Leaflet: Looking after children’s teeth (pdf)
Children in the 6 – 12 year age group can be at great risk from dental decay. This is the stage when the permanent teeth come through from about the age of 6 years old. As the teeth start to appear, they may cause minor discomfort. You may notice that the teeth are not as white as the ones they are replacing. The front teeth are larger than the baby teeth which can cause over-crowding as there isn’t enough room for them because the jaw hasn’t finished growing.
|Ages when the teeth normally come through|
|1st incisor||6 – 7 years||7 – 8 years|
|2nd incisor||7 – 8 years||8 – 9 years|
|Canine||9 – 10 years||11 – 12 years|
|1st Premolar||9 – 12 years||9 – 12 years|
|2nd Premolar||10 – 12 years||10 – 12 years|
|1st Molar||6 – 7 years||6 – 7 years|
|2nd Molar||10 – 12 years||11 – 13 years|
|3rd Molars||17 – 21 years||17 – 21 years|
Decay is one of the most common diseases in the West and is responsible for a large number of days off school and work. Sugar is the main cause of tooth decay and so decay is completely preventable and is due to diet and oral hygiene. There are two main things that can lead to tooth decay in children:
- The frequency and amount of sugary snacks and drinks consumed. The more frequent, the more likely decay occurs.
- Not brushing their teeth twice a day with fluoride toothpaste.
Decay can be caused by giving children drinks for long periods or at night and filling the cup with sugary drinks, fruit juice or adding sugar to drinks.
The biggest cause of decay is the amount and frequency of sugar consumed. Bacteria break down the sugar to produce acid and this attacks the teeth. Food and drinks containing sugar or acid should be limited to mealtimes and only sugar-free snacks eaten between meals. Many foods contain sugar, not just sweets and cakes. Cereals, plain biscuits and flavoured yogurts are also high in sugar content. Sugars should not be eaten more than four times a day.
Labelling can be confusing: ‘low sugar’ may simply mean that the product contains less sugar than the standard product and ‘no added sugar’ may be sweetened with concentrated fruit juices or fructose. Other words may be used to describe ingredients that are harmful to teeth: glucose, glucose syrup, fructose, concentrated fruit juice, sucrose, dextrose, honey, invert sugar, maltose and hydrolysed starch. In general items listed ending in ‘ose’ are sugars; for example, sucrose, glucose and fructose.
It is not realistic to expect children never to have sugary foods, but what is important is how often they have them. Keeping them until immediately after a meal is a good suggestion.
If children are hungry between meals, fresh fruit or vegetables, breadsticks or wholegrain bread or toast is a good alternative.
Water and milk are the healthiest drinks for teeth.
Fizzy drinks, fruit juices or fruit squashes are popular among children and it is important to reduce the number of times that these are drunk between mealtimes. Because they contain sugar or acid, they can have a harmful effect on the teeth. How long and often the sugar in the drink is in contact with the teeth influences the chance of decay occurring and so drinking times should be kept short. Frequent drinking of these drinks mean acid is attacking the teeth often. Fruit juices and squashes can be diluted with water to partly reduce the harmful effect. Fizzy drinks can cause the wearing away of teeth (erosion) due to their high acid content, while milk shakes also contain high amounts of sugar.
Older children are more independent and may be able to buy drinks at school. It is important that they know the risks to help them make healthy choices.
Toothbrushing is important to control plaque and prevent gum disease. Effective tooth brushing twice a day with a small headed brush should remove plaque. Brushing last thing at night is vital. The brush should be a manual one with round end filaments, or a powered toothbrush with a rotating head that moves back and forth. The brush should be replaced every 3 months and each person should have their own to prevent infection being transferred. The recommended amount of toothpaste is a pea sized amount containing 1350 – 1500 parts per million of fluoride. This is displayed on the toothpaste tube. The toothbrush with toothpaste should not be rinsed before using. The toothpaste should be spat out after without rinsing to avoid washing the fluoride away. Children under the age of 8 should be helped or supervised to make sure that they are brushing well.
If a child is wearing an orthodontic appliance (brace) it is important that both the brace and the mouth are kept as clean as possible to reduce the chance of tooth decay and gum disease.
Extra fluoride treatments (e.g. fluoride mouth tablets, drops, rinses, varnishes, gels and foams) help to protect teeth against decay. The dentist will be able to recommend these if the child needs them and are suitable to about the age of 12. They should be kept out of children’s reach. Parents must follow the correct dosage and they should not be used where there is added fluoride in the water supply.
Visiting the dentist
As with any age group, it is important for children to visit the dentist at least once a year to check for any problems and help stop decay. The dentist can provide preventative treatment, as well as giving advice, but also look for trouble with the gums and soft tissues round the mouth. The earlier problems are found, the better the result of treatment.
Dental treatment is free for all children up to the age of 18 years.
Leaflet: Looking after children’s teeth (pdf)