Back to school: one in four children has tooth decay. Here's what works

The Royal College of Paediatrics and Child Health published its State of Child Health 2026 report in July, and the dental chapter did not pull its punches. Roughly one in four children in the UK has visible tooth decay. Progress, which was steady for two decades, has stalled since 2020. The report warned that the UK risks raising “one of the unhealthiest generations of children in decades”. With the new school year under way in Stevenage, here is what the report found, what the evidence says actually works, and how we look after children at Bowling Green.

What the RCPCH report found

• Around 22% of five-year-olds in England had obvious tooth decay in 2024. In Scotland and Wales it was 27%
• In the poorest areas of England the figure was 32%, against 14% in the wealthiest
• Tooth extractions for children aged 0 to 19 cost the NHS in England £74.8 million in 2024
• Tooth decay remains one of the most common reasons for children aged five to nine in England to be admitted to hospital

What makes this frustrating is that tooth decay is almost entirely preventable. The report's recommendations, which include supervised toothbrushing in schools, dental checks by a child's first birthday and limits on sugar in baby food, are all things we already know work. The problem is access: the August 2026 NHS figures show that 40% of children in England did not see an NHS dentist in the last year.

The four things that actually prevent decay

Dentists are sometimes accused of overcomplicating this. The evidence base is actually quite simple.

• Brush twice a day with fluoride toothpaste, and spit rather than rinse. Rinsing washes the fluoride away. For children aged three to six, use a pea-sized amount of toothpaste with at least 1,000ppm fluoride. From seven, a family toothpaste with 1,350 to 1,500ppm. Check the tube; the number is on the back.
• Brush for them, or with them, until at least seven. Children do not have the dexterity to do it properly on their own before then. Last thing at night is the one that matters most.
• Keep sugar to mealtimes. It is the frequency of sugar, not the amount, that drives decay. A packet of sweets eaten in one go does far less damage than the same sweets grazed across an afternoon. Juice and squash in a bottle or sippy cup are the worst offenders we see.
• See the dentist regularly from an early age. Fluoride varnish applied twice a year at check-ups reduces decay significantly, and a child who has been to the dentist a dozen times for pleasant, quick visits is not a child who is frightened when a filling is eventually needed.

Back to school: the practical bits

September is a natural reset point. A few things we suggest to parents at this time of year:

• Water or plain milk in the school bottle. Nothing else.
• If there is a packed lunch, put the sweet thing in the lunch box rather than the snack box, so it is eaten with the meal.
• Move the toothbrush to somewhere it will be seen in the morning rush. A brush on the kitchen windowsill gets used.
• Book the check-up now while the diary is still relatively clear. October and November fill quickly.
• For children who play rugby, hockey or football, a custom mouthguard is cheaper than the front tooth it saves.

Children's dentistry at Bowling Green

We see children from the age of five. A child examination is £31 and includes a check of every tooth, a look at how the adult teeth are coming through, fluoride varnish where appropriate, and some honest, unhurried advice for parents. Samantha, our dental nurse, has twenty years' experience of putting nervous children at ease, and Dr Alan uses a tell-show-do approach: he explains, he shows the child the instrument, and only then does he use it.

We are also experienced with children who have additional needs. Autistic children, children with ADHD and children with sensory differences are all welcome, and we support the Hidden Disabilities Sunflower scheme. Extra time, a quiet first visit with nothing done, and a parent in the room throughout are all normal here. There is more on our SEN-friendly dentistry page. We do not offer sedation, so for children whose needs go beyond what a gentle general practice can manage, the right route is the NHS Special Care Dental Service, and we will help you get there.

For families who want to budget, children can be added to a parent's Denplan plan so that routine care is a fixed monthly amount. Full details of everything we offer for children are on the children's dentist page.