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Towards Better Oral Health in Children
The Causes
Scotland's diet
Dental disease in childhood may be broadly attributed to a high sugar diet - especially sweets and confectionery, fizzy drinks and sugar-sweetened foods.
A contributory factor is the lack of self-care through use of protective measures, mainly toothbrushing with a fluoride toothpaste and restriction on the use of foods and drinks containing sugar.
In both these respects, deprivation is a key influence in the emergence of dental and oral disease.
60 teaspoons of sugar per day.
Average daily sugar consumption of a 12 year old in an area of deprivation in Scotland.
Regular consumption of sweets and confectionery, sugar-sweetened foods and high-sugar fizzy drinks are the major causes of the development of dental decay. Sugars encourage acid production, which gradually dissolves teeth, leading to dental caries (decay).
Cutting down on the frequency and amount of sugar intake is crucial. After a sugary snack, the acid attack lasts for approximately 60 minutes.
Teeth can recover after a single attack but our eating habits prevent this. Why? Because another high sugar snack comes along soon after, and the acid attack continues. This repeated cycle of events eventually rots the teeth (dental decay).
Fact
A chocolate bar, a can of sugary fizzy drink and a sweetened yoghurt provides the equivalent of 20 teaspoons of sugar.
Diet in Scotland is, therefore, a significant factor in the poor status of our oral health. This is well documented in The Scottish Diet Report, which pointed to the fact that patterns of infant sugar consumption are related to those of their mothers. There was a direct link between the use of sweetened comforters in infancy and the consumption of sugar-containing snacks and drinks in later years. The report also identified the particularly damaging effect on dental enamel of high sugar carbonated drinks and the fact that rusks, commercially-prepared desserts, puddings, baby foods and drinks nearly all have high levels of added sugar. These substances not only contribute to dental decay but also establish a habit of sugar consumption throughout life - often described as a "sweet tooth". Conversely, the report said that many children never ate fresh fruit or vegetables, with many eating exclusively snack foods and high-sugar fizzy drinks.
Fact
The 1998 Scottish Health Survey showed that most children ate chocolate, crisps or biscuits every week, and most did so daily. Four in 10 were eating these foods more than once a day. A third of children ate sweets or ice cream more than once a day. For just over half of children, drinking high-sugar soft drinks was a daily event and many boys (37%) and girls (33%) consumed these drinks more than once a day.
A mother brushes her young child's teeth
To keep teeth healthy and free from decay, it is important that good toothbrushing habits are established early in life.
Fizzy, sugary and acidic drinks are a major feature of the poor Scottish diet. These drinks, as well as being highly acidic, can contain between six and eight teaspoons of sugar. They are often consumed regularly by children throughout the day, sometimes starting at less than 3 years of age. High frequency use, combined with high sugar and high acid content, makes these drinks highly damaging to teeth.
Although dental health attitudes amongst Scottish people are improving, poor dental hygiene remains a problem. Too many children and adults still do not brush their teeth regularly with fluoride toothpaste. Adequate toothbrushing helps to remove dental plaque (the soft bacterial deposits which form on teeth) from the tooth. Importantly, the toothpaste acts as a vehicle for delivery of fluoride to the teeth and the largest benefit to children's oral health is the fluoride in the toothpaste. Children in disadvantaged areas do least well. And 5-year-old children from more affluent groups are more likely to brush their teeth twice daily compared with those from poorer households.
Regular visits to the dentist are an important part of caring for your child's teeth
The dental team are a valuable source of advice in caring for your child's teeth. Regular visits will help to keep teeth healthy and free from decay.
Visiting the dentist for regular advice, check-ups and treatment can contribute to changes in behaviours and attitudes to oral health. However, less than half of adults in Scotland are registered with a dentist, and fewer still attend regularly. There may be reasons for this, including difficulty in finding a dentist, fear, anxiety and cost. But the most common reason is often apathy. A recent survey has shown that the age of children at their first dental visit was found to be closely related to the maternal attendance pattern, with children of mothers who are regular attenders more likely to be regular attenders than those whose mothers only attended when in pain.
Deprivation again influences visits. Five year olds from unskilled backgrounds are less likely to have visited a dentist compared to children from non-manual or professional backgrounds.
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