The British Society of Paediatric Dentistry (BSPD), the UK’s leading organisation advocating for good oral health for children and young people, welcomes the publication of NHS England’s landmark updated Clinical Standard for Oral Health and Dental Care for Children and Young People. Replacing the previous 2018 standard, the new framework sets out, for the first time, a fully structured national model describing how children’s dental care should be delivered, by whom, and to what standard, from a child’s very first dental visit through to the most complex specialist treatment.
A framework fit for the next generation
Published on 22nd June 2026 and developed by BSPD in collaboration with the Office of the Chief Dental Officer (OCDO) for England, the updated standard represents the most comprehensive revision of paediatric dental care guidance in nearly a decade. It introduces a formal five‑level model of care, replacing the previous three‑tier structure with clearer expectations, defined workforce requirements, and explicit minimum standards at every level.
The framework sets out not only what high‑quality care looks like, but what it requires: the staff, facilities, governance, and performance data that commissioners and managed clinical networks should expect to see.
Dr Oosh Devalia OBE, President, British Society of Paediatric Dentistry, said: “This standard is a pivotal moment for children’s oral health in England. For the first time, we have a single, coherent national document that supports every professional, from a newly qualified dentist in general practice to a consultant leading a tertiary team. It sets the benchmark not just for clinical care, but for equity, safety and accountability.”
What is new in the 2026 standard?
- Level 1b: Enhanced Primary Care. A new ‘child‑focused dental practice’ tier enabling more children to be managed safely in primary care by practitioners with additional training, reducing unnecessary referrals and easing pressure on specialist services.
- Integration with neighbourhood health teams. For the first time, paediatric dental services should be planned and delivered as part of integrated neighbourhood teams, working alongside health visitors, school nurses, GPs, early years providers, paediatricians and social care.
- Formalised role for dental therapists in GA settings. Clear, national guidance now defines the scope, supervision and governance for dental therapists working in general anaesthetic environments, reflecting a 2026 joint professional statement.
- Standardised referral and complexity scoring. Referrals into Level 2 should now include a minimum dataset and formal complexity scoring using the BDA Case Mix Tool, improving consistency and ensuring children access the right care first time.
- Recommended performance standards. For the first time, key performance indicators are specified, including trauma response times (e.g. avulsion/luxation injuries within 24 hours; pulp‑exposing fractures within 48 hours), waiting time standards, General Anaesthetic (GA) audit, Patient Reported Outcome Measures (PROMs), ‘was not brought’ monitoring and equity reporting.
- Expanded cross‑specialty pathways. Clear expectations for shared care with oncology, congenital heart disease, cleft, transplant, haematology, diabetes, mental health and looked‑after children services.
- Strengthened safeguarding requirements. A consolidated safeguarding section aligned with Working Together to Safeguard Children 2026, including the statutory Operation Encompass duty and explicit classification of missed appointments as a potential safeguarding concern.
Why this matters for children and families
Tooth decay remains the leading cause of hospital admission for children aged five to nine in England, a stark indicator of long‑standing inequalities and fragmented pathways. The new standard addresses this directly by embedding prevention at every level, requiring structured preventive interventions at every dental contact, including during general anaesthetic episodes.
The standard also strengthens the national commitment to equity. Services should now stratify data by deprivation, ethnicity, disability and looked‑after child status, ensuring commissioners can identify and address inequalities in access, experience and outcomes.
Dr Oosh Devalia OBE said: “Children deserve dental services that are joined up, accessible and safe, wherever they live. This standard gives commissioners, managed clinical networks and providers the clearest possible picture of what that looks like. We now need to see it implemented consistently, with the workforce, funding and system support to make it real.”
