Keeping your children's teeth healthy, by Dr Katz


How many times a day you should brush your kids teeth/what time?  How long should kids brush their teeth for?

In children as in adults, good oral health begins with a regular oral hygiene routine. It's never too early to start. You can clean your baby's mouth with a soft, clean cloth even before their baby teeth come in. Yes, your baby will fuss at first but after two or three times, they'll get used to it. Be careful not to stick the cloth far enough into your baby's mouth to elicit a gag reflex. Once baby teeth sprout, you can switch to a soft toothbrush. Breast milk doesn't promote tooth decay, but other liquids may, so never let your baby fall asleep with a bottle in his mouth.

As soon as your child is old enough to hold a toothbrush, begin teaching them the essentials of brushing their own teeth. Begin using toothpaste only when your child is old enough to understand it's not supposed to be swallowed. A pea-sized dollop should suffice. Children are generally old enough to begin brushing their teeth unsupervised around age five, though official recommendations by the NHS and Oral Health Foundation in the UK state that you should supervise up to the ages of seven or eight to ensure that they are brushing properly.

Children should brush (or have their teeth brushed by an adult depending on their age) twice a day.  Brush once in the morning and once at night before bedtime for at least two minutes at a time.  Try and have a designated time as this will help to get your child used to it.  Use a small, soft brush with gentle filaments that won’t damage the gum line, and a small amount of toothpaste (a smear for under three’s) and brush over every surface of the teeth with gentle pressure, remembering the gum line.  Don’t rinse with water afterwards as this will wash away the fluoride in the toothpaste and make it less effective.

One other important consideration is the type of oral care products that are being used by children.  Many of them may be very acidic to give them a "candy-like" taste.  That can be just as dangerous because tooth decay is caused by acids as well. Studies show that low pH mouthwash can erode tooth enamel just as much as too many sweets. In the US, children's dentists recommend the anti-acid formula used in The Breath Company product line. They are pH balanced to neutralise oral acids instantly.  And they don't contain any artificial flavours, colours, or sweeteners. The Breath Company adult range is available now on sale online and in-store at Boots and Superdrug stores nationwide.

Any foods they should never have?

Contrary to popular opinion, children aren't born with an insatiable appetite for sugar. In cultures where sweets aren't given out routinely as rewards, neither children nor adults seem to crave them. Avoid using candy as a treat and your child won't make the automatic association between sweets and happiness. You can maintain your child's oral health by making sure they eat a nutritious diet that's low in sugar, and practices regular oral hygiene, using products that are safe and effective.  Half the sugar children are having comes from snacks and sugary drinks, and when you consider that this can lead to a whole host of health problems as well as tooth decay then it’s worth considering an alternative.   

If you feel that you can’t avoid giving your child sweets completely then help to prevent problems by limiting the amount that they have and don’t give them sweet treats before bedtime when saliva flow naturally lessens. 

Avoid fizzy drinks completely as not only do they contain large amounts of sugar, but also contain acids that can erode tooth enamel and stick to water or milk for under threes.  

It may sound clichéd but the best snacks for children really are fruit and raw vegetables such as cucumber or carrot sticks.  Toast, rice cakes and plain popcorn also make great snacks.  In terms of drinks then only serve water and keep natural fruit juices or no added sugar variants to a minimum at meal times.   

Would you recommend an age limit for sugary drinks?  How many sugary drinks e.g. juice per day/week should be a limit?

Water or milk only is recommended for children aged 3 and under.  Take the recommended daily amounts of sugar for your child’s age group in to consideration and swap sugary drinks for older children to healthier alternatives such as plain water, lower-fat milks or no added sugar drinks. Added sugars shouldn’t make up more than 5% of the energy (calorie intake) you get from food and drink each day so try and stick to these guidelines.  If you feel that you want to give your child a sugary drink then limit to a couple of occasions a week at meal times at the absolute maximum. 

Are there any foods or drinks that are deceptively sugary?

Fruit juices and smoothies can often be deceptively sugary as it takes a lot of fruit to produce a single glass of juice, so you get more sugar, but less fibre. 

In addition, dried fruit (often given to children as snacks) is high in sugar and can be bad for teeth, so only ever give it to children with meals – for instance, as a dessert – and never as a snack between meals.

What to do if your kids teeth have become affected?

It may sound obvious, but if you find that your kids’ teeth are becoming affected then don’t ignore it as the problem (and potential long-term damage) may worsen.  Ensure that you make regular appointments for them to visit the dentist.  They really are the very best source of advice and will be able to check for more subtle signs of decay and gum disease and discuss any treatment plan with you, as well as offering advice on how to prevent issues from returning.  Your dentist will advise how often you and your children should visit them, but it is usually between three months and two years.  Treatment for under-18s is free in the UK so there’s no excuse not to take them!

Children (especially pre-schoolers) can often be afraid of visiting the dentist, so ensure they visit regularly with you to help them understand that there’s nothing to fear.  They will then just see it as an ordinary part of everyday life.  If you have any fears of your own about visiting the dentist, then don’t let your child hear you talk about them as your fear will make them anxious.

What to do if your kid has a tooth extracted?  

The costs of repairing a tooth that has a cavity will only increase the more the tooth decays and so it’s important to remember that prevention is better than cure when it comes to avoiding tooth extraction.  A combination of good oral hygiene, limiting sugar-laden food and drinks and routine visits to your dental practitioner can reduce the likelihood of your kids needing an extraction through decay. 

Extractions can be painful and scary for children, so avoiding them at all costs really is a must.  However, if your child needs a tooth extracted then your dentist or surgeon will give you advice about how to care for your child’s teeth and gums post extraction.  They may recommend age appropriate painkillers and possibly some antibiotics to reduce the chances of an infection developing. 

How to discourage kids from having too much sugar?

The first place to start is to model good eating and drinking habits.  Children tend to mimic behaviour so if they see you adopting good lifestyle habits then the chances are that they will too.  Get them involved in preparing and choosing the food and drink that they eat and encourage them to make healthy decisions.  Make healthy swaps and make water more interesting to children by adding fruit to flavour and swap out sugar-laden foods with healthier alternatives.  The NHS Change4Life website is a great place to get some ideas and recommendations. 

Dr. Harold Katz is dentist, bacteriologist and founder of The Breath Company.