Brushing for Britain

Toothbrushing has been a regular part of most people’s daily routines since the mid-20th century, but it was only a few decades earlier that the British state first began to impress upon the public the importance of maintaining good dental hygiene.

Two conflicts highlighted the need for state intervention. Both the Second Boer War and the First World War exposed the extent of poor dental health among army recruits and, by extension, the wider British population. During the Second Boer War approximately 2,000 soldiers were evacuated back to Britain and a further 5,000 classed as unfit for duty in the field due to decayed teeth. In response, the Inter-departmental Committee on Physical Deterioration was set up in 1903 to investigate the state of the troops’ health. The resulting report recommended a number of welfare interventions intended to improve the health and wellbeing of the nation, among which was the suggestion to the Board of Education that the care of teeth should be taught in schools. Schools were also to enforce daily teeth cleaning, as well as systematic inspection and treatment of children’s teeth by dentists. Despite this, bad teeth among army recruits persisted. During the first year of the First World War one of the leading causes of hospitalisation was dental disease.

In the ensuing years, further committees and organisations were founded to promote dental health and education. In 1923 the Dental Board – an offshoot of the General Medical Council – set up the Dental Health Propaganda Committee, which was to oversee a new programme of dental health education in Britain. Then, in 1927, the Central Council for Health Education was established, supplying personnel, equipment and educational materials to local authorities to assist them in their work in spreading public health messaging, including information on how one could best take care of one’s teeth.

Dental propaganda produced in the 1920s and 1930s framed bad teeth as not only detrimental to health, but also as something that could impact one’s social life and economic prospects. Children and mothers were often targeted by this messaging, to encourage them to implement changes at home. Films, exhibitions, posters and other material warned children of grim futures if they did not take care of their teeth through daily brushing, avoiding sugary foods and through regular dental exercise, such as chewing hard foods. A 1936 film Beware of the Demons, for example, followed the lives of two siblings, Elsie, who listens to her mother and brushes her teeth every night, and Jack, who always forgets to brush his teeth and eats sweet biscuits at bedtime. Later in life Elsie is successful, but Jack has bitter regrets:

Although bright and intelligent, employers will not take him because of his bad teeth and appearance …Elsie[’s] winning smile and good looks bring her success ...not only in business does her smile help, for she wins the heart of a young man.

This propaganda was extended to the workplace. Posters produced by the Dental Board stressed the economic importance of dental health. One, produced in the 1920s, showed a worker next to the turning cogwheels of industrial machinery:

If the teeth are in bad condition the wheels won’t work efficiently – it is the same with your teeth. Take care of your teeth and your teeth will take care of you!

These messages were disseminated in a wide variety of formats to reach the largest possible audience. Local cinemas screened films on the care of teeth – such as ‘A Brush with the Enemy’, or ‘Smile If You Dare!’ – arranging special matinees for schoolchildren. Similar films were also shown for free on local councils’ premises, with some even taking the cinema to the street using cinema vans. Bermondsey council, for example, organised screenings on the streets of the borough in the 1920s. Posters advising on tooth care appeared on electric street signs, the London Underground and at major railway stations across the country, and dental health maxims were printed on London, Midland and Scottish railway tickets.

Councils across the country also put on ‘Health Weeks’, exhibitions aimed at educating local communities. As the Medical Officer of Health for Deptford, Charles S. Thomson, stated in 1925, the objective of a Health Week was:

to teach every householder to be his own Medical Officer of Health. Public Health should begin at home and not at the Town Hall … It must be inborn upon the citizen that to a very large extent disease is preventable, and it rests with him, and not with the other man, to see that it is prevented.

Stressing personal responsibility was necessary: professional dental care was inaccessible to many due to cost. The state’s promotion of tooth care as an area of self-care was, therefore, more practical – and cost-effective – than advocating for professional intervention.

The introduction of NHS dentistry in 1948 meant that all British citizens had access to free professional dental treatment for the first time. The state now had greater responsibility for ensuring the health and care of the nation’s teeth. However, charges for NHS dental treatment were introduced in 1951 and remain in place today.

Dental care is, for most people, now part of their everyday health rituals. To an extent the state’s dental health campaigning throughout the 20th century has been a success. However, the increasing inaccessibility of NHS dentistry has led to a dental crisis and the rise of ‘DIY’ dentistry. News reports have included stories of people making their own dentures out of resin and superglue, or using pliers to extract their own teeth. In 2024 the British Dental Association found that 80 per cent of dentists had treated a patient who had performed dentistry on themselves since lockdown. While tooth care remains an individual responsibility, the state remains important in ensuring that these crises and inequalities do not cause teeth to, once again, become a national health concern.

Georgia Haire is a Postdoctoral Research Fellow at Vancouver Island University.