CHILDSMILE is a national programme designed to improve the oral health of children in nonfluoridated Scotland and reduce inequalities both in dental health and access to dental services.

The CHILDSMILE Programme is available throughout Scotland.

Every child receives:

  • a Dental Pack containing a toothbrush, tube of 1000ppm fluoride toothpaste and an information leaflet on at least six occasions by the age of five.
  • a free-flow feeder cup by one year of age
  • children in nurseries and schools are offered healthy snacks and drinks
  • free, daily, supervised tooth brushing in nursery and junior schools

Both parents and children receive education on healthy eating.

Visit the CHILDSMILE official site
Read the NHS Scotland: An Action Plan
See BBC Report Toothbrushing saves £6m in dental costs


How does it compare to New Zealand?

 Scottish kids used to have worse teeth than Kiwi kids. But today far more Scottish kids do not have any dental decay and, those that do, have less fillings. They have also reduced the number of children needing General Anaesthetics surgeries for severe dental decay. They have done this without any fluoridation AND they have saved money.

Yr 8 Free


Cover page
Download Fluoride
Download In-depth Comparison Analysis

One of the biggest differences is that all children are offered supervised tooth brushing in pre-schools and primary school classes. Research indicates that tooth brushing is one of he most important factors in reducing dental decay.

As well as our booklet, which provides a summarised overview, we have compiled an in-depth analysis comparing the outcomes of Scottish CHILDSMILE program to outcomes in New Zealand.


Do other countries have similar programmes?

A number of other countries have adopted similar programmes to the CHILDSMILE programme. Wales has implemented Designed to Smile which is very similar to CHILDSMILE. Japan and Thailand have also implemented tooth brushing programmes.

Denmark has the NEXO progamme that started in 1980 in the community of NEXO. This programme has had remarkable success and has since been rolled out to the rest of Denmark.

NEXO Caries free

It is based on:

  • individualized non-operative caries treatment for children and adolescents aged 8 months to 18 years
  • parents and children are shown how to perform proper oral hygiene (i.e. plaque control) in home visits
  • children’s teeth are checked on each visit.
  • If oral hygiene is not considered adequate or caries start developing, the next home visit is scheduled sooner

According to WHO (2015) Denmark has lowest caries rates in the world and has never fluoridated its water or its salt.

See The Nexø Method for more information.