Tooth decay is the single most common childhood disease in the world. It is the most common infectious disease in UAE children, while 170 children have teeth extracted every day in the UK.
With the high sugar content of modern foods and frequent snack times, it's never been more important to practice good oral hygiene for our kids. We caught up with Dr Milad Shadrooh - aka The Singing Dentist, who runs a UK dental practice and is famous for his tooth-themed song parodies - to ask him to share his pearls of wisdom about our little one's pearly whites.
From what age should you start brushing your baby’s teeth?
You should start brushing teeth as soon as they appear, usually around 5-6 months of age.
Should you still brush your baby’s teeth even if they are teething?
Yes, you should still try to get some fluoride protection on the teeth but be gentle as they will have teething pain, use a tiny smear of toothpaste on your finger or a rubber teething brush.
Most young babies and toddlers have milk just before bed. Is this OK if you brush their teeth straight afterwards? If not, why not? And what’s the best thing to do instead?
Although milk contains lactose, which is a sugar, it is broken down differently so needs a longer exposure time to have ill effects on teeth which is why it is important to not allow children to fall asleep with bottles in their mouth. Most children fall asleep drinking that milk so waking them up after to brush their teeth will not go down well! I have two small kids and I know never to wake a sleeping baby! Instead, I brush their teeth before the milk so they have some fluoride protection on their teeth.
Some children swallow when brushing their teeth rather than spitting it out. Is this something that should be discouraged and if so why?
This should be discouraged because of the fluoride content of toothpaste, which when ingested in large amounts can lead to permanent tooth discoloration (dental fluorosis), stomach ailments, or even acute toxicity. However, it is unavoidable to begin with as children have to learn to spit. I taught my kids by spitting myself and getting them to copy me. Until they learn this, they will swallow the toothpaste so using the correct amount is key. A tiny smear of toothpaste is enough.
We all know sweets and chocolates are bad for teeth, but what are the top ‘healthy’ foods and drinks that are a top cause of tooth decay in children and why?
Sticky foods are the first thing to avoid, for example dried fruit like raisins and dried apricots. Although they are fruit, drying them makes them highly concentrated in sugar and also they stick to the teeth so continue that exposure to the teeth for longer. Also, fruit juices and smoothies, although considered healthy, are highly concentrated in sugar because pulping and juicing fruits releases the sugars from the fibres that they are locked in. It is much better to actually eat the fruit rather than pulp it.
In the morning is it better to brush children’s teeth before or after breakfast? Why?
As long as you brush them, I’m not overly critical of what people do, its all about making it a habit so working it into your routine is fine. However, I recommend brushing as soon as you wake up and before breakfast. The reason for this is that when you sleep, the plaque forms on your teeth and this plaque is what contains the bacteria that cause decay. If you eat breakfast with all this bacteria in your mouth, you are feeding them straight away. I think it is better to brush away the plaque and get some fluoride protection on the teeth before eating so there is less plaque in the mouth.
How many times a day should you brush your children’s teeth ideally? And for how long each time?
Brush for two minutes, twice a day. Last thing at night before bed is very important and this one mustn’t be missed! If you miss the morning brush, you can always encourage brushing as soon as they get home from school so they still get two hits of fluoride on the teeth.
There has been some debate about the safety of fluoride in baby and toddler’s toothpaste. What does fluoride do and what’s the most current advice regarding fluoride in toothpaste for young children?
Fluoride helps to strengthen the enamel layer and it can inhibit the oral bacteria from causing cavities. It can also re-mineralise small areas of early decay so it has many benefits. The amount of fluoride in toothpaste varies from 1000ppm to around 1450ppm. I would always recommend using fluoride toothpaste and getting the amount you use correct. So up to three years old, use a tiny smear on the brush, three to six years, use a small pea-sized amount and from six and over, a regular amount or double pea-sized amount. Teaching them to spit is also important so they don’t swallow the paste. That is why I am not a fan of the sweet flavoured toothpastes because it encourages them to swallow. Also, its important to not rinse afterwards so you leave the fluoride on the teeth for as long as possible for continued protection.
Are there any other top mistakes that parents tend to make when brushing children’s teeth?
Not starting early enough! Start from five months or when the teeth first appear and then the children will grow up used to having it done, it would be a normal thing for them to have it done and the habit is formed.
What are your tips for good dental health in children?
Using a straw for sugary drinks can help as the liquid will bypass the teeth. A small bit of cheese with sugary things can help neutralise the acid that is formed, even eating the cheese beforehand can create a film over the teeth and make them a bit more protected.
The frequency of sugar intake is key, if you do want to give your children a chocolate or a sweet, do it around meal times, as part of dessert for example. Don’t allow them to snack on it as that is when the saliva is not working on protecting the teeth. Start dental visits early, getting kids to the dentist from even before their first birthday can help them to get used to the whole experience of seeing a dentist and it will allow the dentist to reinforce the messages so you can prevent any issues ever arising. That way, children wouldn’t need extensive treatment that is distressing for them and can turn them into a dental phobic adult!
Many children hate having their teeth brushed – any tips to help?
Try to make the process fun and get them involved. Let them choose their toothbrush and toothpaste, maybe with their favourite cartoon or movie character on it. Brush as a family so they see you brushing and want to copy you, maybe get them to brush your teeth while you brush theirs, that is great distraction. I brush my kids' teeth while they are in the bath because its happy play time and I can brush without them even realising I’m doing it! Also, reward good brushing, maybe have a chart and for every good brush, they get a star, 14 stars at the end of the week equals a prize!
We also think that showing your little ones a The Singing Dentist song video might also help!