Caries (tooth decay) is perhaps the most common disease of children in the UK. It is caused by bacteria which act on certain foods in the mouth. Sugary foods and drinks are the worst. The combination of bacteria and food causes acids to form which can slowly dissolve the teeth. If this happens, a filling may be needed. If it is left untreated, the tooth may decay further and need to be removed. Caries be prevented by brushing teeth, using fluoride, the right choice of foods, and a dental checkup ever 6-12 months.

Brushing teeth

Encourage children to brush their teeth at least twice a day. Start as soon as the first tooth develops in infancy so that you and your child get into a habit. Many children don’t like their teeth being brushed at first. However, it is possible to make it into a game when first started. Do persist as it is very important to develop this habit. By the age of 3 or 4 children can often clean their own teeth (under supervision). A fluoride toothpaste is recommended.

Foods

As far as possible, limit sugary foods and drinks between meals. If you children have sweets, it may be better to eat them all at once as a snack rather than spread them over several hours. Try fruit or raw vegetables as snacks instead. If you child needs medicine, sugar-free medicines are best if they are available.

Fluoride

Fluoride is a chemical that is found naturally in water in very low concentrations. It helps to protect teeth against caries. Some areas have fluoride added to the water supply. This has greatly reduced tooth decay in those areas. It is worth finding out if your area is a fluoride area (your dentist will know). If not, your dentist may advise fluoride drops.

Dental checks

It is worth getting your child used to dental check-ups from an early age. A check up every 6-12 months is best. In some areas, particularly where there is no fluoride in the water supply, a ‘sealant’ can be placed in the crevices at the back of the teeth by a dentist. This helps protect the teeth from caries and tooth decay. It is 6-7 year olds who may benefit most. A dentist will advise about this.

Fissure sealants

Some children have very deep fissures (crevices) in their permanent back teeth, which can be difficult to keep clean. These fissures can be sealed with a resin film to protect the surface from decay. Fissure sealants are quick and painless to apply. The dentist cleans the tooth with a special acid, then washes and dries it. The resin is then painted on to the tooth and hardened with a bright, blue light. Fissure sealants can last for several years, but your child should visit the dentist regularly to check that they haven’t worn through. Children with fissure sealants still need to brush their teeth with fluoride toothpaste.

To reduce your child’s risk of tooth decay and dental erosion:

• take your child to the dentist regularly
• don’t give him or her too many sugary or acidic foods and drinks
• encourage your child to brush his or her teeth twice a day with at least 1,000ppm fluoride toothpaste
• encourage your child to spit out toothpaste and not rinse with water, as this reduces the effect of the fluoride
• take advice from your dentist about protective treatments such as fluoride supplements and fissure sealants (see Fissure sealants)