For lower levels of child tooth decay, begin at home

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  Posted by: Dental Design      2nd April 2021

For improving children’s oral health, a practitioner’s biggest ally is often the family unit. If you encourage everyone to adopt good preventive behaviours, its youngest members will get into the hygiene habit early and enjoy the benefits for years to come.  

Previously published statistics for children’s oral health in the UK have been concerning; in 2019, figures showed 100,000-plus hospital admissions for under 10s due to tooth decay in England alone.[i] With caries being largely preventable, why was this number so high?

Partly, it is because reducing levels of childhood decay is a complex issue, a tangle of multiple threads. For general health and wellbeing, household income has always been a key determinant, for example. Mitigating the impact of poverty is a public health priority, and children living in disadvantaged communities are more likely to suffer from chronic disease and problems relating to poor nutrition, including dental problems.[ii]

Pandemics “disproportionately affect” the poorest in society; the economic crisis perpetuated by COVID-19 has already exacerbated inequality in the UK, with the long-term impacts yet unknown.[iii],[iv]  Oral health practitioners who work in these communities will know that families are finding it even harder to access dental care and vulnerable patients, including children, are falling deeper through the cracks that were present before 2020. A report published at the end of 2020 suggested that eight million people waiting for an appointment with an NHS dentist were unable to get one.[v]

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If a child has untreated decay, it can lead to pain and discomfort, problems with nutrition, issues with sleeping and can affect their concentration and confidence. Prevention is key, which is why good engagement with families and carers is essential. The messaging should be clear and based around simple changes. Sugar consumption is perhaps the best place to start, as children in the UK historically have a sweet tooth, and regularly consume more than the recommended daily intake.[vi]

Milk is our first food, and whether mother’s or formula, it is sweet tasting, so maybe we are conditioned early to favour sweet, soothing things. But even if children enjoy savoury foods too, there is the problem of hidden sugars in everyday, seemingly healthy, items given with good intentions – breakfast cereal is one of the biggest culprits, also dried fruit, yogurt and some juices. For drinks, there really is no better choice for children that plain water, which will quench their thirst and keep their oral cavity healthy and well lubricated. Fizzy soft drinks full of sugar should not be offered – parents will benefit from staying away too, as even drinks labelled “sugar-free” are acidic due to the carbonation. The Sugar Tax in the UK, a levy applying to drinks containing more than 5g of sugar per 100ml (with certain exclusions including fruit juice and milk-based drinks) was introduced to discourage consumption based on cost, although people may simply choose cheaper versions.

Supporting a family to reduce or, better, eliminate sugary drinks is a step in the right direction that is easy to take. So is taking better care with snacking. Children tend to enjoy snacking and snacks are routinely given to pre-school children as a distraction – fruit is best, or something savoury like crackers (check the salt content), or a bagel, which is also filling. As they grow older children should get used to eating enough at mealtimes so they don’t need a snack “to keep going”, but snacking is often just a habit, that can easily be broken.

One of the most effective ways in which parents can be allies is by practising good hygiene themselves. Since the pandemic, there has been a greater focus on the importance of home regimens, to prevent oral disease and avoid the need for treatment. If children see their parents or carers cleaning their teeth regularly and properly, they are more likely to follow by example. For toddlers and young children, being shown correct technique, so they can do it themselves once they have the motor skills will reinforce habits. So, work with parents first, by demonstrating brushing technique and the benefits of cleaning interdentally to elevate a routine. Interdental cleaning doesn’t have to mean string floss or an interdental brush because there are alternatives, such the Waterpik® Water Flosser, which will clean deeply, but gently, between the teeth and below the gumline. The Waterpik® Water Flosser is simple to master and takes just a few minutes every day – consistency is key, children respond to consistency and can see how taking care of their teeth is easy.

To support children, we must support their families and carers. Reducing childhood decay is a big issue, but not one a practitioner should feel overwhelmed by. Tackling sugar consumption and effective home care requires a family to make small, practical changes which will pay huge dividends and maybe motivate them to make bigger ones, to maintain good oral health for a lifetime.

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[i] Admissions of children aged 10 years and under to hospital for extractions due to decay. NHS Digital, 10 January 2019. Link: (accessed December 2020).

[ii] Health at a price: reducing the impact of poverty. BMA, a briefing from the board of science, June 2017. Link: (accessed December 2020).

[iii] Abrams EM, Szefler SJ. COVID-19 and the impact of social determinants of health. The Lancet. Respiratory Medicine. 2020 May 18.

[iv] Financial inequalities widen due to Covid-19. Study from UCL, 20 November 2020. Link: (accessed December 2020).

[v] New report shows at least 8 million people will be waiting for an NHS dentist this Christmas

ADG, 15 December 2020. Link: (accessed December 2020).

[vi] Results of the National Diet and Nutrition Survey (NDNS) rolling programme for 2014 to 2015 and 2015 to 2016., 11 April 2018. Link: (accessed December 2020).

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