Looking after children’s teeth

What causes tooth decay? 

Tooth decay and gum disease are caused by a build-up of plaque, which is a sticky film found on teeth that contains bacteria.

When children eat, food can get trapped between and inside the grooves of their teeth. Tooth decay occurs when plaque bacteria break down the sugar and starch contained in the trapped food, producing acids. These acids can erode the protective enamel layer of their teeth, causing holes to form.

Sweets and sugary foods are not the only baddies when it comes to tooth decay. Plaque bacteria can break down any foods that contain sugar or starch, including fresh and dried fruit, biscuits and crackers, potato chips, snack bars, and peanut butter. Acidic foods (e.g. fruit juices, cordials and fizzy drinks) can also damage teeth as they can etch away the enamel.

Dental care starts with your child’s first teeth 

Even though children’s baby (milk) teeth will be replaced later on, it is just as important to prevent tooth decay in milk teeth as it is in permanent teeth.

Your baby’s first baby tooth will usually appear at about 6 months of age, but it can appear as early as birth or as late as their first birthday. These first teeth are essential for chewing, speech development and the successful development of adult teeth.

Children start to lose their baby teeth around 6 years of age and this continues until they are about 12 years.

Tips for brushing children’s teeth

Children up to 18 months

• Even before your baby's first teeth appear, you can gently wipe their gums once a day with a clean soft wet cloth. 
• Brush their teeth with a toothbrush specially designed for babies and children. It should have a small head and soft, rounded bristles that will be gentle on their teeth and gums.
• Brush your baby's teeth with plain water once a day after their last evening feed. Fluoride-containing toothpaste is not recommended for children younger than 18 months.
  

Children 18 months to 2 years

• Children in this age group should use a pea-sized amount of low-fluoride toothpaste, and encourage them to spit out after they are finished brushing their teeth
• Read the label on the toothpaste to make sure it is suitable for your child.
• Let your children watch you brush your teeth and teach them how to brush their own. Also explain to them how important it is to look after their teeth.

Children 2-8 years

• Your children should brush their teeth twice a day for about 2 minutes each time (i.e. after breakfast and just before bed) using low-fluoride toothpaste. Read the label on the toothpaste to make sure it is suitable for your child.
• Your children can begin to brush their own teeth, but they may need your help to brush them correctly until they are about 8.
• Rinse your child's toothbrush thoroughly after use and air dry it. Bacteria grow on wet toothbrushes.
• Replace toothbrushes every 3 to 4 months or when the bristles start to fray.

Don't use fluoride toothpaste in children younger than 18 months

While fluoride is essential for building strong teeth, fluoride-containing toothpaste is not recommended for children younger than 18 months. This is because overexposure to fluoride during childhood can discolour and mark the enamel surface of developing teeth. For this reason it’s important to make sure you store all toothpaste out of the reach of children and try to prevent your child from eating fluoride-containing toothpaste.

In most places across Australia, tap water contains fluoride. Fluoride helps protect teeth by slowing down the enamel breakdown caused by acids, as well as helping to rebuild tooth enamel. Ask your dentist for advice about the best toothpaste for your child if you live in an area where fluoride is not added to the water.

Make flossing fun

Flossing helps remove the more difficult-to-reach food from between the teeth. You can start flossing your child's teeth at least twice a week from about 2½ years of age. Children can start flossing for themselves by about age 7 or 8. Ask your dentist to show you how to floss your child’s teeth properly.

Floss is available in many different sizes, coatings and flavours to make flossing more fun for children. Make brushing and flossing as enjoyable as possible to encourage your children to participate.

Preventing tooth decay from a young age 

• Limit consumption of sugary and acidic drinks and snacks (this includes fruit juices, fruit bars and muesli bars) – and be careful how often you give these products to your children throughout the day. This is just as important for preventing tooth decay as it is for your child’s overall health.
• Encourage your child to eat ‘tooth-friendly’ foods such as cheese, nuts, apples, vegetables and toast.
• Fruit juice and sweet drinks can cause tooth decay, so it’s best to give your children tap water or plain milk to drink. Boil and then cool tap water for babies younger than 12 months. If you do give your older children fruit juice, dilute it with water.
• Don't put your child's cutlery, dummy or bottle in your mouth because this can transfer decay-causing bacteria from your mouth to your child’s. For the same reason, don’t share a toothbrush with your child or store toothbrushes so that they touch each other.

Visit your dentist regularly 

Take your children to the dentist for their first dental check-up before they are 2 years old.

The first check can be carried out by a dentist, a maternal and child health nurse, or a doctor.

Regular checks by a dentist at least once a year are recommended to help diagnose and prevent tooth decay as early as possible.

Seek dental advice immediately, ideally within 30 minutes, if you or your child has an accident involving teeth (e.g. a loosened, badly damaged or knocked out tooth).

The Child Dental Benefits Schedule (CDBS) provides access to basic dental services for some children aged 2–17 years based on certain eligibility criteria regarding individual or family circumstances (for more details see Further Information section below).

Other dental dilemmas 

Ditching the dummy

Dummies help to soothe children and there is no hard and fast rule about when your children should stop using one. If your child does use a dummy, don’t dip the dummy into any foods or liquids (e.g. honey), as this can cause tooth decay. Children sometimes stop using dummies by themselves, but you can start encouraging them to give up their dummy once they reach 12 months.

Thumb sucking

Thumb sucking is a natural reflex for babies and small children. Most children usually grow out of it between 2 and 4 years of age. However, once permanent teeth start to replace the baby teeth, thumb sucking should be discouraged, as it can push the front teeth forward out of their normal position. This can also affect some speech sounds by causing a lisp. If you have problems getting your child to give up, ask your dentist for advice.

Teeth-grinding

Teeth grinding is common in young children but it doesn’t usually last or damage their teeth. However, if you are concerned, or your child complains of headaches or tooth or jaw pain, see your dentist.

Further information 

Australian Dental Association
www.ada.org.au

The Child Dental Benefits Schedule.
www.humanservices.gov.au/customer/services/medicare/child-dental-benefits-schedule

Sources 

Australian Dental Association. FAQ. [online] [Accessed 29 July 2014] Available from: www.ada.org.au

Australian Dental Association. Oral health of babies and infants. [online] [Accessed 29 July 2014] Available from: www.ada.org.au

Australian Institute of Health and Welfare 2014. Australia’s Health 2014. Australia’s health series no.14. Cat no. AUS 178. Canberra: AIHW.

British Dental Association. Diet. [online] [Accessed 29 July 2014] Available from: www.dentalhealth.org

Dental Health Services Victoria. Dental advice for children. [online] [Accessed 11 August 2014] Available from: www.dhsv.org.au

Queensland Health, Royal Flying Doctor Service of Australia (Queensland Section) and Apunipima Cape York Health Council. Section 7: Management of diagnosed conditions – oral health. In: Chronic disease guidelines, 3rd ed. 2010.

Pharmacy Self Care. Oral health. Deakin, ACT: Pharmaceutical Society of Australia, 2010.

Raising children network. Dental care for toddlers. [online] [Last updated 27 Jan 2012; assessed 29 Jul 2014] Available from: www.raisingchildren.net.au

Raising children network. Dental care for babies. [online] [Last updated 27 Jan 2012; assessed 29 Jul 2014] Available from: www.raisingchildren.net.au

State Government of Victoria. Better Health Channel. Fluoride. [online] [Last updated 13 May 2014; assessed 31 Jul 2014] Available from: www.betterhealth.vic.gov.au

Disclaimer
This information has been developed and reviewed for Bupa by health professionals. To the best of their knowledge it is current and based on reputable sources of medical research. It should be used as a guide only and should not be relied upon as a substitute for professional medical or other health professional advice.

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