Wakefield's approach to tackling the rising prevalence of tooth decay and obesity in children

SWAP delivers interactive sessions on sugar content, dental health, hydration, and healthier drink choices, followed by a three‑week challenge and final review. From 2024–2026, 916 pupils participated, showing substantial reductions in sugary and energy drink intake, increased water and milk consumption, and improved toothbrushing habits. Teacher feedback highlights strong engagement and improved understanding. Early results indicate potential long‑term benefits for dental health, healthy weight, and overall wellbeing across the district.

20 per cent of children aged 0-17 in Wakefield live in areas that are in the most deprived 10 per cent nationally.

Yorkshire and the Humber have the highest rate of decayed tooth extractions in children (per 100,000 population) in England, with an increasing number of these requiring hospital admission for the procedure, according to official statistics published February 2026.

The Wakefield District has a high prevalence of tooth decay in children, with 40 per cent of 12-year-olds having some form of tooth decay. 

In addition to this, 2024/25 NCMP (National Child Measurement Programme) data shows the rates of children living with overweight (including obesity) are higher than the national average in Year 6, at 38 per cent compared to the national average of 36 per cent. Similar differences to national averages are reported when looking at just obesity and severe obesity.

The Wakefield School Health Survey, which is conducted anonymously with Year 5 students, showed 48 per cent of them reporting they had not visited a dentist in the last 6 months and 24 per cent reporting they brush their teeth less than twice a day.

According to the NHS Better Health reports, on average children are consuming over two times more sugar than is recommended, with half of it coming from snacks and sugary drinks.

To address the above, the Wakefield Wellbeing team devised SWAP – Sip Water Avoid Pop. Building on the work of the Food Active campaign with GULP (Give Up Loving Pop) we wanted to create something similar using our own resources, combining this with a session we already delivered to KS3 children and making it relevant to the Wakefield area.

The SWAP Programme consists of two interactive classroom-based sessions which last approximately one and a half hours. An information sheet is sent out to parents before the sessions so they are aware of what the children will be learning and asks them to encourage the children to participate in the challenge.

Session one covers the data stated above: sugar and the effect this has on teeth. It’s a practical session looking at how much sugar is in popular drinks with their age group, an explanation of the effects of caffeine and demonstrating how much is in popular drinks.

Session two focuses on energy and sports drinks, interpreting food labels, and the importance of hydration. The messages are then reinforced with strong visuals around the effects of drinking more water/fewer sugary drinks compared with not drinking enough water. The children are then given postcards to take home as a reminder of the lessons learnt and also set a challenge to brush their teeth twice a day and not drink anything other than water, milk or no added sugar dilute juice for at least 14 out of 21 days (this could be shown on the postcards they take home). We felt this was realistic if they had a party/celebration/weekend away they could still complete the challenge.

Session three is a quick follow up session taking place three weeks later to see how the children have done with the challenge. All children receive a dental pack with toothpaste and toothbrush in. The children who complete the challenge then have the chance to win a water bottle in a quick-fire quiz.

The impact of SWAP is measured through a questionnaire which the children complete at the start of the first session, with a similar one completed at the last session. Teachers are also asked for their feedback. The feedback is anonymous and self-reported, with only full class level data available.

Between April 2024 – February 2026 a total of 916 children participated in SWAP with the following results from the before and after questionnaires:

• 58 per cent reduction in children drinking sugary drinks every day
• seven per cent increase in children drinking water and nine per cent increase in children drinking milk
• 40 per cent reduction in children drinking energy drinks and 27 per cent reduction in children drinking fizzy drinks
• An overall increased awareness around the effects of too much sugar in the diet
• 13 per cent increase in children brushing their teeth twice a day
• 86 per cent of children reported feeling healthier for brushing their teeth twice a day and drinking less sugary drinks
• 67 per cent of children completed the SWAP challenge.

In addition, children have shared how they have convinced parents to stop, cut down or switch to zero sugar energy drinks.

Teacher’s feedback from Year 5 and 6 classes includes:

• The class found this useful - I know lots of our children struggle with healthy packed lunches and we have 'push back' when asking for water only. This has supported our message and given them the knowledge as to why.
• Prior to the sessions, we have found previously that some students were not aware or didn't brush their teeth twice a day and some children or parents drank lots of high sugar drinks.
• I am very mindful of what I drink and what I allow my six-year-old to drink because of this.
• The children are aware of how much sugar drinks contain and caffeine for energy drinks which has linked well with our PSHE lessons.
• It helped children to visualise the amount of sugar in their drinks, and they have frequently discussed this during the school day.
• The children were discussing their drink choices throughout the course of the challenge, and we had a few discussions as a class. They retained a lot of information from the sessions. 

The progress made so far implies there is potentially a huge cost saving implication due to reduced dental issues, as well as a potential reduction in children being overweight or obese. However, as the programme is still in its infancy it is not yet possible to measure this in a monetary value. In addition, improved dental hygiene could have a positive increase in school attendance rates and decrease in preventable hospital admissions.

Wakefield offers a free health and wellbeing school charter which is open to all schools within the district. The sessions are offered to all schools free of charge.

If we were to become oversubscribed in the future we could provide schools with the training, lesson plans and PowerPoint presentations for them to deliver it. They would just need to source the additional resources (drink bottles, sugar cubes, food packaging).

Positive:

• The class challenge is an effective way in engaging the children in the challenge.
• Many positive results reported.
• Schools like the fact that it is someone from outside the school who delivers the information.
• The session has been adapted as more have been delivered. For example, the children come to the front and guess the number of sugar cubes in 12 popular drinks. To make this more inclusive, all children are now given a sheet to guess the amount and then record actual amount. This is also a good take home for them to share with parents/carers.

Negative:

• We currently give away dental packs to all children and five water bottles per class. However, with reducing budgets, we do not know how long we can sustain this.
• Parental engagement is something we are trying to address as a parent information session has been developed but as yet no school has asked for this.

Dawn Clark – Health and Wellbeing Office, [email protected]