Your child's dental needs explained

DENTAL decay is the single most common chronic disease of childhood.

So says paediatric dentist Dr Jennifer McCafferty who in the last few months has “had to take teeth from three-year-olds under general anaesthetic”.

McCafferty says the ten-year-old findings from the North South Survey of Children’s Oral Health in Ireland are still “absolutely true” today – 35% of children aged five living in fluoridated areas and 55% in non-fluoridated areas have experienced tooth decay. “This means one or more teeth has been filled or extracted due to decay.”

The figures for tooth decay in fluoridated areas for older children are:

* 21% of eight-year-olds

* 54% of 12-year-olds

* 73% of 15-year-olds.

“It’s not that parents don’t care but they’re not aware of what damages children’s teeth, which is fundamentally the level and frequency of sugar in the diet,” says McCafferty, adding that it’s sugar eaten between meals that causes a lot of the harm. Basically, she explains, each time you eat you get a level of acid attack — acid produced in the mouth starts breaking down the enamel surface of the teeth. The good news is after about 20 minutes, if no further sugar is taken, the acid begins to neutralise and tooth surface is restored to normal by the buffering effect of saliva. “The objective is to have food-free time between meals to give the mouth a break.”

The daily aim, say McCafferty, is three set meals and two healthy snacks — raw vegetable sticks, cheese and crackers, bananas, pita bread and hummus, natural yoghurt with chopped melon or blueberries. High-sugar snacks — obvious treat foods like chocolate, sweets and biscuits but also many yoghurts targeted at children and innocent-sounding smoothies, as well as sticky foods, especially sticky fruits like raisins, are a no-no. Apples and oranges — very high in natural sugars and very acidic — should also be avoided between meals. Low sugar content is less than 5g of sugar per 100g of the particular food.

When it comes to drinks, avoid anything fizzy and don’t give children fruit juices between meals (even diluted). Milk and water are the best drinks for children from when they’re babies, says HSE dentist Jackie O’Neill, who warns against sending toddlers to bed with a bottle of milk — it causes early childhood caries. Keep unsweetened fruit juice for meal times – drinking it through a straw means it bypasses teeth.

Once child’s teeth start erupting at about six months, parents with untreated dental disease can pass bacteria (main one is streptococcus mutans) to the child if they practice unthinking behaviours – holding soother in parent’s own mouth before passing it to the child or putting a spoon of food in their mouth to check temperature prior to feeding it to baby.

Age three is a good time to bring your child with you to the dentist so s/he can simply sit in the chair and discover the dentist isn’t an ogre, suggests O’Neill, who advises against telling kids how brave they are for visiting the dentist.

Children as young as three can get toothache due to decay. Areas of discolouration on teeth may indicate this. The HSE children’s dental service usually sees primary school children twice during their school career. They’re also entitled to free emergency treatment (if a child’s in pain or has broken front permanent tooth). Post-primary children under 16 are entitled to free emergency treatment, as are under-sixes.

At the child’s first visit to a HSE dentist – once first permanent molars have erupted and are decay-free – they’ll be offered fissure sealants, a plastic material that coats molar teeth. This is a durable barrier preventing build-up of plaque that can lead to cavities. If child’s teeth are not decay-free, s/he will be offered fillings.