Kensington and Chelsea NHSNHS Kensington and Chelsea:

Bigger Smiles – Increasing access to NHS dentistry



To increase access to NHS dentistry for people who had not seen a dentist for 2 years or more, and to improve the child oral health rates.


The population of Kensington and Chelsea is one of the most diverse in the country with some of the most affluent and deprived areas in Europe within yards of each other. At the time of this project, it had the second poorest oral health rates in the country and the highest level of serious treatment rates in London.

Target audience

Kensington and Chelsea residents in deprived wards

Accessible Dentistry


Extensive scoping phase

Recruitment of sub group of local dentists

Social Marketing and Dental Commissioning groups combined

Stakeholder engagement with schools, Royal Borough of KC, community groups

Multimedia PR and marketing campaign


  • A low value was placed on preventative treatment; good oral health was associated with a lack of pain or trauma
  • Pain or trauma triggered a dental appointment, consequently treatment was painful and expensive, creating a cycle of reluctance and anxiety around preventative visits such as regular check ups
  • Confusion over costs, cultural beliefs and registration
  • Lack of child-friendly services meant parents were anxious about their child’s experience
  • Dental practices lack of expertise
    and resources in their own
    marketing to patients


Our approach involved a unique collaboration between Commissioning, Public Heath and Community Engagement teams at the PCT, and the Royal Borough, local dentists, British Dental Association, and GlaxoSmithKline.


A dental Quality Outcomes Framework was introduced, whilst a number of behaviour change initiatives tackled access;

  • ‘Bigger Smiles’; an outreach pilot providing fluoride varnish for children, delivered with live theatre performance and free oral
    health products.
  • Improved patient services, including same sex dentists, enhanced translation services, relaxation techniques, extended opening
    hours and guidance during Ramadan
    and fasting
  • A ‘Registration’ campaign matching patients to a dentist with the services they requested
  • Dental Practice Toolkit to improve patient engagement
  • Free membership to the British Dental Association’s Good
    Practice scheme


  • 2.9 % increase in adults accessing NHS dentistry
  • 4.4 % increase in children accessing
    NHS dentistry
  • A dramatic increase in the number of children receiving a fluoride varnish from under 1% of in 2008 to 10.5%
    in 2009
  • Registration campaign generated approx 10% new patients


Accessible Dentistry