Small teeth, big opportunities: strengthening oral health communication in early years settings

BACKGROUND: Dental caries remains a significant public health issue across the UK. Early years settings, such as nurseries and preschool playgroups, provide a unique opportunity to promote oral health, yet implementation of oral health interventions varies widely. This study explored early years professionals' and parents' views on oral health activities and conversations undertaken within early years settings in a socioeconomically and ethnically diverse English city. METHODS: Semi-structured qualitative interviews and focus groups were undertaken with early years professionals and parents of children aged 0-4 years old. Topic guides were informed by the COM-B model. Interviews and focus groups were audio-recorded, transcribed, anonymised, and analysed using reflexive thematic analysis in NVivo. RESULTS: Sixteen early years professionals and fourteen parents participated. Three key themes were identified. (1) Collaboration between early years settings and home: parents valued the authority of early years staff in encouraging oral health routines, while staff highlighted the importance of trust and clear communication to support shared responsibility. (2) Embedding oral health in practice: staff were motivated to promote oral health and often created innovative activities, such as songs, role play, and links to healthy eating, which families reported as beneficial. (3) Sustaining oral health beyond the setting: parents acknowledged that maintaining routines at home could be difficult, but described how structured practices within early years settings, alongside peer influence and regular reinforcement, supported children's engagement. Both groups recognised the value of early years settings in supporting oral health but highlighted some inconsistency in delivery and uncertainty around roles. While structured routines were seen as effective, sustaining behaviours beyond the settings remained a challenge. CONCLUSION: Early years settings have strong potential to promote children's oral health. Building on existing creativity, consistent training, clear communication, and stronger links with dental services could help ensure these efforts are sustained and equitable.