In almost all children, remaining cavity free is possible if the right preventive measures are taken from the start. People often ask me why their child got cavities? Was it due to their diet? Or because they didn’t brush enough? Or perhaps due to a lack of protective fluoride in the water or toothpaste? In almost all instances it isn’t one of these reasons alone, but a combination of these (and sometimes other) factors.

What causes tooth decay?

Oral bacteria process sugars in the diet to produce acid, which can cause tooth decay. There are over 700 types of germs or bacteria that live in the mouth, although not all of these cause cavities. Historically the bacterial film was called dental plaque. However, we now realise that these germs form a complex bacterial community, termed an oral biofilm. Early lifestyle and behavioural factors determine if a healthy biofilm will be established in the child’s mouth. The first 2 years are therefore crucial to long-term oral health.

Does diet influence the growth of certain types of bacteria?

Yes! Sugar creates stress in the oral cavity disrupting the healthy oral balance developing in your child’s mouth. Sugar provides the energy for the bacteria, which produce acid as a by-product. Frequent ‘acid attacks’ can cause cavities in the teeth. Some simple tips are:

  • Only give children plain milk or water to drink. Children should not sleep with bottles of milk at night, nor sip on-demand during the day.
  • Encourage children to enjoy a range of nutritious, unprocessed foods. Foods such as unsweetened yoghurt and cheese along with whole grains and nuts actually protect the teeth from decay.

More simple tips include:

  • Give whole pieces of fruit and vegetables, but not juice.
  • Do not add sugar to children’s foods.
  • Avoid sweet foods wherever possible and that means honey, jam, lollies…and have the courage to say no to marshmallows at cafes!

Brushing basics – how do I get the habits right from the start?

The teeth need to be brushed using a soft toothbrush twice daily from the time they first appear through the gums. Infants and toddlers should be laid on the floor or bed so that you can position yourself behind them to brush their teeth properly. Preschoolers can stand in front of the bathroom mirror on a step whilst you stand behind them to brush. If the adjoining teeth touch, dental floss should also be used to clean the areas between the teeth. Floss first, then brush.

It’s normal for children to offer some resistance to toothbrushing so persistence is the key! As children learn to understand that brushing is a ‘nonnegotiable’ it becomes part of their healthy routine. Always try to make toothbrushing fun. For younger children have a colourful mobile/toy for them to look at and sing some nursery rhymes for entertainment. Give them praise for having their teeth cleaned. Older children may have a rewards chart and be allowed to listen to a brushing ‘app’ or favourite song. This helps to ensure they clean for a full 2 minutes, twice a day. Young children cannot effectively clean their teeth independently; in fact, all children should be actively supervised and assisted until they are 8 years of age.

Fluoride – a ‘safety-belt’ for teeth

Fluoride works by making teeth more resistant to the acid attack following sugar consumption. Drinking fluoridated tap water and using fluoridated toothpaste are simple, and inexpensive ways to help protect the teeth. Unfortunately, some Tasmanian water supplies remain unfluoridated. Tank and bottled waters are not optimally fluoridated.

Toothbrushing not only cleans the teeth but also delivers protective fluoride to the tooth surface. A tiny smear of fluoridated toothpaste should be pushed into the bristles. For children under 2 years this amount is equivalent to 1 grain of rice, those 2-3 years 2 grains of rice, and the amount for children 3 years and over is only a small pea.

Children should neither rinse the mouth, nor drink or eat anything for at least 30 minutes after brushing. From 5 years of age children should use adultstrength toothpaste. Some children under 5 years actually require the protection of adult-strength toothpaste, so please check with your dental professional.

When should children visit a dentist?

The Australasian Academy of Paediatric Dentistry recommends that children first attend the dentist by age 1. Most children need to be checked every 6 months throughout childhood.

Newer ideas for oral health…probiotics, calcium crème, sugar-free gum

Probiotics may help to establish a healthier oral biofilm for a child’s entire life. So watch this space as more research is released.

Tooth Mousse is a topical crème that provides calcium and phosphate to help protect the teeth. Dental professionals often recommend Tooth Mousse for children at higher risk of decay.

Sugar-free chewing gum encourages saliva to help neutralise plaque acids, when the teeth cannot be brushed after meals. For obvious reasons, only provide such gum to responsible, school-aged children.

The take home message…Cavity-free kids are healthier kids

As a parent or guardian you are the expert about your own child’s life. So work with an oral health professional to help ensure your child’s mouth stays healthy. Let’s prevent dental decay from starting.

Chat sponsor, Dr Marilyn Owen is a Paediatric or Children’s Dental Specialist, who cares for children at Tassie Kids Dental. After being a general dentist for a decade, Dr Owen completed 3 years-full time specialty training at The University of Melbourne. Tassie Kids Dental is located in both Hobart and Launceston to offer dental care to Tasmanian children.