At work I love seeing little ones for check ups- helping advise on brushing, fissure sealing teeth to prevent decay for the future and catching problems at the earliest stage so treatments are as minimal as possible. My Saturday clinics are full of twentysomethings returning from uni or London to have there perfect, unblemished teeth checked with their only concerns being whether to have a little bleaching or orthodontics, and I am full of congratulations- mostly for their parents. This is because, as a mum of two trying to keep my own children on the path to this dental health utopia, I know our modern lives are full of huge pitfalls for children’s teeth and gums.
Tooth decay can only occur if sugar is eaten frequently. Most people, and especially children, do actually eat frequently throughout the day and it is very easy to be lulled into thinking a snack is safe because it is fruit based or has no added sugar. Sadly, as a rule, if it tastes sweet then it is because it is sugary. Food companies word packaging to sound healthy so mums buy the snacks but it is the sweetness of them that the kids love. Rice cakes sweetened with concentrated apple juice, yogurt coated raisins, breakfast cereals and bars, sticky pure dried fruit bars- the sugar may have come from fruit but it is concentrated and sticky so clings to teeth and causes decay. Fizzy drinks, no added sugar squash, juices, even diluted, they all cause damage either from sugar or from acid which dissolves tooth enamel causing erosion. Even fresh fruit is now grown to be far sweeter than ever before and all fruits are acidic so erosive to teeth. Of course the vitamins and fibre are a bonus and fresh fruit is always better than processed sugar added snacks but beware too much of it as it can be very damaging to teeth.
Brushing teeth to prevent decay and gum disease is a lot harder than it sounds to get right in real life. Time pressure before school or childcare and getting to bed after can easily mean teeth are not cleaned well enough or for long enough and are not checked by an adult which is recommended until at least aged 8. I believe brushing together as a family is a great way of showing children what is needed. Spending a full 2 minutes to reach all the surfaces of all the teeth- “have we done the insides?” and “what about the very back ones?” whilst showing them how you do it helps promote good habits. Also seeing parents use floss and interdental brushes helps demonstrate what is necessary as you grow up and are dextrous enough to clean between teeth. Keeping a second set of toothbrushes downstrairs also makes the whole process far swifter in the mornings. It is also worth remembering that children older than 3 can move on to adult toothpaste which has more protective fluoride and not rinsing it out after brushing, just spitting, means it stays there working its magic for hours after.
So what should children snack on? We often hear they shouldn’t snack at all but any parent knows how impossible this is to achieve however making sure there are enough calories at meals to stay full between them is worth checking for very persistent snackers. Children actually need lots more fat and protein from meat and full fat dairy then adults and complex carbohydrates from rice pasta and bread to keep them full. These foods are also harmless to teeth, as long as sugar is not added, so if they hungry between meals then cheese and oatcakes or plain nuts for older kids will satisfy for far longer than fruit. If they are pestering for something whilst a meal is prepared raw vegetables are less erosive than fruit and drinks between meals should only be milk or still water as all other drinks are either decay causing, erosive and often both.
I know that all this sounds totally unrealistic when every shop, playgroup and cafe is packed with sugar and many patients say to me that their children just won’t drink plain water or eat plain snacks. I agree that they won’t at first but very young ones will realise that if that’s all they are getting then they will have to except it eventually and older children will appreciate an explanation of the consequences for their teeth. Of course everyone wants the sweet stuff sometimes but try to give sweets, cakes, biscuits and fizzy drinks or juice at the end of meals and then it’s limited to three times a day and not replacing more important foods. Of course in some settings you just have to forget the rules- birthday parties and the whole of Easter Day particularly!
I know my biggest risk is being too strict on sugar and bashing and prompting a revolt from my son or daughter so I try to remember my mothers stance of ‘ everything in moderation’ but with the last UK survey of children’s teeth finding a third of 5 year olds and nearly half of 8 year olds have tooth decay- I’m going to try my hardest to make sure my children and my patients children are not the ones suffering with it!