This factsheet contains some information for parents to help their children
grow up with healthy teeth. It covers diet and oral hygiene, as well as some advice about taking your child to the dentist.
Children's teeth start to develop before they are born. There are two
sets of teeth: "milk" teeth and permanent teeth.
Milk
teeth
Children usually have 20
milk (or deciduous) teeth. They start to grow through the gums (erupt) at about six months old. Most children have all 20
teeth by the age of two or three.
Milk teeth have an important part to play in the development of the permanent
teeth, so it is very important to look after them.
Permanent
teeth
Permanent teeth usually start
to erupt at the age of six. Adults have up to 32 permanent teeth. Most of these will erupt by the age of 13. However, wisdom
teeth - those at the very back of the mouth - often don't erupt until the late teens or early twenties.
Permanent teeth press on the roots of the milk teeth. The roots dissolve
until the milk teeth fall out. This is called exfoliation and happens between 7 and 13 years old.
If permanent teeth are damaged or need to be removed, there will not be
another set of natural teeth to replace them.
What
can damage my child's teeth?
Many children fall over and bump their teeth accidentally. This is usually
unavoidable and you should take them to the nearest dentist or Accident and Emergency department for treatment.
However, tooth decay (dental caries) and dental erosion are two common
causes of damage to children's teeth that can be avoided.
Tooth
decay
Our mouths are full of bacteria
that build up on the teeth in a sticky layer (plaque). These bacteria digest some of the sugar in our food and drinks, making
acids that can weaken the tooth enamel.
Frequent sugar in the diet combined with insufficient toothbrushing mean
that the acids from the bacteria stay in contact with the teeth for long periods of time, resulting in tooth decay.
Untreated decay will eventually reach the centre of the tooth and can
result in an infection or toothache.
Dental
erosion
Dental erosion is gradual
wear of the surfaces of the teeth. It is caused by acid attacking the surfaces of the teeth, but this time the acids are not
made by bacteria. Instead, the acids usually come from drinks such as fruit juices, fizzy drinks and squashes - even the sugar-free
varieties.
Dental erosion is irreversible and can result in sensitivity and pain.
How
can I protect my child's teeth?
There are a number of things that you can do to reduce your child's risk
of tooth decay and dental erosion. Some useful tips include:
- take
your child to the dentist regularly
- restrict
sugary or acidic food and drinks in their diet
- encourage
regular toothbrushing
- take
advice from your dentist about protective treatments such as fluoride supplements and fissure sealants
These tips are discussed in more detail below.
Going
to the dentist
It is a good idea to take your child when you go for your own routine
dental check-ups, even when they are too young to have teeth. This helps them to become familiar with the people and the surroundings
at the dental surgery.
Your dentist will look in your child's mouth in a fairly informal way.
This allows your dentist to count how many teeth have erupted and spot any early signs of decay. Quick, painless check-ups
like this help to encourage good co-operation when your child is older.
Your dentist will recommend check-ups at intervals that are suitable for
your child's needs. Children usually need more frequent dental visits than adults. This is because milk teeth are smaller
and have thinner enamel, so decay can spread very quickly. Frequent check-ups help your dentist to treat decay early, before
it causes toothache.
Diet
Most parents know that reducing sugar in the diet is the best way to prevent
tooth decay. What many don't realise, though, is that it is how often their child eats sugar - rather than how much - that
is important. Eating sugary food and drinks frequently is the main cause of tooth decay.
Similarly, it is the frequency of acidic food and drinks - rather than
the amount - that affects tooth erosion. Consuming acidic drinks frequently is the main cause of tooth erosion.
To protect your child's teeth against decay and erosion, try to keep squashes,
fizzy drinks, natural fruit juices, sweets and cakes to a minimum. It is especially important to avoid sugary food and drinks
as snacks between meals or before bedtime.
Fruit, vegetables, cheese and milk are all healthier snacks because they
contain natural sugars. These are much less likely to cause decay. You can help to protect against erosion by finishing a
meal with an alkaline food such as milk or cheese. This will neutralise the acid in your child's mouth.
Plain water doesn't cause tooth decay or erosion. Some children find it
hard to drink water if they usually have sweeter drinks, but they will get used to it in time.
Toothbrushing
You should start cleaning your child's teeth as soon as they come through
the gums. Toothbrushes specifically for babies are available. It is important to try and make toothbrushing a regular activity,
after breakfast and before bedtime, so that it becomes part of your child's daily routine.
As your child gets older you can teach them how to brush their own teeth,
using a gentle, circular motion and fluoride toothpaste. Make sure that they understand that they have to clean every tooth.
Give them plenty of encouragement and praise.
You should supervise your child while they brush their teeth. Once they
are about seven years old - or can write legibly - they can start to brush their teeth on their own, but check how well they
are doing every few days.
Disclosing tablets are small pills that, if chewed for 30 seconds, turn
plaque a bright colour - usually pink. This can help you to show your child any areas that they have missed.
Toothpaste
Most toothpaste contains a mineral called fluoride that has been proven
to protect teeth against decay.2 In areas where it is added to the water supply (water fluoridation), tooth decay
has been significantly reduced.3 Fluoride is present in the water supply in some parts of the country.
The use of fluoride has caused some controversy and a great deal of research
has been done to determine its safety. The scientific opinion is that fluoridation does not affect general health. However,
excessive fluoride in young children can result in a mottled appearance on their permanent teeth (dental fluorosis).
The amount of fluoride in different brands of toothpaste varies. This
amount is measured in "ppmF" (parts per million fluoride). This is printed on the side of the tube or box. Most toothpastes
are about 1000 to 1500ppmF. Some children's toothpastes are much lower and may not be strong enough for children who are more
vulnerable to decay. Your dentist will recommend a suitable toothpaste for your child.
If your child is less than two years old, only use a smear of toothpaste.
Then, use an amount about the size of a small pea until they are seven years old. You must make sure that they spit the toothpaste
out after brushing. However, fluoride needs to be in contact with the teeth in order to have an effect, so you should not
ask your child to rinse their mouth out with water after toothbrushing.4
Fluoride
supplements
If your area doesn't have fluoridated water, or your child's teeth are
particularly vulnerable, your dentist may recommend extra fluoride in the form of tablets, drops or mouthwashes. You should
give these to your child several hours before or after toothbrushing, following your dentist's instructions.4
Fissure
sealants
Some children have very deep fissures (crevices) in their permanent back
teeth. These 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 onto the tooth and hardened with a bright,
blue light.
Fissure sealants can last for several years but regular visits to the
dentist are needed to check that they have not worn through. Children with fissure sealants still need to brush their teeth
with fluoride toothpaste.
Further
information
References
2. Marinho VCC, Higgins JPT, Logan S, Sheiham
A, Topical fluoride (toothpastes, mouthrinses, gels or varnishes) for preventing dental caries in children and adolescents,
The Cochrane Database of Systematic Reviews 2003, Issue 4.
www.cochrane.org
3. Water fluoridation and health, Medical Research
Council working group report, 2002.
www.mrc.ac.uk
4. Preventing dental caries in children at high
risk, Scottish Intercollegiate Guidelines Network, publication number 47, 2000.
www.sign.ac.uk
Published by BUPA's
health information team, healthinfo@bupa.com, April 2005
