Senior health visitor Shirley Adebayo, of North Middlesex University Hospital, sets out how early years settings can help tackle the epidemic of tooth decay among young children
Many of us have memories of our first tooth falling out – the excitement of carefully placing it under the pillow and finding a shiny coin in its place following a visit from the tooth fairy. Now here is the wake-up call:
- Nearly a quarter of five-year-olds in England have tooth decay, affecting three to four teeth on average, and the problem is worse among disadvantaged families.
- Nine out of ten dental practices are not accepting new NHS patients.
- Poor dental health can impact sleep, ability to eat and speech and language development.
- Tooth decay is largely preventable, but it is still a serious problem among young children. This will be due to a variety of reasons – the shortage of health visitors and the cost-of-living crisis, which means many families are buying cheaper food which is often higher in salt and sugar. Some parents still believe that milk teeth don’t matter because they will be replaced by the permanent teeth. This may mean not brushing the child’s teeth regularly or not visiting the dentist.
Dental surgeons are now extracting more children’s teeth in hospitals than they had done in the past, thus contributing to the £3 billion spent by the NHS per year on child dental health.
How can we help?
- As soon as children’s teeth appear, they can be brushed. Settings can clean children’s teeth and parents should be advised to clean the child’s teeth twice daily.
- Settings and parents should limit the amount of added sugars children eat or drink, as well as how often they consume them.
- Bottles with teats ought not to be used regularly, beyond eight months, as they deliver the contents directly onto the child’s teeth. Instead, spouts and open cups should be introduced from around seven months; these allow the various muscles in the tongue and mouth to develop for speech.
- Juices contain fluoride, and over-fluoridation can be evidenced by visible brown spots on the teeth. If given, all juices should be heavily diluted and consumed with a meal; however, water is the drink of choice.
- Bleeding gums must not be ignored – professional help should be sought as soon as possible.
- Parents ought to take the child for their first dental check between the ages of eight to 12 months but certainly by the age of two years.
- Health visitors can be used as a source for advice, e.g. to do sessions on toothbrushing using a model of a mouth. Settings can link oral health to other key topics, such as healthy eating and physical development.
- Bad teeth can be an indicator of neglect, in which case the usual safeguarding procedures should be followed.
For more information, see the DfE’s recent guidance on promoting oral health in early years settings: https://bit.ly/46ZLlv8