Responding to oral health inequalities: How GULP supports the Core20PLUS5 strategy for children and young people

Oral health remains a priority within the NHS Core20PLUS5 framework for children and young people, where reducing inequalities in oral health outcomes is a key focus of national improvement efforts. Core20PLUS5 seeks to improve health for the most deprived 20 per cent of the population and prioritises five clinical areas, including oral health, where accelerated local action is needed to address longstanding inequalities in disease and access to prevention and care. National surveillance data underscore this need: tooth decay continues to be a leading reason for hospital admissions among children aged five to nine, with thousands of young people undergoing extractions each year.

Alongside Core20PLUS5, the UK government’s recently announced dental health drive will provide supervised toothbrushing and distribute more than two million toothbrushes and tubes of toothpaste to three- to five-year-olds in the most deprived communities. This initiative forms part of a broader prevention-focused approach to embed positive daily hygiene routines from the early years onwards and complements local oral health improvement planning.

Give Up Loving Pop (GULP) contributes to this evolving landscape by offering a structured, school-based programme that supports children at Key Stage 2 to develop healthier hydration habits over a four week programme. Through interactive lessons and relatable delivery via community sports coaches, pupils engage with age-appropriate learning about sugar-sweetened beverages, the sugar content of common drinks, and the links between drink choices and oral health outcomes. Evaluation data demonstrate significant increases in children’s preference for water across school, sport, and out-of-home settings, reflecting meaningful shifts in routine behaviours associated with reduced free-sugars exposure.

For local authorities and NHS partners seeking to strengthen local oral health improvement strategies, approaches that influence daily practices can sit alongside supervised toothbrushing and other established interventions. GULP’s model is designed to minimise burdens on schools through clear delivery support and training, and costs typically range from £11 to £13 per child, depending on scale and delivery model. By focusing on children’s routines when it comes to hydration, GULP can complement broader prevention efforts aimed at reducing oral health inequalities where they are most pronounced.