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Children as young as two are increasingly suffering tooth decay, with some having to have every single tooth removed. But what's causing this epidemic and what can be done about this.

Children's dental hygiene is becoming an increasing problem. In the UK, 12% of three-year-olds have tooth decay. In the USA, the figures are even higher, with 27% of five-year-olds showing obvious signs of tooth decay. In the UK, more than 100 operations take place every single day to remove multiple decayed teeth from the jaws of teenagers and children as young as two-years-old: a total of 40,970 operations on children under the age of eighteen every year, 14,000 of the cases in children under five.

Removing decayed teeth is the main cause of hospitalisation in children aged between five- and nine-years-old in the UK, with many children requiring more than half of their teeth removing.

Shouldn't we blame bad parenting?

The stereotypical image of the child with decayed teeth is of the child mainlining Coca Cola, staring dead-eyed at the dancing TV screen, while their overweight mother shovels Turkey Twizzlers into their mouths.

Having a child with decayed teeth is the first frontier of "bad parenting". It's seen as shameful, a sign you're not taking your responsibility seriously. In the best homes, you can talk quite cheerfully about little Timmy's habit of biting the dog or how Tilly wants to be Gypsy Rose Lee when she grows up and everyone will chuckle and pass the tea and scones. Mention that your child has tooth decay, and eyes gape in horror.

Oh, she's one of those mothers!

The toxic issue of social advantage also comes into play here. 29% of children from well-off homes (in the UK) have tooth decay, compared with 40% of children from disadvantaged homes.

But that doesn't mean that our stereotype - of the blank-eyed Cola-drinker - is necessarily true.

But children don't get tooth decay if they eat healthily, do they?


Parents want the best for their kids. No-one sets out with the intention to harm their child. That's why many parents are now feeding their children "healthy" fresh fruit juices, instead of Coca Cola and other carbonated drinks.

Did you know that of the biggest risks to children's teeth is a diet full of "healthy" fresh fruit juices? We all know that Coca-Cola is high in sugar, but did you know that fruit juices can be just as sugary.

Have a look at these values for 350ml of liquid:

  • Coca Cola: 140 kcal, 40 grams of sugar (10 teaspoons)
  • Apple juice: 165 kcal; 39 grams of sugar (9.8 teaspoons)
  • Orange juice: 160 kcal; 35 grams of sugar (8.3 teaspoons)

Fruit juices are very high in fructose. Fructose and sucrose are equally bad for the teeth, and are both broken down into glucose by the body.

All our mouths are filled with dental plaque. When we eat sugary food, whether fructose or glucose, our dental plaque uses the carbohydrate to make acid. The acid breaks down the surface of the tooth, causing cavities. When cavities form, the process of decay begins, leading to pain, abscesses, and tooth removal.

However, this isn't the whole story.

What's the Deal With Toothpaste?

Some dentists worry that children's toothpastes may have a part to play in the rising epidemic of tooth decay. The NHS recommends that children over six-years-old use a family toothpaste with 1350-1500 ppm (parts per million) fluoride, and that children under six (if they don't have tooth decay) use a child-friendly toothpaste with at least 1000 ppm (such as Aqua Fresh Milkteeth).

Many children's toothpastes do not have these levels of fluoride, with some toothpastes having as little as 250 ppm. Claire Stevens, Consultant in Paediatric Dentistry in Manchester, says that parents who can't find a toothpaste with enough fluoride for their children should give their youngsters an adult toothpaste.

Always check the label.
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