How to keep children's teeth safe: A Q&A with the British Dental Association

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British Dental Association: Yes. Sharing feeding spoons with your baby should be avoided for as long as possible! Research shows that bacteria can be transmitted from parents to the baby through saliva by sharing eating utensils, dummies or even kissing on the lips. Infants’ first teeth begin to erupt at around six months of age. As babies often fall asleep with milk, formula or food in their mouths, this leaves their teeth more susceptible to dental decay. But decay only occurs if tooth tissue, carbohydrates or sugar and cariogenic bacteria – the bacteria that causes tooth decay – are together in the mouth. So the longer we can keep infants from being inoculated with harmful cariogenic bacteria, the better.

What is 'bottle tooth decay'?

British Dental Association: Infants’ and toddlers’ primary teeth can be affected by an aggressive form of tooth decay called early childhood decay. The disease is associated with frequent consumption of sugary drinks in baby bottles or sipping cups as it occurs in the upper front teeth and spreads rapidly to other teeth.

"Flavoured fizzy drinks can have pHs of as low as 2.0. This is about the same pH as gastric acid!"
British Dental Association

Why is tooth decay a rising problem in children?

British Dental Association: High levels of consumption of sugar-containing food and drinks and low exposure to fluoride are the causes of tooth decay. Children in deprived areas are more likely to have higher rates of decay than children from more affluent areas, although the impact of this seems to be mitigated in areas where the water is fluoridated. In 2014, the first ever survey undertaken of three year olds in England showed a dramatic variation of tooth decay prevalence, ranging from 2% to 34% across the country. However the large majority of children (88%) in this age group have no decay at all.

If children’s baby teeth get decay does it effect their adult teeth?

British Dental Association: It can do. Decay in the primary teeth can cause abscesses that harm the permanent teeth developing inside the gums. In the case of advanced tooth decay where dental extraction is required, children are more likely to develop orthodontic problems as the premature loss of primary teeth can affect the alignment of permanent teeth.

When should babies first go to the dentist?

British Dental Association: Around six-months, when the first deciduous teeth start erupting. Taking your baby from this age helps them to get used to the sights, sounds and smells of a dental practice and gives you access to information, advice and support for looking after your child's teeth. The dentist will check your child’s teeth and gums at least once a year, from around 18 months, and give any treatment your child might need.

"Beware of ‘hidden sugars’, particularly in foods marketed to parents of young children"
British Dental Association

What's the big deal with fizzy drinks?

British Dental Association: Fizzy drinks are acidic in nature and studies show them to be the biggest factor in causing dental erosion among teenagers. Erosion, caused by acidic substances, is a wearing away of the enamel coating of teeth. While drinking 'diet' versions of fizzy drinks reduces sugar consumption, these are very acidic and can still cause erosion. Enamel in teeth can start to dissolve when the pH of any liquids consumed is 5.5 or lower. Fizzy water can have a pH as low as 3.0, while flavoured fizzy drinks can have pHs of as low as 2.0, though this is about the same pH as gastric acid!

Is fizzy water bad for your teeth?

British Dental Association: Unfortunately fizzy water is bad for your teeth. To minimise any damage, limit consumption to meal times as the chewed food and increased saliva flow during mastication (chewing) helps neutralise the acidity in the mouth.

What seemingly healthy snacks should we watch out for?

British Dental Association: Honey, dried fruit (for example dates, raisins and apricots), grapes and figs are some ‘healthy’ foods found to have a high cariogenic potential. Watch the frequency of their consumption and try and limit their intake to around mealtimes rather than between meals.

Avoid concentrated sugars, for instance, smoothies – blending fruits in smoothies releases intra-cellular sugars making the juices more cariogenic. Beware of ‘hidden sugars’, particularly in foods marketed to parents of young children, eg. yogurts, breakfast cereals, cereal bars, sauces, and baked beans. And note that food and drinks promoted as ‘no added sugar’ foods may still be cariogenic.

Is fruit bad for children's teeth?

Whole fresh fruit is considered to be part of a healthy diet because it contains vitamins and fibre. However, like everything, it should be eaten in moderation, and best consumed at meal times. It does contain acids, which can be damaging to teeth if eaten in large quantities.

If your child is going to have juice, when is the best time to drink it and what is the best way of drinking it?

Juice should be restricted to mealtimes only and in a free-flow cup, not a feeding bottle. Straws are also good, as they direct the juice to the back of the mouth (and away from the teeth). Pure unsweetened fruit juices are a good source of vitamin C but contain natural sugar which can cause decay. Fruit juices are also acidic. Acidic drinks can quickly damage your baby’s teeth. Small amounts of pure, unsweetened fruit juice should be diluted half and half (50% juice to 50% water), or with a greater proportion of water to juice if your child is thirsty. It’s not advisable to brush teeth after drinking juice – it’s best to wait at least an hour before brushing.

At what age can you let a child start brushing their own teeth?

Children who are unable to brush their teeth unaided should be assisted to do so; all children should be supervised when brushing their teeth till at least seven years of age.

Do children's molar teeth fall out?

Yes, these are normally the last of the milk teeth to fall out and this normally happens around age 11.

What are your top tips for keeping a child's teeth decay free?

Choosing drinks without sugar for your baby will set healthy habits for life, and help prevent decay in first teeth.
Foods containing sugar should be kept to a minimum and are best given at mealtimes.
Children should be assisted to brush their teeth as soon as they erupt.
Brush teeth at least twice a day for at least two minutes with fluoride toothpaste. They should be encouraged to spit out excess toothpaste and not rinse with water after brushing.
Take your child to the dentist as soon as the teeth start to emerge or at six months. It also means that any problems can be picked up and treated early.

For more advice on teeth care, visit the British Dental Association.

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