Oral Health

Our public health and early years policies, including Hall 4, Better Health Better Care, Equally Well and The Early Years Framework, all outline the commitment to improve the oral health of infants and young children.

Childsmile is a national programme designed to improve the oral and general health of children in Scotland and reduce inequalities. 

Visit the Childsmile website.

First Teeth, Healthy Teeth is a practical guide for health visitors/public health nurses and others to provide clear, up-to-date information about oral health to parents and care givers.

Download a copy of the guide.

Oral health inequalities in the early years

Children's first teeth have a crucial role in supporting good nutrition, speech development and dental health.

Children from the most deprived areas suffer disproportionately from tooth decay, with a linear gradient across society.

Resources and interventions are available to promote dental health in the early years.

Quick links:

What are health inequalities?

The WHO defines health inequalities as "differences in health status or in the distribution of health determinants between different population groups."

For a fuller discussion, please see Inequalities in the early years.

Policy context

Activity in this area is consistent with commitments and priorities detailed in the Early Years Framework and the National Parenting Strategy, Equally Well, Achieving our Potential, a range of NHS Scotland's Quality Indicators, maintenance of the 2010 Health Improvement, Efficiency, Access, Treatment (HEAT) target nine for child oral health and is relevant to Scotland's national practice model for child-centred services - Getting it Right for Every Child (all external links).

How do inequalities impact on children's oral health in Scotland?

There is a strong link between living in a deprivation (poverty) and poor oral health in children right across society.

The National Dental Inspection Programme collects reports on the dental health of children in Scotland in Primary 1 (5 year olds) and Primary 7 (11 year olds). It categorises results using the Scottish Index of Multiple Deprivation quintiles, where quintile 1 represents the most deprived areas and quintile 5 the least deprived.

In 2012, quintiles 2,3,4 and 5 continued to meet the 2010 HEAT target of 60 per cent of children having no obvious experience of decay, while for children in the most deprived fifth of areas the figure was 50.5 per cent. (NDIP Report (external link)).

In 2012, in ten out of 14of Scotland's regional health boards, overall rates of registration with an NHS dentist were lowest in the most deprived areas (ISD Scotland: Registrations and Participation analysis in NHS General Dental Service (external link)).

Among groups classed as low service users in the early years (across all services and including dental health services), low socioeconomic status was the most significant association with low service use.

Other factors included:

  • families with mothers who had lower educational qualifications
  • who were in routine or semi-routine occupations or who had never worked
  • who worked part time or were not in employment.

Having a child with a long-standing illness or disability was also associated with low service use (Growing up in Scotland: Parental service use and informal networks in the early years (external link)).

Identifying those at risk of poor dental health

Although children living in the most deprived areas of Scotland have a higher prevalence of dental decay, in 2012 over a third of all children in Scotland in primary 1 had some obvious decay experience (National Dental Inspection Programme Report (external link)).

It is important therefore that all parents and carers are made aware of good oral health practices and that they and their children register with and visit their dentist regularly.

A Pathway of Care for Vulnerable Families (0-3) (external link) sets out key contact points and interactions for those working with vulnerable families.

For specific advice for various workforce groups, please see How can I help address inequalities and support oral health?

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The Childsmile programme

The national Childsmile programme was created in response to Scotland's poor record in dental health and inequalities in dental health.

The universal 'core' programme is for all children in Scotland and consists of:

  • a free toothbrush, 1000ppm fluoride toothpaste and information leaflet delivered on at least six occasions by age 5
  • a free-flow feeder cup delivered by age 1
  • free, daily, supervised toothbrushing in all nursery schools
  • twice-yearly fluoride varnishes delivered at dental practices from age 2.

Further interventions are targeted at children living in areas of higher deprivation. These include twice-yearly fluoride varnishes delivered in nurseries and schools and enhanced support for vulnerable families via dental practices and dental health support workers.

Read more about Childsmile (external link).

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Articles in this topic



Professional support materials

Information for the public

  • External Resource

    British Dental Health Foundation

    Information for the public and professionals, with access to promotional material for National Smile Week.

    • When was this published? 9/24/2010
  • External Resource

    Directory of NHS dentists

    A directory of NHS dentists in Scotland. For help finding an NHS dentist you can also call the NHS Helpline on 0800 224488.

    • When was this published? 5/6/2013
  • External Resource

    First Teeth, Healthy Teeth: A guide for health professionals, parents and carers (NHS Health Scotland, 2010) [2.7MB]

    A guide to oral health care for infants and young children.

    • When was this published? 8/17/2010
  • External Resource

    Ready Steady Baby!

    A website for the public providing information and advice through pregnancy and the baby's first days.

    • When was this published? 8/18/2010
  • External Resource

    Ready Steady Toddler!

    A website for the public with information, tips and advice for bringing up toddlers.

    • When was this published? 9/30/2010
  • External Resource

    You and your baby

    A book for new parents with learning disabilities. This book is available free of charge to Early Years professionals in Scotland as an alternative to Ready Steady Baby! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011
  • External Resource

    You and your little child

    Book for parents with learning disabilities with children aged 1 - 5 years. This book is available free of charge to Early Years professionals in Scotland from NHS Health Scotland as an alternative to Ready Steady Toddler! To order contact nhs.HealthScotland-EarlyYears@nhs.net.

    • When was this published? 2/15/2011