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Innovative apps and games could hold the key to improving children's oral health

Article By: Ellie Spanswick, News Editor

Recent figures revealing the tens of thousands of young children undergoing major dental surgery to remove decayed teeth has led to increased calls from educators, campaigners and health professionals to introduce a ‘sugar tax’ on soft drinks and introduce dental health education in the early years.

Designers, educators and dental professionals have been finding ways to be more creative to help prevent child tooth decay and encourage children to have good oral health from an early age.

Some of the latest innovations in dental health technology include London based Play Brush and France based Kolibree which provide children with the technology to play games as they brush their teeth.

Ben Underwood, dentist and creator of Brush DJ

Brush DJ is the work of dentist and NHS Innovation Accelerator fellow, Ben Underwood, who developed the free tooth brush timer app to help make brushing less boring for its users by allowing them to listen to some of their favourite music as they brush.

He explained: “Every year approximately 26,000 young children are admitted to hospital in England to have decayed teeth extracted under a general anaesthetic, making this preventable disease the most common reason for children between the ages of five and nine to be admitted to hospital. The decay that results in these teeth needing to be extracted often starts before the age of five.

“Children start to get teeth from the about six-months-old and as soon as they erupt into the mouth there is a risk of tooth decay. An effective daily oral hygiene routine from as soon as teeth erupt can prevent the build-up of dental plaque, which causes tooth decay."

'Raising awareness and reducing the need for invasive treatments'

A recent survey conducted by the British Dental Health Foundation found that almost 60 per cent of women and 35 per cent of men skip brushing their teeth at bedtime, creating a worrying trend for younger generations who will learn basic dental hygiene from their parents.

Mr Underwood recognises that the idea of brushing to music to encourage people to brush longer is not new, and admits using the technique in dental school to help encourage patients to brush for longer. However, listening to music in the bathroom has become easier and more practical in recent years, with the increased availability of portable devices with built in speakers allowing someone to have access to thousands of songs at once.

Brush DJ allows its users to set reminders to brush twice a day, floss, use a fluoride mouthwash at a different time of day to brushing and when to next visit their dentist. So far Brush DJ has been downloaded in more than 190 countries worldwide, across more than 220,000 devices, while more are expected as an improved version of the app is already under development.

He continued: “The Brush DJ app contains the evidence-based oral health information given in the Public Health England document, ‘Delivering Better Oral Health’ on how best to reduce the risk of tooth decay from birth and upwards.

“This excellent document was sent to dentists, but sadly a public or patient facing version was never produced - Brush DJ is a public and patient facing version that aims to make this information accessible to anyone. Whilst awareness of this information by parents and carers is important, it is vital that the knowledge gained is actioned - hence the use of music to makes the mundane task of brushing for the correct length of time more fun and therefore more likely to happen.

“As an NHS general dental practitioner I see first-hand the distress experienced by children and their parents and carers that can result from tooth decay and its treatment.

“I am passionate about raising awareness of the Brush DJ app to help more people benefit from its use and therefore reduce their need for invasive and expensive dental treatment. I want children to grow up free from dental decay by motivating them to have an evidence-based oral hygiene routine and enjoying carrying this out every day of their lives."

A US study revealed that the average time spent brushing was just 46 seconds, substantially shorter than the recommended time of two minutes.

'An avoidable epidemic'

Earlier this year, figures from the Health and Social Care Information Centre revealed that more than 10,000 children under-five had teeth removed in hospitals in England between 1 April 2014 and 31 March 2015.

Chair of the British Dental Association, Mick Armstrong, said: "These new figures should offer a wake-up call to Government on its failure to get to grips with prevention.

“Under-fives are ending up in hospital for tooth extractions because successive Governments have treated oral health as an afterthought. An entirely preventable disease has been left to emerge as the leading cause of hospital admissions among children. That means paying a premium for general anaesthesia, when we should be saving pain and money by aiming to keep healthy teeth in healthy mouths.

“This evidence underlines the fact that oral health inequalities are widening. Today sugar consumption is driving decay, simple health messages are struggling to be heard, and dentists are told their priority isn’t prevention, but hitting Government targets. We are dealing with an avoidable epidemic, and are looking to Government for real leadership, not more half measures.”

A number of dental support schemes are already in existence to help reduce the number of children developing tooth decay and dental problems before they start school and encourage them to live healthy lives.

Dental Buddy was created by the British Dental Foundation, a not-for-profit organisation working to educate and inform people about their dental health choices and how they can improve their oral health and hygiene.

'Educators play a key role in all aspects of child development'

Dental Buddy

The Dental Buddy programme helps to encourage children to brush properly and for the recommended length of time, and supports dental professionals when they offer advice to children in an education setting.

The British Dental Foundation recognise that approximately 80 per cent of primary school children have already developed tooth decay as a result of poor dental hygiene and the significance of a child’s first experience of oral health can impact on the rest of their lives.

Director of educational resources at the British Dental Health Foundation, Amanda Oakey commented: "Educators play a key role in all areas of children's development as they are a trusted and familiar figure for them to learn and develop important behaviour from. They therefore can make a real difference when it comes to nurturing children's tooth brushing habits and improving their dental lifelong health.

“All of the schools and nurseries that we’ve worked with are very keen to ensure that all of the children in their care are being as healthy as possible. Unfortunately there is a lot to learn about teeth and if you’re not going to the dentist regularly or if your dentist isn’t talking with you, then you may not know that you shouldn’t brush your teeth straight after you’ve eaten for example.

“Brush Time offers all the right information to help nurseries with situations such as ‘open snacking’ where child come and go at different times of the day so they can still help the children to brush their teeth half an hour after snacking.”

Brush Time has been well received by nurseries and schools, similar to the ‘Designed to smile’ programme in Wales, an NHS dental programme, funded by the Welsh Government to help and encourage children from birth to key stage one to have healthier teeth.

Ms Oakey added: "“We assume that children brush their teeth last thing at night and first thing in the morning, when they might not be. The only tooth brushing they might get could be a school or nursery, so at least they’d be getting their teeth brushed and getting fluoride on their teeth, which is good for them.”

For more information on Brush DJ, visit: or to find out more about Dental Buddy and Brush Time, visit:


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