BRIGHT for policymakers

Preventing tooth decay in secondary school pupils: the BRIGHT trial.

Illustration of a child brushing their teeth next to an image of a checklist and a magnifying glass.


Tooth decay causes pain and difficulty eating and impacts children’s ability to attend school. It is very common, with a higher prevalence and severity among children living in deprived areas.

Previous programmes to promote toothbrushing with fluoride toothpaste have helped to prevent tooth decay in young children.

In the BRIGHT trial, we focused on secondary school pupils and investigated whether a toothbrushing intervention aimed at them could prevent tooth decay.


We developed an intervention that included a dental health lesson and text messages sent twice daily to the pupils’ mobile phones.

Pupils were followed up for 2.5 years to compare their levels of tooth decay, plaque, frequency of toothbrushing and life quality. We also analysed the cost-effectiveness of the intervention and asked for the views of pupils and school staff.


Our findings are summarised below.

View our findings

Policy links

From September 2021, teaching about dental health is compulsory for primary and secondary schools in England as part of the ‘health and prevention’ component of the statutory guidance on relationships, sex education and health education.

View the statutory guidance on RSE and health education

Lesson pack

The lesson pack used in the BRIGHT trial, including resources for teachers and pupils, has been endorsed by the Personal, Social, Health and Economic (PSHE) Association and is freely available from their website.

Find classroom resources


This study was funded by the National Institute for Health and Care Research (NIHR) Health Technology Assessment (HTA) Programme. Project number 15/166/08: Interventions to Improve Oral Health in Deprived Young People.

The views expressed are those of the authors and not necessarily those of the NIHR or the Department of Health and Social Care.

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