North Central London’s Dental Transformation Programme shows what’s possible when dental care is prioritised and shaped locally.
A deep-dive exercise into dental health inequalities in NCL identified a clear link between deprivation and poor oral health outcomes in children, including much higher hospital admissions for tooth decay. Children from our most deprived wards not only experience more severe tooth decay but also face associated anxiety, school absence, and long-term health risks, reinforcing the cycle of inequality.
NCL ICB has invested in dental services to improve access and outcomes and has worked with partners and residents to co-design creative initiatives to drive behavioural changes.
Working closely with Whittington Community Dental Service, local authorities, public health teams, schools, and charitable organisations, the programme is preventing problems early and reaching those children most at risk.
Key initiatives:
- Supervised Toothbrushing Programme (STB): this targets 3-4-year-olds in early years settings in the most deprived wards. Staff are trained to deliver daily toothbrushing sessions and promote good oral health. STB is reinforced by educational materials for parents and policies promoting healthier food and drink choices. ICB funding supplements local and national funding.
- Giving Up Loving Pop (GULP): Delivered by Tottenham Hotspur Foundation to Key Stage 2 children (aged 7-11) in 20 schools in high-deprivation areas, focusing on sugar reduction, hydration, oral hygiene, and physical activity.
- Dental General Anaesthetic (GA) suites and weekend clinics: NCL ICB has commissioned expanded community capacity to treat children, reducing reliance on secondary care and waiting times.
These initiatives have had a significant impact with STB reaching over 1,000 children and trained 280 staff. One early years staff member fed back: “children enjoy it and… even prompt each other to brush the back teeth themselves”. Parents felt the initiative is “healthcare on the doorstep,” and children said they will “stop rotty teeth with the toothpaste and toothbrush.”
GULP reported increased preference for water (in school: 51.1% to 79.2%; sports: 21.3% to 49.7%), and daily toothbrushing improved from 47.1% to 61.8%. Other Premier League clubs have been in touch to express their interest in replicating the initiative locally.
The ICB’s investment in additional clinics reduced acute referrals by 85%, increased GA appointment capacity by 65%, and cut waiting times from 21 to 17 weeks.
Rakhee Patel, Deputy Chief Dental Officer for NHS England and Chair of the NCL Dental Transformation Board commented: “NCL’s collaborative, patient-centred approach is making a measurable impact on oral health improvement and the reduction of health inequalities. By prioritising oral health as a key element of overall wellbeing and working across public health and primary care, NCL is setting a strong example for integrated, equitable healthcare.”