Diet and healthy teeth

Research into the factors that cause tooth decay has progressed a great deal in the past 30 years. Originally, only one culprit food, namely sugar, was blamed for tooth decay in infants, toddlers, children and teenagers. Nowadays we know that there are a variety of factors that are responsible for decayed, missing and filled teeth in people of all ages.

Mouth logistics
To understand what causes tooth decay, you need to keep in mind that we all have the following in our mouths:

  • Teeth that are vulnerable to attack by acids.
  • Saliva that circulates in the mouth and is capable of rinsing acid from the teeth.
  • Microorganisms that ferment carbohydrates to form acids.
The other important factor is time - how long and how often the teeth are exposed to acid will determine if decay can take place or not.

Factors that cause tooth decay

  • Poor oral hygiene - children who do not brush their teeth or rinse their mouths or eat cheese after a meal, will have an increased likelihood of developing caries (holes in their teeth).
  • Lack of fluoride - fluoride has been identified as the most important factor in preventing tooth decay - fluoride in the water supply, in toothpaste and oral rinses will coat teeth with a protective layer and promote so-called tooth remineralisation (repair of holes in the teeth).
  • Long contact times - if food, any food, remains in contact with teeth for long periods, it will cause decay.
  • Frequent contact times - if the teeth are repeatedly exposed to food, any food, the chance that decay will occur increases.
  • Food - many types of food cause tooth decay depending on how ‘sticky’ they are, thus most carbohydrates, such as bread, biscuits, dried fruit and sweets will stick to the teeth, causing caries.
  • Acid food and drinks, such as fruit juices, can cause demineralisation or ‘etching’ of the tooth enamel and expose the underlying tooth to acid attack.

It is clear that tooth decay is not just caused by eating sugar, but by a complex set of factors that interact to cause damage to the teeth. The question is: “How can you prevent tooth decay in your children?”

How to prevent tooth decay

a) Baby bottle tooth decay

Do not allow your baby to suck on a bottle filled with milk, fruit juice or sweetened tea for long periods, especially at night. The practice of allowing your baby or toddler to use his bottle as a dummy, allows milk, fruit juice or sweetened tea to be in contact with the teeth for long periods and therefore promotes tooth decay. This is especially true at night when the production of saliva is less than during the day. Without enough saliva to rinse the teeth, decay sets in rapidly.

b) On-demand breastfeeding
Breastfeeding is one of the best things you can do to ensure the health of your child, but it is not a good idea to let your baby sleep in bed with you and to let her suck whenever she wants to. This creates a similar situation to baby bottle tooth decay. The baby will retain breast milk in her mouth and her supply of saliva will be inadequate to rinse away the milk surrounding the teeth, so decay gets a headstart.

When you breastfeed your baby during the day, the strong sucking action shoots the milk into the back of the mouth and any teeth that may have erupted will not be exposed to milk for long periods. In addition, strong salivary flow in the day will rinse the milk off the teeth.

c) Sticky food
It is essential that toddlers, children of all ages and teenagers should follow a balanced diet, which should contain sticky carbohydrates. Children should be taught to rinse their teeth with water after eating meals and to use dental floss to remove particles of food that get stuck between their teeth.

d) Acid food and drinks
Children and teenagers will also inevitably eat acid food and drink acid beverages, such as fruit, fruit juices and cola drinks. Teach them to rinse their mouths if possible and ensure that their teeth are protected by fluoride (see below).

e) Fluoride
If you are lucky enough to live in an area where the water supply has a high fluoride content, it is to your children's advantage because their teeth will be resistant to acid attack. However, many areas of South Africa have practically no fluoride in the water. If the proposed legislation is eventually passed, fluoride may be added to the water supplies in these areas.

In the meanwhile, your child needs to brush her teeth with fluoride toothpaste twice a day. In areas where there is no fluoride in the water supply, you can also consider giving your child a fluoride supplement, but discuss this with your dentist, because overdosing on fluoride can leave brown marks on your child’s permanent teeth. Fluoride mouthwashes are also an option to coat the teeth with a protective layer.

f) Oral hygiene
Teach your children as soon as they are able to understand, to brush their teeth and to rinse their mouths after eating and drinking. Research has shown that children who brush their teeth with fluoride toothpaste twice a day hardly ever develop caries. Flossing is also important to remove sticky food particles.

A child or young person with a mouth full of sparkling white teeth is a wonderful sight. So let’s ensure that our children have strong, healthy teeth for the rest of their lives by teaching them to rinse, brush with fluoride toothpaste and floss.

Do your children thing brushing their teeth is optional? What healthy alternatives do you include in their diets?
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