Elsewhere in this issue we look at the teething period, and the importance of early dental care for babies and their mothers. But it seems that for many, good advice hasn’t been heeded. A recent NHS report showed that the number of children having teeth removed in hospital has risen almost a fifth in the last six years.
The NHS figures show that there were more than 45,000 hospital operations to remove teeth from teenagers and children in 2017/18 – a rise of 18 per cent since 2012/2013.
The severity of the tooth decay often means that the treatment has to be undertaken in a hospital under general anaesthetic, rather than by a dentist. In 75 cases, children had to have every single tooth removed – a 40 per cent rise over the period.
Dentists agree that there are two main causes of this shocking rise in tooth decay among children – a sugary diet, and too little toothbrushing.
The Local Government Association (LGA) urged ministers to introduce measures to cut sugar consumption, including labelling on food packaging. Ian Hudspeth, chairman of the LGA’s community wellbeing board, said: “These figures, which have risen sharply, highlight the damage that excessive sugar intake is doing to young people’s teeth.
“The fact that, due to the severity of the decay, 180 operations a day to remove multiple teeth in children and teenagers have to be done in a hospital is concerning and also adds to current pressures on the NHS.
“This trend shows there is a vital need to introduce measures to curb our sugar addiction which is causing children’s teeth to rot.
“There must be a reinvestment in innovative oral health education so that parents and children understand the impact of sugar on teeth and the importance of a good oral hygiene regime.
And Mick Armstrong, the chairman of the British Dental Association said: “The Government says ‘prevention not cure’ is the mantra, but still treats dentistry as an optional extra.
“Tooth decay remains the number one reason for hospital admissions among young children, but ministers have not put a penny of new investment into early years prevention.
“In the NHS’s 70th year, ministers need to offer more than unfunded gimmicks. We require a dedicated and properly resourced national effort to end the scandal of childhood decay.”
Dental development means that prevention is certainly better than cure, and getting into dental are habits early will pay dividends.
The first permanent adult molars will appear at about the age of six, probably before the first baby teeth start to fall out at about six to seven. The lower front teeth are usually lost first, followed by the upper front teeth shortly afterwards. All permanent teeth should be in place by the age of fourteen, except the ‘wisdom’ teeth, which can be expected to appear at any time between the ages of about 18 and 25.
Overcoming Dental Anxiety
To overcome a child’s nervousness about visiting the dentist –
- Start visits early in life – this gets them used to the sights and smells of the surgery.
- Explain the importance of oral health from an early age
- Always tell them in advance when they have a visit scheduled
- Answer questions with straightforward responses. Let them know they can also ask the dentist questions.
- Bring a favourite toy as a calming distraction
- Stay calm and follow the dentist’s instructions
Fluroide
There’s a debate about the use of fluoride to prevent tooth decay – some are opposed to the fluoridisation of the water supply, and others oppose its use in toothpaste. Fluoride is a naturally occurring mineral which has been added to drinking water for decades, and is generally regarded as a valuable aid in the fight against tooth decay. But there have been suggestions that it may be a neurotoxin. Nevertheless, even the American Dental Association firmly supports fluoridation of water, and won’t put its seal of approval on any toothpaste that doesn’t contain it.
It’s recommended that children up to three years old should use a smear of toothpaste with a fluoride level of at least 1000ppm (parts per million), and after three years old, they should use a pea-sized amount of toothpaste that contains 1350ppm to 1500ppm. You can check the level of fluoride on the packaging of the toothpaste.
Cleaning
Cleaning the teeth should become a part of daily routine as soon as possible, and will probably require supervision until the age of about seven. Start off with a children’s toothbrush (if it makes it more fun for the child that the brush is colourful or has a character on it, that’s fine). Use a small smear of fluoride toothpaste. You will probably find it easiest to stand or sit behind your child, with one hand cradling their chin so you can reach both their top and bottom teeth.
Once all the teeth are present, an adult toothbrush with a small head and soft bristles is recommended. Brush in small, circular, motions, concentrating on once section at a time. Don’t forget to brush gently behind the teeth, and onto the gums.
Spit out after brushing – do not swallow fluoridated toothpaste – but do not rinse, so that the fluoride in the toothpaste stays on the teeth longer.
Tooth brushing should be made part of your child’s daily routine, before bed, and at least one other time during the day. Some toothbrushes have a time function which will help your child keep up a consistent standard of brushing, and in later years an electric toothbrush is ideal and adds a fun element to dental care. hc
