In The News

After settling down at home following a long day at work, I tuned into the local news, to find that children’s teeth were top of the agenda. I was astounded by the statistics:

• 4 out of 10 children have rotten teeth.
• 314 children in the Bedford region needed a general anaesthetic under the age of 5 for dental treatment alone.
• An average of 5 teeth needed extractions.
• Rotten teeth continue to be the number one cause of general anaesthetics in children across the country.
• Nationwide- 7926 episodes of children under the age of 5 have had one or more teeth extracted in hospital due to tooth decay

£50.5m was spent on tooth extractions of children under the age of 19 from 2015-2016 (Public Health England, 2017)

This continues to bode the questions amongst parents, children and health professionals- why do children need to have general anaesthetics and sedation to have dental treatment, namely removal of rotten teeth? Dental decay has, and will always be, a preventable disease. In this blog I would like to discuss the impact of one of the main causes of tooth decay, diet, and how a healthy diet can promote good oral health, as education is power.

What role does diet play in oral health?

It is known that frequent consumption of sugars increases the likelihood of developing tooth decay in children. Usually ingredients ending in ‘ose' are sugars, for example: sucrose, fructose and glucose are just three types. These sugars can all damage your teeth (Oral Health Foundation, 2018). Consuming sugary foods and drinks more than 3 or 4 times per day provides food for harmful bacteria to damage young teeth, causing cavities (decay) which could then lead to toothache, causing a whole plethora of problems (including dental abscesses, broken teeth, time off school, and antibiotics). Even consumption of drinks which contain ‘no added sugar’ or ‘low sugar’ are marketed to have less sugar than similar products within the range (e.g. fruit squashes), but that by no means equals safe, which can be misleading.

                High acid intake can also be particularly harmful to soften the outer shell of teeth (enamel) making them weaker or wearing them away. Moreover, by reducing the strength of teeth they can be exposing the underlying layer of teeth (dentine) making them prone to discolouration and sensitivity.

                Fruit juices, milk and dried fruit may appear to be a healthier alternative for children’s general health, however contain naturally occurring sugars which can be harmful to teeth if consumed multiple times during the day, and dried fruit (such as raisins and sultanas) may stick to the teeth causing damage.

What initiatives are out there to promote good oral health and prevent dental decay in children’s teeth?

Dental Public Health continues to promote excellent oral health amongst parents, children and professionals, and prevention of diseases such as dental decay. Many successful initiatives are and have been rolled out across the country to tackle tooth decay:

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Dental Check By 1- this is an initiative set out to ensure that all children would have seen the dentist by the time they reach the age of one. This is not only to ensure that children’s teeth are developing normally, but also for dental professionals to instil diet advice to parents, to prevent problems with tooth decay from the very beginning, as well as acclimatising children to a new environment.Oral Health Advocates, Dentists and Dental Care Professionals- have extensive knowledge and are able to go out into communities such as schools, residential areas and children’s centres (pictured) to promote healthy diets. Change for Life- a flagship programme helping to tackle causes of childhood obesity and associated health risks provide a wealth of education on how to prevent tooth decay as well as other diseases by adopting a healthy relationship with food (Change4Life). The Department of Health and Social Care have also produced resources to tackle childhood obesity (National Child Measurement Programme, 2018)

https://www.bbc.co.uk/news/health-43659124

Sugar tax initiative-The British Dental Association (BDA) have campaigned for a sugar tax on soft drinks for many years, and the Government have announced a levy on sugary soft drinks from 2018, but are calling for measures to go further to cover a wider range of sugary food and drinks, and for proceeds of the sugar levy to go towards funding children's oral health initiatives. < >Social media power- videos such as ‘Do you know how much sugar is in your drink?’ produced by the BDA and information on NHS Choices help to illustrate the effect of refined sugars on a child’s oral health, how much sugar is safe for children of different age groups and healthy alternatives for reducing sugar in food and drink.Eatwell Guide- Shows how much of each food group we should have in order to maintain a healthy diet.

5 Top Tips for Tiny Teeth

Sugar Swaps- swap sugary and fizzy drinks for low fat milk and water.

https://www.nhs.uk/change4life/food-facts/sugar

Frequency is key- reducing the number of times when having sugary food and drinks to meal times and another time during the day (Delivering Better Oral Health, an evidenced-based toolkit for prevention). Sugary drinks can be consumed through a straw to reduce the impact on the teeth.After sugary foods and drinks, snacks such as low fat nuts, seeds and cheese can help to neutralise the acidic effects of sugar on teeth.Taking a child to a dentist regularly, as soon as their first tooth erupts. Until their 18th birthday, the time between appointments should never be more than 12 months. Dentists can answer your questions about tips for a healthy diet and lifestyle and check that children’s teeth are developing normally (British Society of Paediatric Dentistry).Limit the amount of fruit juice and smoothies a child drinks to a maximum of 150 ml (1 portion) in total per day and drink it with meals to reduce the risk of tooth decay, and where possible, request sugar free medicines. Fruits are better than fruit juices as the sugar is contained within them (Change4Life)https://www.bbc.co.uk/news/health-43659124. [Accessed 18 November 2018].

British Society of Paediatric Dentistry (2015) Obesity and Dental Decay in Children- A Position Statement

British Society of Paediatric Dentistry (2016) A Practical Guide to Children’s teeth

Change4Life. 2018. Sugar. [ONLINE] Available at: https://www.nhs.uk/change4life/food-facts/sugar. [Accessed 18 November 2018].

NHS. 2018. The Eatwell Guide. [ONLINE] Available at: https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/. [Accessed 18 November 2018].

Public Health England (2017) Delivering Better Oral Health, an evidenced-based toolkit for prevention (Third Edition)

Public Health England. 2017. Health matters: child dental health. [ONLINE] Available at: https://www.gov.uk/government/publications/health-matters-child-dental-health/health-matters-child-dental-health#how-to-prevent-tooth-decay. [Accessed 18 November 2018].

The BDA. (2016). Do you know how much sugar is in your drink?. [Online Video]. 19 February 2016. Available from: https://www.youtube.com/watch?time_continue=29&v=ssZi4MoTOzg. [Accessed: 18 November 2018].