A child’s first teeth are important for speech, eating, and facial appearance, and establish space in the mouth for adult teeth to develop normally.
First teeth are just as prone to dental caries as permanent teeth; by the time they are five years old, over 30% of children in the UK have dental decay1.
The Infant & Toddler Forum (ITF) and British Dental Health Foundation (BDHF) work together to promote positive dental health in the under-threes. Endorsed by the BDHF, the ITF produced ‘Protecting Toddlers from Tooth Decay’, a Factsheet for healthcare professionals to use with parents and carers to help ensure healthy mouths in the early years.
Along with a good daily oral health routine, it’s important to consider a toddler’s diet. Dipti Aistrop, Supervisor at the Family Nurse Partnership and member of the ITF, says: “Parents and carers should take special care of a child’s mouth in order to prevent dental decay and avoid extractions and fillings. There are many risk factors for dental caries, including excess dietary sugar intake.
“In the UK it’s estimated that toddlers get about a third of their total daily calories from sugar, a lot of which is added sugar2. Between the ages of 1 and 3 excessive sugar is strongly associated with the development of caries.”
Toddlers need a nutritious balanced diet, with three regular meals and two to three planned snacks each day. Intake of sugary foods and drinks should be limited to a maximum of four times a day, given at these meal and snack times.
Drinks should be offered six to eight times a day, and from as early as possible should be sipped from a cup or glass, not sucked from a bottle. Children should be encouraged to drink still water, rather than sweet drinks. Fruit juices are a good source of vitamin C, but they are acidic and can cause dental caries and therefore should always be served diluted one part juice to ten parts water, and at meal or snack times only. Other sweet drinks – such as fizzy drinks, squashes, flavoured waters, and cordials for milk – are unsuitable for toddlers.
The ITF has also produced a Factsheet giving evidence-based portion sizes for children aged 1-3 years, which gives a guide on appropriate amounts of food and drink to offer toddlers, including recommendations on limiting foods high in fat and sugar.
Karen Coates, Dental Advisor at the BDHF, says: “Good dental care should begin from an early age to make sure teeth and gums remain healthy throughout childhood and beyond. We have worked closely with the Infant & Toddler Forum to provide guidance specific to the under-threes, helping healthcare professionals and parents look after children’s oral health at this important developmental stage.”
Sally Simpson, President at the British Society of Dental Hygiene & Therapy, says: “Diet, especially the intake of sugar, is so important when taking care of a child’s first teeth. Advice tailored to toddlers is incredibly useful in practice, as it helps inform clinical knowledge at a stage when prevention is definitely better than cure.”
1. The NHS Information Centre for health and social care. 2007-2008. Compendium of clinical and health indicators / clinical and health outcomes knowledge base. North West Public Health Observatory, The Dental Observatory.
2. Bates B, Lennox A, Swan G. National Diet and Nutrition Survey: Headline results from Years 1 and 2 (combined) of the Rolling Programme (2008/2009-2009/2010): London: HMSO, 2010.
‘Protecting Toddlers from Tooth Decay’ and ‘Portion Sizes for Toddlers: 1-3 Years’ can be downloaded for free from www.infantandtoddlerforum.org.
Case study: Lindsey Reed, 49 – ‘The Lasting Effects of my Childhood’
Neglecting oral care has consequences. You may feel them in the short-term in the form of toothache, or worse you could be feeling them 30 years later. Throughout her childhood Lindsey’s parents neglected to teach her the benefits of good oral care. She has been forced to live with those consequences throughout her life.
“My lower teeth front teeth are false, my upper front teeth are false and I have more fillings than I care to remember”, she said. “I’m terrified of the dentist, and it’s only with hindsight I can point to the fact my parents didn’t tell me what was good or bad for my teeth, never mind how I should look after them.”
According to the British Dental Health Foundation, education and exposure to dentists from an early age are crucial to developing life-long good oral health.
“I’m the proud mother of two children who both have excellent oral health. Although I was terrified of the dentist, my partner wasn’t and he took them when needed. My startling lack of knowledge meant I had no chance of ever having good oral health, but it highlights the importance parents and educators can play in a child’s oral health development.”