrushing models.