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Rachael Hinton

Baby teeth removals "up 24% in a decade"


The Faculty of Dental Surgeons and the Royal College of Surgeons have released data this week that shows more 0-4 year olds than ever are having tooth extractions. Here is a quick guide on how to avoid this for your child.

Being a parent is hard work. As a mother that has to regularly pin her toddler down to brush his teeth I know that it is not easy to do all the right things when it comes to our little ones. The new data out today, shows some shocking stats about how badly our children are being affected by tooth decay. This is a largely preventable condition that can really cause such pain and misery for a child and lead to them needing a potentially risky general anaesthetic.

So here is a quick guide to avoid the pitfalls that could lead to this situation:

1. Brush your baby's teeth and gums.

No one is going to pretend that this is always easy. Babies and toddlers are notoriously difficult or choose to assert their independence when you are feeling at your most frazzled. But, it is so important to brush their teeth in the morning before breakfast and at night before going to bed. And start as soon as those bottom front teeth first break through. Try to sit your child on your lap facing away from you, with their head cradled against your arm and bring the toothbrush in from the side. It's far less threatening. Buy a children's toothbrush with a small head and different length bristles. Many health visitors will even give these out to parents. Be as methodical as possible brushing all of the surfaces of the teeth you can see. Sing a song if it helps, do it in the mirror or tickle if it gives you a better view! If you can make it fun do so. By the way, you should continue to brush your child's teeth until they are at least 8 years old because they don't develop the small movements of their hands enough to brush their teeth properly alone until around that time.

2. Use fluoride toothpaste.

Fluoride toothpaste is safe. The jury is not out, its conclusively been proven to be safe when used appropriately. That said, it is NOT safe if used inappropriately. So you do need to be careful. Using a children's fluoride toothpaste is absolutely the right thing to do. If you look on a toothpaste tube you will see that the amount of fluoride in it is written there, you want it to say 1000ppmF. No more and no less for children under three, since your child will not be able to reliably spit the toothpaste out. Anyone above the age of three can use an adult toothpaste, which contains more fluoride. But you must be careful not to leave the toothpaste in reach of your child especially if they like the taste as too much is harmful. Put a small smear on the toothbrush for under threes and a pea sized amount for the overs. Fluoride works in lots of ways by strengthening the tooth enamel and stopping the bacteria that cause tooth decay directly. It is the best protection we have against tooth decay.

3. Reduce sugar in their food.

There are so many times when parents bring their children to see me, that they are confused about sugars or they think that their child doesn't have any sugary food but they have tooth decay. Tooth decay cannot happen without sugar. It is impossible as the bacteria that cause the decay only eat sugar. Of course there are obvious refined sugars like those in penny sweets, crisps, cakes, biscuits, juices and soft drinks. But don't forget that lots of sugar can be hidden in healthy foods. Often yoghurts are sweetened with sugar, so try to choose natural yoghurt instead of fromage frais to give your child the dairy they need. Dried fruits such as raisins and overripe fruit (think yellow/brown bananas) are as sugary as sweets and stick to teeth for a long time after they are eaten. Blended fruits in milkshakes and smoothies have had all the natural sugars released and made accessible to those decay causing bacteria. It really can be a minefield providing a healthy diet to your choosy toddler and then being told that you have to watch out for some fruits too! So first of all just be aware of what counts as sugar. Nobody would suggest that you cut out healthy foods from your child's diet, instead what we need to do is reduce how often their teeth are exposed to this sugar. Saliva or dribble is very protective and given a chance will cleanse teeth through the day. You need to expose teeth to less than four sugar hits in a day to keep them protected.

4. Regular mealtimes are important.

The more your toddler snacks, the more likely they are to have tooth decay. This is because to get tooth decay, sugar needs to be feeding the bacteria in your mouth regularly enough that your baby's saliva can't protect their teeth. It is how many times in a day that sugar hits those teeth that is the most important thing where tooth decay is concerned. So try and give your baby and toddler routine from an early age and give them a breakfast, lunch and evening meal. Try and avoid sugary cereals for breakfast - think about something like porridge and unblended fresh fruit. Don't think that because you don't like something that your baby won't with lots of positive encouragement. Toddlers need meals little and often to maintain their energy levels. So once you have your main meals sorted you need to consider what might be safe snacks. Cheese, vegetable sticks, breadsticks, savoury pastry, potato croquettes, bean burger bites. Make it as simple or as complicated as you want. A dentist will happily give you a diet sheet to complete at home, which they can then go through with you to look at whether there are any potential problems.

5. Make water and milk the only things they drink.

No child needs juice or soft drinks. Many adults are not that keen on drinking water on its own and so when their child refuses a drink on occasion they immediately think they just don't like it. But if a child is never given juice or soft drinks, they will always drink water and milk. It is that simple. Between birth and six months your baby will be exclusively milk fed. In an ideal world they would be breast fed as this provides the perfect balanced diet for your baby, but if not a formula preparation. Breast milk is not harmful to teeth on its own. At around six months you will start to wean. Between this age and one, how much milk your child has will depend entirely on how weaned they are. Water should be offered with meals. Cow's milk should only be given from one year old. From then until three, full fat milk should be given to your baby. They typically need around 300ml per day (half a pint). Milk provides the calcium, proteins and fats they need to grow so is an important part of their diet as a child. Water should however, be the go to liquid for thirst, and that is because prolonged exposure to milk can contribute to tooth decay. If you choose to give your child juice or a soft drink as a treat, never put if in a bottle. Sipping on a bottle with sugary drink can cause terrible tooth decay. Give it in an open cup at meal times. No bottles should be left overnight in bed with anything other than water in them.

6. Breastfeed until they gain their nutrition from solid food.

Breastfeeding is a deeply personal decision. Some mothers never want to breastfeed, some desperately want to and can't and other mothers want to do it forever! When to stop is a decision each mother and child makes together, however some dentists believe that prolonged breastfeeding contributes to tooth decay. Breast milk on its own seems to cause no decay, but combined with solid foods it may speed up tooth decay in some circumstances. So once a child gains their nutrition from solid food, it is probably a good time to consider when to stop breastfeeding. That might not gain me popularity in some circles, and the benefits of breastfeeding are enormous, but later on some believe the downsides outweigh the benefits.

7. Look out for signs of tooth decay

When you look at your child's teeth if you see frosted patches or brown spots, you need to get these checked. These are the first signs of tooth decay. Later you might see an actual hole or your child might start avoiding eating, complaining or crying from tooth pain. If there is a problem, the earlier you can see it the better, so make sure you look at your child's teeth and go to a dentist straightaway if you are concerned.

8. Take your child for regular dental check-ups.

Dentists prefer to see your child when they are happy, smiley and healthy! Many people have a fear of the dentist from an early experience. The earlier you can bring your child to see the dentist the less likely it is that they will have a fear in the future. Try not to be scared for your child if you have a fear as they will pick up on this. Be brave, smile and make it a fun experience. If you bring your child from the time their first teeth appear, they will be used to the sights and sounds and find the whole experience less scary. The dentist might not be able to look at your child's teeth at the first visits, but they will be able to give you advice and support you. You can ask questions about diet and brushing. When your child is used to the dentist they will let the dentist look at their teeth and regular check ups allow the dentist to spot early signs of trouble. If we know there is a problem we can get to the bottom of the cause quickly and stop anything getting out of hand!


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