The EYFS welfare requirements are broken down into the following sections:
These sections remain the same and settings should already be aware of their statutory requirements under the EYFS for each of these.
The main change in the new framework comes in the form of a new addition to the welfare requirements where settings are now required to promote the “good oral health of children” which has been introduced following research by Public Health England that suggests that 1 in 5 children aged 5, have experienced tooth decay.
The aim of the new requirement is to reduce tooth decay in children and associated hospital admissions, since it is the most common reason for children aged 6 to 10 to be admitted to hospital to have teeth removed.
Precisely how settings promote oral health is not set out in the framework and it will be down to individual companies and nurseries themselves to decide how best to do this. The approach is one of promoting the welfare of the child and there is no requirement for practitioners to assess oral health, although, that said, a child who presents with very poor oral health might be cause for concern and may prompt a conversation with parents.
The framework clarifies that the changes relate to:
Teaching children about healthy eating habits, and Dental hygiene
It is not suggesting that settings need to carry out supervised toothbrushing, but this might be something that you wish to consider if you feel it would benefit the children in your care and there is more information on this below. The changes do not come into force until September 2021 however, so this is not a requirement until then and should not be judged within any Ofsted assessment before that
Early adopters do not have to follow this until September 2021 either although the DfE is hopeful that settings will begin to adopt these ideas as soon as practically possible.
Practical ways we aim to promote good oral hygiene
In practice, promoting good oral health includes:
There is no requirement in the revised EYFS to introduce supervised toothbrushing, but this is an initiative that some settings and schools have already adopted to promote good dental health. You can speak to your local authority about any schemes that they run.
There are two main toothbrushing programme models that have been promoted which are:
In 2016, Public Health England published guidance and a supervised toothbrushing toolkit supporting the commissioning and delivery of supervised toothbrushing programmes. It was aimed at both commissioners (local authorities) and providers of supervised tooth brushing programmes in England to make sure that programmes were evidence-based and safe for children and staff. It contained infection prevention and control advice and was also designed to ensure there was clear reporting and accountability. A 2014 report had previously recommended such schemes following some research.
The toolkit gives guidance on brushing techniques, how to practically undertake the brushing programme, how to clean and store toothbrushes and how to clean the areas used. It recommends brushing once a day for all children, whether they attend full-time or part-time.
If you are considering setting up a supervised toothbrushing programme now or in the near future, you should read the guidance on supervised toothbrushing during coronavirus (COVID-19) issued by the government. During the initial COVID-19 pandemic, it was recommended that settings cease using the wet brushing model as there was a higher risk of droplet or contact transmission with children using sinks and water, and the government published guidance on safe working in education, childcare and children’s social care settings, which also included the use of personal protective equipment (PPE) and complemented the toothbrushing guidance.
Although the changes to the EYFS require settings to promote oral health, best practice would also involve parents and promote good oral health at home so settings should find ways to encourage parents to get involved in their initiatives and promote a partnership regarding the children’s health and welfare generally.
As we emerge from lockdown, the risks of transmission are still present, so it is vital that settings are mindful of this and continue to be vigilant. The pandemic has also created its own safeguarding issues and all settings need to be aware of the increased stress and pressure that have been put on families and children over the last year, and make sure their safeguarding practices are updated to reflect this, especially in relation to children’s mental health.
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