Childhood Tooth Decay: The New Epidemic

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?

False!

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.

READ Nutrients You Shouldn't Skip If You Want Strong Teeth And Bones

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.

What Else Can You Do To Prevent Tooth Decay?

From the time that first milk-tooth peeps out of that reddened gum, it's important you help your child take care of their teeth. Here, we have a few simple tips to help your child avoid the modern epidemic of tooth decay:

Toothbrush Tips

• Begin with toothpaste as soon as your baby cuts their first tooth. Using a baby-toothbrush, rub a tiny smear over the tooth to keep it healthy. Be sure to use toothpaste with 1000 ppm fluoride. Use adult toothpaste if no children's toothpaste is available.

• From teething to three years, use a smear of toothpaste and a baby-soft toothbrush.

• After three years, your child will need a pea-sized amount of toothpaste

• Brush your child's teeth twice every day: just before bedtime and at one other time in the day.

• Monitor your child's toothbrushing until they're eight-years-old: make sure they routinely brush for two minutes a time and that they get right to the back of their mouth. Even when you stop monitoring them every time they brush, you should still watch occasionally to make sure they're not getting lazy without supervision - brushing your teeth doesn't seem very important when you're eight and nine and would rather do something more interesting.

• Encourage your child to spit the excess toothpaste away but not to rinse with a lot of water: rinsing makes the fluoride less effective. If your child must rinse their mouth (some really don't like the taste of toothpaste) encourage them to rinse with the minimum of water and to wait a minute or two after they've finished brushing. If they follow the rest of these tips, it shouldn't do any serious harm. A three-year study confirmed that, in individuals with healthy teeth, rinsing the mouth with water "does not significantly affect the cavity-reducing effect of fluoride toothpaste".

Food Facts

Your child doesn't have to have a bland, boring diet full of nothing but curly kale and quinoa to avoid tooth decay. Some simple tips will help keep their teeth healthy:

• It's important that sweet treats are never given after bedtime brushing. Saliva flow decreases as we sleep. High acid and low saliva is a perfect breeding ground for decay.
• Try to use sweet treats as treats. Your child can have cookies, colas and ice-cream, but should only have them on special occasions and not every day. Remember, that sucrose will destroy those pearly teeth quicker than almost anything.
• Don't give sweets as a reward for good behaviour, or deny a sweet as punishment: it will just make your child crave them more and reinforce unhealthy eating habits.
• Limit those fruit juices: that "healthy" fructose is every bit as much a tooth-killer as that cola drink. Your child can still have fruit juice, but should be limited to 150ml a day and only at mealtimes. Giving the juice at mealtimes limits the risk of tooth decay. The rest of the time, plain water and milk are the best and most hydrating choices for children over the age of one-year (children under 12 months should never have cow's milk, under any circumstance!)
• Limit between-meal snacks. Reducing the amount of acid-rises in the mouth gives your teeth a chance to repair themselves. That said, children often get hungry and frequently need a daytime snack. The following make good choices: toast, rice cakes, plain popcorn, bananas, and carrot and cucumber sticks dipped in cream cheese.

READ Yikes, Your Child Just Injured Their Teeth: What Now?

How to teach a child to brush

• When your child's very small, you'll need to brush their teeth for them.
• As they're starting to get to three- or four, and are wanting to be independent, however, you can help your child learn by guiding their hand, so that they will learn the correct way of brushing their teeth
• Set an egg timer for two minutes, so that children know how long they've brushed their teeth.
• Never let a child run around with a toothbrush in their mouths. They might get hurt

Dentist Facts

• You should start taking your child to the dentist when their first milk-teeth appear. This is so they become comfortable in the environment.
• Be positive about trips to the dentist
• Take your child to the dentist as often as recommended: this could be every three months or every year depending on the individual needs of your child.
• Don't reward a child with sweets for a good dental check-up - find something fun to do instead.

READ Do Those Amber Teething Necklaces Really Soothe Your Baby's Pain?

But does it work?

Ultimately, reversing the alarming rise in childhood tooth decay is not going to be simple. Fast-food chains and convenience stores frequently open near schools, placing temptation in the way of children too young to resist. Although, in the UK, there is talk of legislation to ban businesses that offer fattening, tooth-destroying junk-food within five-minutes' walking distance of schools, that does nothing to help the children who are already at risk of this dangerous and devastating disease, which cost the NHS £30 million last year.

However, legislation can only do so much. Parents must do their part by ensuring their children visit the dentist so problems can be caught early, by limiting sugary temptations in the home, and by ensuring their minor children brush properly and often.

Because no parent wants their child to be the next two-year-old who loses all their teeth.