Protecting children's teeth against decay
30.4% of children are NOT seen on a regular basis by a dentist. 33% have missing teeth or fillings by the age of 5.
Your child's teeth are forming in their gums even before birth, so good tooth care starts while you are pregnant. Eating a healthy diet during pregnancy, including plenty of (low-fat) dairy foods with calcium and vitamin D, can help the formation of strong teeth and bones in your growing baby.
Even before your baby's first tooth comes through, from the age of about 6 months, encourage drinking and eating habits that will minimise the risk of tooth decay. Breastfeeding is generally considered to better for teeth than bottle-feeding. If you are bottle feeding your baby, stop as soon as your child can drink from a cup. Drinking fruit juice or other sweet drinks from a bottle is particularly damaging to teeth, because of the way the drink swills around the mouth. So try to give only water from a bottle and switch to a cup as soon as possible. Never dip a dummy in anything.
Keeping first teeth clean is just as important as second teeth, to minimise the risk of your child needing fillings or losing teeth early and to help establish healthy habits.
Protecting children's teeth against decay
Tooth decay occurs when acid, which is produced by bacteria that live in the mouth, attacks the protective coating of enamel that covers each tooth. Enamel has no nerve endings, so the initial phase of tooth decay does not hurt. But when the damage reaches the softer dentine layer inside the enamel, toothache signals that there is a problem. There are two main solutions:
Cleaning the teeth regularly to remove plaque - the sticky film that can form on the teeth and where acid-producing bacteria live
Eating healthily, in order to minimise the sugar on which plaque bacteria feed and to minimise the acid content of the diet.
Decay can start as soon as the gum breaks - even before teeth are visible, so start cleaning early. Research has shown that children whose teeth are brushed before they are 1-year-old are likely to have less decay later. In the early stages, it is best to clean your baby's first teeth by wrapping a clean flannel or cloth around your finger or buying finger brushes and rubbing the teeth and gums gently to rub away plaque. Once your baby can hold things give them a soft-bristled toothbrush and encourage them to use it.
Dentists have found that most children can't clean their teeth adequately until they can write, so it is best if you clean their teeth. Many children find it intimidating if you approach them from in front with a toothbrush. Sit them on your lap and get them to open wide and tip their head back while you clean their teeth gently and thoroughly.
Don't use adult toothpaste before the age of 6 because it contains too much fluoride and increases the risk of causing mottled teeth due to excess fluoride (known as fluorosis). Use a pea-sized blob of children's toothpaste and brush each tooth gently, from the gum to the tip. Brush twice a day - in the morning and last thing at night, before bed.
However tired your child is at night, it is important that they clean their teeth before going to bed. Saliva normally protects the teeth but its production drops at night. So it is particularly important to clean teeth well after the last food or drink of the day.
Unfortunately, cleaning teeth can be a real battleground. Toddlers often like the idea initially, but it soon becomes a task that seems boring and time-consuming to them. Several things can help your child to get the teeth cleaning habit:
Let them watch you brush your teeth, so they can observe how it should be done
Make teeth cleaning fun. Let your child choose a toothbrush. There are a wide range of children's tooth brushes available, including ones based on cartoon characters and others which change colour
Use a toothpaste suitable for small children and try different flavours - many children dislike peppermint
Make a game of it - pretend their mouth is a tunnel and the brush is a train, or sing a funny song
Use a star chart for teeth cleaning with a small reward for lots of stars.
It is a good idea to keep snacking to a minimum in order to develop healthy eating habits, but most children need snacks at some point. Allow sweets or chocolate only at certain limited times, rather than throughout the day. Ideally, keep sweets for special occasions and treats. Some parents find that just allowing sweets on one particular day, or just at the weekend, helps. The length of time your child spends eating sweet or acidic things matters more than the amount of sugar (making sweets such as hard lollipops or toffees particularly problematic). Also, encourage your child to think of other foods as treats, such as fruit and savoury foods.
So what can you give them that won't harm their teeth?
Dried fruits, such as raisins or sultanas may seem like a healthier option, but they contain as much sugar as sweets and because they stick to the teeth may be worse than chocolate
If your child wants sweets, liquorice and chocolate are probably the least damaging options
Snacks that are kinder to teeth include savoury biscuits such as cream crackers, perhaps spread with butter or low-fat cheese. Breadsticks are generally popular - most toddlers like holding them
A small portion of cheese (about a half inch cube) eaten up to 10 minutes before or 20 minutes after sweet or acidic food reduces the acid level in the mouth and reduces decay
During meals, give your child healthy foods that need chewing such as wholemeal bread, raw vegetables and fruits. These exercise the jaws and improve the health of the teeth and gums.
Drinks can be a particular problem in the quest for healthy teeth. Water is really the only drink that will not harm your child's teeth, so get them into the habit of drinking water on a regular basis. Real fruit juices are no better for teeth than squash drinks, because they tend to be acidic. Watering down fruit juices doesn't help either, because the drink remains acidic. Fizzy drinks, even low-sugar versions, are particularly harmful because they tend to be very acidic. Children drinking them every day are twice as likely to have decay as those having them less often. Cola drinks are more damaging than other fizzy drinks.
Opinions differ on fluoride. Dentists insist it strengthens teeth and reduces decay but some say you should not use fluoride before the age of two. Anti-fluoride campaigners argue that it is toxic and only delays eruption of teeth and so just delays decay. Check with your dentist about whether or not to give your child fluoride drops or mouth washes. If you do use them, make sure that you give your child the amount on the label, and no more. Not all areas have fluorinated water, so check with your health visitor or water supply company.
Going to the dentist
Get your child into the habit of going to the dentist as early as possible. Ask your dentist when they should start. Dental checks and treatment are free for all children under the age of 18 in the UK. Initially, the dentist will just want to sit your child in their chair and look at their teeth. Try to find a dentist who is good with small children, as this will encourage your child to feel confident and trusting so that they will carry on being happy to pay regular visits and proud to show off their perfect teeth!
Good mouth care from birth sets the pattern for healthy teeth for life. To maintain healthy teeth it is important to choose the right drinks and foods, to brush your teeth twice every day and to visit the dentist on a regular basis throughout your life.
Tooth decay is still a major problem in this country, but it is preventable. Make sure you know how to use your toothbrush properly and choose a fluoride toothpaste to help strengthen your teeth.
Tooth care should start from birth, long before the primary teeth come through. The early months are the best opportunity to influence what a child will enjoy eating and drinking as he or she grows up, and to establish good habits that will reduce the risk of tooth decay in later years.
Milk, cooled boiled water and diluted fruit juice are all that are necessary for young babies. Sugar in drinks or food causes tooth decay. It is not just the amount of sugar that matters, but also how often there are sugary things in the mouth. This is why sugary drinks and sweets are so bad. They stay in the mouth for quite a long time. For this reason, babies bottles should never be used to give sweetened drinks. If they are given, they should be given at mealtimes. Beware of labels which say ‘low sugar' or ‘no sugar' which could disguise the fact that there is sugar in concentrated fruit juice, or an artificial sweetener such as Saccharin.
Older children are risk from too many sweets, drinks, biscuits and cakes which provide most of the sugar in young people's diets. It is not necessary to cut these out of children's diets completely. However it is important to reduce them to a minimum and, if possible, to keep them for mealtimes. Sugar-free, diet and low-calorie drinks will not necessarily cause decay. However, the acid in some drinks such as fruit juice, squash and fizzy drinks, even diet ones, may attack the enamel of some people's teeth if they drink them frequently. Remember, too, that liquid medicines contain large amounts of sugar. Try and find sugar-free forms wherever possible.
If your child is hungry between mealtimes, try to encourage sugar-free snacks such as fruit, vegetables, bread, cheese, yoghurt, milk or water. Avoid giving sweets as treats and rewards. Instead use stickers, hair slides, crayons, soap and badges.
Start brushing your baby's teeth as soon as they appear in the mouth. This establishes the practise as a habit and protects the teeth with fluoride. Use a small baby brush and a tiny smear of fluoride toothpaste.
At first, the brushing technique does not really matter. Once the child has started to accept the brush happily, his or her teeth can be brushed more thoroughly. One way your baby will learn is by watching you brush your own teeth. Make brushing fun.
As children get older they should be encouraged to brush their teeth twice a day, using a fluoride toothpaste which strengthens teeth against decay and keeps them healthy. Use a small, pea-sized amount of toothpaste. Supervise children when they brush their teeth until they are at least 7 years of age. Clean the teeth with a gentle back and forward movement.
Buy a new toothbrush regularly: at least every 3 months. Choose small-headed brushes with soft or medium texture bristels to reach all the corners of the mouth. If possible, don't share brushes between children. Remember that older children often need reminding to brush their teeth. It is also worth checking that they've cleaned them properly.
Visiting the Dentist
• Register your child with a dentist even before the first teeth come through.
• Find a dentist who will register babies and young children and who will see them and give advice. Ask family and friends to recommend one. Your local health authority will also be able to help.
• Ask your dentist for advice on how to prevent tooth decay, what type of toothpaste to use and whether your baby needs fluoride drops or tablets.
• Children should visit the dentist at least once a year - more often if so advised by the dentist. Take your children with you when you go to the dentist to set a good example.
• The dentist can advise if your child needs extra protection against decay, for example fluoride tablets or fissure sealants which are plastic coatings placed on the biting surfaces of the teeth.
• If you think your child's teeth are crooked, ask the dentist for advice.
Remember that NHS dental treatment is free for expectant mothers, and for one year after giving birth.