Exploring how supervised toothbrushing in early years settings influences home toothbrushing in young children: a qualitative study

Abstract Background Previous studies have shown that supervised toothbrushing programmes in nurseries and schools are effective in preventing dental caries among young children, particularly those living in deprived areas, yet little is known about how supervised toothbrushing (STB) influences toothbrushing behaviours at home. Aim To explore the perspectives of children, parents and nursery/school staff of how STB influences home toothbrushing. Design A qualitative study was conducted in two educational settings in England (one nursery and one primary school) delivering STB. Semi-structured interviews and focus groups with children, parents, and staff ( n = 37) were conducted and analysed using a framework approach, guided by the Theoretical Domains Framework (TDF). Results Three overarching themes were identified: (1) Value of the STB, parents and staff perceived STB as beneficial for improving children’s oral health, encouraging increased independence when brushing their own teeth, oral health knowledge, and school readiness; (2) Brushing with classmates and staff, peer and teacher modelling normalised toothbrushing and encouraged participation; and (3) Link between STB and home toothbrushing, school routines and consistent messaging supported home toothbrushing, however, limited communication between nurseries/schools and families constrained impact. Parents were supportive of having take-home resources and interactive tools to promote toothbrushing at home. Conclusions While STB did appear, to some extent, to promote home toothbrushing there is further scope for this link to be strengthened through improved communication, demonstrations, co-designed take-home materials and resources to maximise the opportunity for promoting positive family-based oral health behaviours through STB.