The early years of a child’s life are crucial for their overall health and development, and good nutrition and oral health plays a key role in shaping this. The first 1000 days, from pregnancy to a child’s second birthday, are a critical window for establishing healthy habits that can last a lifetime. Lack of balanced meals and poor nutrition foods can lead to poor oral health, obesity and long-term developmental issues. Unfortunately, many young children suffer from tooth decay due to excessive sugar consumption and lack of proper oral health habits.

Nurseries are in a unique position to support children and families by promoting good oral hygiene and healthy eating habits. By implementing assisted brushing programs and encouraging nutritious diets, nurseries can help prevent dental problems, improve overall wellbeing, and set children on the path to a lifetime of healthy smiles.

Oral health plays a crucial role in a child’s overall health and wellbeing. Despite improvements over the past 20 years, almost a quarter of 5-year-olds in England have tooth decay.

Children are at more risk of developing tooth decay if they:

• eat a poor diet
• brush their teeth less than twice per day with fluoride toothpaste
• reside in areas of greater deprivation
• don’t have access to local NHS paediatric dental care

Nutrition and oral health in the first 1000 days

The first 1000 days of a child's life are a vital period for development. During this time, the brain, body and immune system undergo rapid growth and development. Good nutrition is crucial in ensuring that a child receives the necessary nutrients for optimal growth, including those that support the development of teeth and gums.

Inadequate nutrition during this period, especially if it involves excessive sugar intake, can significantly impact oral health. Poor nutrition can lead to the early onset of dental issues such as tooth decay, which, if not addressed, can affect a child’s ability to eat properly and cause long-term damage to their dental health.

For instance, excess sugar consumption, particularly from fruit juices and fizzy drinks, is a primary cause of tooth decay. The bacteria in the mouth feed on sugars, producing acid that damages tooth enamel, leading to cavities. During the first 1000 days, it’s vital to establish healthy eating patterns that promote strong teeth and overall health. Ensuring the child’s diet is rich in essential vitamins and minerals, such as calcium and phosphorus, which are crucial for building strong teeth, will help set them up for good oral health in the future.

Nurseries hold a unique position in shaping children’s eating habits and oral health. By implementing assisted brushing programs, and providing nutritious meals and promoting healthy eating practices from a young age, nurseries can lay the foundation for long-lasting healthy habits.

The growing issue of poor oral health in children in certain parts of the country

In 2025, poor oral health remains a persistent issue in the UK, particularly in deprived areas. Children from low-income families often experience the worst outcomes, suffering from limited access to suitable educational materials and dental care, and tending to have a higher consumption of sugary foods and drinks (Royal College of Surgeons, 2023). Ethnic minority groups also face additional challenges, including socioeconomic disparities and limited access to cultural dietary and language specific resources, and are less likely to access local dental services (Public Health England, 2021).

Tooth decay continues to be one of the leading reasons for hospital admissions among young children (NHS Digital, 2023). Poor dietary choices, excessive sugary drinks, fruit juices and fizzy beverages, along with inadequate oral hygiene, such as lack of brushing, contribute to this ongoing issue. Despite parents’ best efforts, some children struggle to brush their teeth effectively at home, making supervised brushing in nurseries a valuable practice.

The role of healthy eating in oral health

A balanced diet is essential for maintaining good oral health. Excess sugar consumption, particularly from fruit juices and fizzy drinks, is a major driver of tooth decay. To promote better oral health, it’s crucial to encourage healthier eating habits from an early age (World Health Organization, 2022). Nurseries can support this by:

• Offering Balanced Meals: Providing meals that are rich in minerals, snacks that are low in added sugars and rich in vitamins and minerals, particularly calcium and phosphorus, to help build strong teeth (British Nutrition Foundation, 2023). Using Nutrition Ed portion plates* is a great way to support early portion and  teach children about food groups.
   
• Promoting Water and Milk: Encouraging children to drink water or milk rather than sugary drinks, fruit juices, or fizzy beverages. While at the same time educating parents about the importance of avoiding milk through bottle during the night-time due to the risk of developing nursing bottle caries.
   
• Avoiding Bottles: Encouraging the use of cups instead of bottles and increase in water consumption helps prevent prolonged exposure to liquids that can lead to tooth decay, especially during sleep times. Using cups such as Nutrition Ed Bamboo cups* promotes better oral hygiene habits and helps prevent "bottle tooth decay," which is a common issue when children drink sugary liquids from bottles for extended periods
   
• Educating Families: Sharing information with parents about the impact of diet on oral health and offering culturally appropriate dietary recommendations. Educate parents about the importance of toothpaste size which is appropriate to the child age.

When nurseries combine healthy eating with assisted brushing programs, they can significantly reduce the risk of dental issues in young children.

What is assisted brushing?

Assisted brushing is a practice where nursery staff supervise and guide children as they brush their teeth, ensuring they use the correct techniques and brush for the recommended two minutes (Scottish Government, 2021). For younger children still developing their motor skills, staff may offer hands-on assistance.

Why implement assisted brushing in nurseries?

Assisted brushing in nurseries offers several benefits:

• Promotes Consistency: Establishing a daily brushing routine at nursery reinforces home brushing, helping children develop consistent habits.
• Early Intervention: Trained nursery staff can spot early signs of dental issues and encourage parents to seek prompt dental care.
• Educational Benefits: Children learn the correct brushing techniques through guided practice, making oral care a natural part of their routine.
• Encourages Peer Learning: Children are often more excited to brush when they see their peers doing the same, promoting positive reinforcement.

Conclusion

Assisted brushing programs in nurseries offer a practical and impactful solution to tackle childhood tooth decay and prevent oral health complications. By fostering positive oral hygiene habits and promoting healthy eating, nurseries play an essential role in ensuring that children grow up with strong, healthy smiles.

Nutrition and oral health in the first 1000 days are essential not only for physical health but also for a child’s cognitive and emotional development. Encouraging the use of bamboo cups* for milk and water, avoiding bottles, and combining these practices with assisted brushing creates a holistic approach to oral health that can set children on the right path for a lifetime of healthy smiles. Let’s continue to work together to prioritise healthy eating and oral health and give every child the best early start as possible.

*For nutrition Ed Plates, cups and toothbrushes visit www.nutritioned.uk