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The tooth hurts: oral health in the early years



Despite significant improvements in oral health over the years, tooth decay remains a big problem in young children and is the most common reason for hospital admission in this age group.

Despite significant improvements in oral health over the years, tooth decay remains a big problem in young children and is the most common reason for hospital admission in this age group.

Yet a child’s first teeth are enormously important developmentally to help them chew and learn to talk, for overall quality of life, self-esteem and social confidence.

Poor oral health (and treatment) can cause pain, discomfort, sleepless nights and difficulties in eating, which may lead to inadequate nutrition.

Those who are treated with fillings or experience early loss of baby teeth may require complex maintenance or orthodontic treatment such as braces later on.

The good news is that tooth decay is largely preventable so it’s important to concentrate on measures that improve oral health in families. An example of a successful intervention is the Childsmile programme in Scotland, which has transformed dental healthcare for children since its introduction in 2006.

The role of nutrition in tooth decay

Oral health has an impact on good eating habits, and diet and nutrition have an important role to play in healthy teeth.

Excess and frequent intake of sugary foods and drinks is one of the main causes of tooth decay. Cutting down on sugary food and drinks, particularly between meals or within an hour of going to bed, reduces the risk of tooth decay.

The Government recommends that free sugars* shouldn’t make up more than 5% of our energy (calories) from food and drink each day. In children aged 4 to 6 this equates to no more than five sugar cubes (19g) and for those under 4 years it’s recommended that they avoid food and drinks with added sugars altogether.

Sugars also occur naturally in fruit, vegetables and milk, but we don’t need to cut down on these types of sugars. However, dried fruit are higher in sugars and can stick to teeth which can also contribute to tooth decay.

Carers may think raisins are a healthy snack but to help tooth health they should be eaten at mealtimes only.

Fizzy drinks and juice drinks, even the sugar-free versions, can cause tooth erosion so these should be avoided. Water and milk are the only tooth friendly drinks.

There are also certain nutrients like calcium that are important for the healthy development of teeth, so young children should get at least 350ml (12oz) of milk a day or two servings of dairy foods (e.g. cheese, yogurt , fromage frais) or calcium-fortified alternatives.

What can health professionals do to prevent tooth decay?

It’s important that children establish healthy eating (and drinking) patterns as early as possible, to help protect their teeth now and as they get older, and of course getting into the habit of brushing teeth and visiting the dentist regularly.

It’s also important to remember the Healthystart scheme supports good oral health by providing free vouchers to families on low income that can be exchanged for fruit or vegetables, milk, and vitamins.

Promoting oral health should be an integral part of the health and care system in young children, and both health professionals and the early years workforce have a key role to play in encouraging and supporting parents and carers to look after their child’s oral health to help every child get the best possible start in life.

*Free sugars are those added to food or drinks, and sugars found naturally in honey, syrups, and unsweetened fruit and vegetable juices, smoothies and purées.

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