MANY toddlers in Bolton do not own their own toothbrush or clean their teeth every day.

Yet learning how to brush your teeth is one of the most important health routines you can learn as a child.

About one in five three-year-olds in Bolton have tooth decay, which is higher than the national average.

Bolton’s oral health team have been tackling the problem for more than 10 years by making oral hygiene fun and accessible.

Thanks to an injection of cash from Public Health, they are reintroducing their Brushing for Life and Keep on Brushing packs, which contain tooth brushes, tooth paste and advice for parents.

Little AJ Williamson, aged 17 months, is one of the youngsters to benefit from the Brushing for Life packs.

His mum, Natalie Rigg, said she started to get him used to brushing as soon as he cut his first teeth at 11 months.

Miss Rigg, from Smithills, said: “AJ cut his teeth quite late so when I first introduced him to a toothbrush he didn’t like it all. I think if he’d cut them earlier at about seven months it would have been easier.

“It was hard at first but he soon got used to it. He watches me brush my teeth and then I say: ‘Time to brush your teggies’ and he let’s me do it. I usually brush them for him and then let him have a go.

“He knows the routine now. I also got him registered with my dentist as soon as he was born. He’s been for his first appointment now and I think that will help get him used to visiting the dentist regularly.”

Jean Holgate, who manages Bolton’s oral health team, said the advice on looking after kid’s teeth is very simple.

She explained: “The main things you need to remember when looking after a child’s teeth are to get them brushing as soon as they have teeth, get them registered at a dentist and keep sugary drinks to a minimum.

“These are simple, preventative steps.”

Health visitors are giving out the Brushing for Life packs to parents on their child’s eight-month assessment.

Experts recommend parents use toothpaste with a fluoride level of at least 1000 parts per million (ppm) for children up to the age of three. After that, children should use toothpaste with a fluoride level of 1,350 to 1,500ppm. The level of fluoride can be found on the pack.

Mrs Holgate added: “The important thing is to get fluoride on children’s teeth as soon as they erupt. It’s also important people check the fluoride levels as some children’s toothpastes only has 500ppm, which is not enough.

“We do come across some children in nurseries who have never seen a toothbrush before, or share a toothbrush with other family members.”

Sugary drinks being given to children in baby bottles or sipping cups are also a huge threat to children’s teeth and cause a particular type of decay known as early childhood caries.

This affects the upper front teeth and spreads quickly to other teeth.

Experts advise parents to only give children milk or water in bottles or sipping cups, and restrict sugary drinks to mealtimes in a small, ordinary drinking cup.

Dr Peter Moss, chair of Bolton Local Dental Committee, said more money needs to invested in programmes like Brushing for Life in Bolton.

Dr Moss said: “The evidence tells us that Bolton’s children have poor oral health when compared with other areas of the country.

“While an improvement has been made in recent years we still lag behind the vast majority of England in oral health.

“Dentists see this on a daily basis: children in pain and often two to three years old with mouths full of rotten teeth. At that age often the only treatment possible is extractions under general anaesthetic.

“Tooth decay is entirely preventable. It occurs when food and drink containing sugars are consumed too frequently.

“This simple cause leads to a simple solution: educate people in healthy eating and with the use of fluoride, both in toothpastes and applied professionally, the condition vanishes.”

Fluoride in the general water supply would also improve everyone’s dental health, according to Dr Moss.

Cllr Ann Cunliffe, cabinet member for Public Health, said: “Improving the dental health of children in Bolton is a priority for us and we are pleased to see the return of the Brushing for Life scheme for all children aged eight months and two years and the extension of the brush bus to more primary schools in the borough.

"We have seen some progress in recent years but there is still a lot of work to be done.

"The oral health promotion team works very hard in the community, and with health partners, to tackle the issues around child oral health and we will continue to monitor progress and seek to develop ways to encourage improvement.”


  • Get your child registered with a dentist as soon as possible.
  • Children up to three years of age should use toothpaste with a fluoride level of at least 1,000ppm (parts per million). Many brands of children’s toothpaste are much lower, so check the packaging.
  • After three years of age, children should use toothpaste with a fluoride level of 1,350-1,500ppm.  
  • Children should be supervised when brushing their teeth until about seven.
  • Brushing your teeth in front of your children sets a good example and helps them learn the routine.
  • The amount of toothpaste your child uses is important. Up to the age of three, a smear of toothpaste is sufficient, and from age three to six, a pea-sized amount is recommended.
  • Encourage your child to spit the toothpaste out after brushing their teeth.