What’s the problem with asking teachers to clean kids’ teeth? 

By Dr Kathryn Spicksley
British Academy Postdoctoral Fellow, Department of Education and Social Justice, University of Birmingham

The polls tell us that it looks increasingly likely that a Labour government will be elected in July. For primary school teachers, this change might bring about an additional responsibility; Keir Starmer has proposed to introduce teacher-led toothbrushing sessions in primary schools, in order to relieve pressure on NHS dentists (Adams & Campbell, 2023).  

I consider this proposal to be problematic for two reasons. First, asking teachers to take on extra jobs when we are currently experiencing a teacher recruitment and retention crisis seems unwise. Second, the policy is unlikely to be an effective remedy to infant tooth decay.  

Asking teachers to clean their pupils’ teeth will have an impact on teacher workload, adding an additional task to an already demanding working day; teachers in England already have a significant workload, working longer hours than most OECD countries (Sellen, 2016). But the issue here is not just that having to clean childrens’ teeth will add to teachers’ workload – this task also changes the nature of teachers’ work.  

A recent systematic synthesis of 40 research papers (Creagh et al., 2023), proposes a distinction between workload, work intensification, and time poverty, which is helpful when analysing teachers’ working responsibilities. Workload refers to quantitative issues – the number of hours teachers work, or are expected to work. Work intensification, conversely, refers to qualitative aspects of teachers’ role – the type of work they are expected to undertake. It is generally acknowledged that the nature of teachers’ work has substantially changed since the latter half of the 20th Century, with increased accountability requirements placed upon teachers in efforts to improve national economic productivity (Easthope & Easthope, 2000). This trend is observed most frequently in high-income nation states, including the UK.  

Both increased workload and increased intensification of teachers’ work leaves teachers with negative feelings around time poverty – a sense that they lack the time to successfully complete all that they are required or expected to achieve. Time poverty leads to decreased self-efficacy as teachers feel dissatisfied with what they can achieve – which, in turn, impacts on teachers’ choices over whether to stay in the profession.  

During the past 14 years of Conservative-led governance, we have seen repeated promises to reduce teacher workload in order to improve retention within the profession (e.g., DfE, 2019). All too often, however, the focus has been on reducing workload, rather than a holistic appraisal of how placing ever increasing responsibilities upon teachers impacts on feelings of both time poverty and self-efficacy. A clear example of workload intensification during the 2010-24 period of Conservative-led administrations is the Prevent strategy. In requiring teachers to assess the risk that their pupils are exposed to extremist or terrorist activities, Prevent arguably expands teachers’ role to that of the police or border force.  

The logic underpinning the Prevent strategy is the same as that underpinning Starmer’s dentistry plan – for any given social problem involving children, teachers can be positioned as the first line of attack (and/or defence). Such plans involve work intensification for teachers because they further expand the roles and responsibilities placed upon teachers, beyond the core expectations of a teacher to impart knowledge and improve academic attainment. 

Making teachers responsible for cleaning pupils’ teeth seems likely to place further stress on teachers, both by increasing their workload and by intensifying their work. This policy therefore risks generating or further exacerbating feelings of time poverty amongst teachers. Such negative feelings are unlikely to be helpful in the current climate, in which teacher supply is in a ‘critical state’ (NFER, 2024).  

Furthermore, teachers are not dentists. To attempt to fix problems in NHS dentistry by shunting the responsibility onto teachers is equally unlikely to resolve the public health crisis concerning tooth decay amongst infants. The World Health Organisation (2017) emphasise the clear association between the consumption of free sugars and dental decay; rather than getting teachers to clean their pupils’ teeth, it would arguably be more effective to introduce policies which limit the availability of foods and drinks containing free sugars to children and adolescents, who are most at risk of tooth decay.  Failing that, recruiting more NHS dentists would be a more direct resolution to the problem of limited NHS dental availability. 

It has become a common practice amongst policymakers to make teachers responsible for an increasing range of societal problems. In order to address the teacher recruitment and retention crisis, any incoming government needs to develop an awareness of this trend, and start to reverse the responsibilities placed on teachers rather than adding to them. In practice, this means that when we don’t have enough dentists, we recruit more dentists, rather than asking teachers to work as proxies. 

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The views and opinions expressed in this article are those of the author and do not necessarily reflect the official policy or position of the University of Birmingham.