A scientific study revealing the seven factors that constitute a good bedtime routine for children has put toothbrushing at the top of the list.

In a new study by a University of Manchester psychologist, the definition has been agreed by 59 UK experts.

The six key areas are:

1. Brushing teeth before bedtime
2. Time consistency for going to bed
3. Read a book before bed
4. Avoiding food and drinks before bed
5. Avoiding use of electronic devices before bed
6. Calming activities, such as a bath, shower and talking.

Funded by the Medical Research Council, the study also devises two different ways of scoring bedtime routines: one that measures a single routine and the other for activities over seven days.

A parent should aim to score at over 50 points to achieve an effective routine, says Dr George Kitsaras who led the study.

The same scoring system is used for another ‘dynamic measurement’ where depending how many nights a week parents achieve the activities they receive different, weighted scores multiplied by 1.0.

Dr Kitsaras said: 'All activities around bedtime matter for children’s development and wellbeing. From the wide range of activities around bedtime, our experts considered toothbrushing to be the most important to remember each night.

'There are strong links between inadequate oral hygiene practices and dental decay in children and adults. For children, early childhood caries can lead to higher occurrence of dental disease in later life and, in some cases, untreated childhood caries can lead to extractions under general anaesthetic causing additional problems for children and parents.'

He added: 'Bedtime routines are important family activities and have important implications on children’s wellbeing, development and health.

'Organisations as diverse as the Book Trust to the BBC and the NHS are all engaged in this debate but up to now, there has been no real scientific consensus to inform them; we need untie the conflicting signals and messages parents receive.

'This lack of a clear consensus-based definition of limits health professionals’ ability to communicate best practice effectively with families.

'Our definition considers the parental stresses and difficulties that might arise at bedtime while incorporating best practice and available scientific advice. This study for the first time provides that expert and scientific guidance.'

The psychologists, dentists, public health specialists and other experts from education, health visiting and sleep research participated in what is known as a Delphi Process, a method of achieving wider consensus by collecting opinions through several rounds of questions.

Study can be found here https://journals.plos.org/plosone/article/related?...