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Keeping children's teeth healthy is all about good care at home. A regular tooth brushing routine is essential for good dental health. Start to brush your baby's gums with a soft toothbrush at bath time, or even let your baby have a go themselves as long as you supervise them. This establishes brushing their teeth as part of the washing routine.
- Start brushing your baby's teeth with family fluoride toothpaste as soon as the first milk tooth breaks through (usually at around six months, but it can be earlier or later). It's important to use a fluoride paste as this helps prevent and control tooth decay.
- Children under the age of three should use a smear of family toothpaste containing at least 1,000ppm (parts per million) fluoride. Toothpaste with less fluoride is not as effective at preventing decay. Children between the ages of three and six should use a pea-sized blob of toothpaste containing 1,350-1,500ppm fluoride. Check the toothpaste packet for this information or ask your dentist.
- Make sure your child doesn't eat or lick the toothpaste from the tube.
- Brush your child's teeth twice a day, once just before bedtime and at least one other time during the day. Encourage them to spit out excess toothpaste but not to rinse with lots of water.
- Supervise tooth brushing until your child is seven or eight years old, either by brushing their teeth yourself or, if they brush their own teeth, by watching them do it. From the age of seven or eight they should be able to brush their own teeth, but it's still a good idea to watch them now and again to make sure they brush properly and clean all surfaces of all teeth.
- Make sure they brush properly.
- Guide your child's hand so they can feel the correct movement.
- Use a mirror to help your child see exactly where the brush is cleaning their teeth.
- Make tooth brushing as fun as possible, use a song or rhyme to encourage them.
- Don't let children run around with a toothbrush in their mouth as they may damage their mouths if they fall over.
Taking your child to the dentist
Another important step is the first trip to the dentist. These tips can make this a lot easier:
- Take your child to the dentist when they're as young as possible, ideally in their first year and at least once by the time they're two. This is so they become familiar with the environment and get to know the dentist. The dentist can help you to prevent decay and identify any health problems at an early stage. Just opening up the child's mouth for the dentist to take a look is useful practice for when they could benefit from future preventive care.
- When you visit the dentist, be positive about it and make the trip fun. This will stop your child worrying about future visits. NHS dental care for children is free. Take your child with you when you go for your own dental check-up appointments so they get used to it.
Finding a dentist
If you live in Manchester, you can use the Manchester Dental Helpline which provides the following services to the residents of Manchester:
- Arranging emergency appointments for patients in need of urgent care, usually on the same day and close to home at more than 30 dental practices across the city
- Support to NHS Manchester residents looking to access local NHS dental services
- Advice and support with dental related queries
- Signposting and referral to other services
To use this service please call: 0161 230 6011 The Dental Helpline is provided by NHS Direct on behalf of NHS Manchester.
If you live outside Manchester, you can find your nearest dentist by using the 'find your nearest…' option on the NHS Choices website at www.nhs.uk or by texting 'dentist' to 64746. You'll receive three free text messages with the contact details for the three NHS dentists closest to where you are.
Fluoride varnish and fissure sealants
Two quick and painless preventive treatments - fluoride varnish and fissure sealants - are available on the NHS from your dentist, and sometimes from your child's primary school.
Fluoride varnish can be applied to both baby teeth and adult teeth. The process involves painting a varnish containing high levels of fluoride onto the surface of the tooth regularly to help prevent decay. It works by strengthening tooth enamel, making it more resistant to decay.
Fissure sealants can be done once your child's permanent teeth have come through (usually at the age of about six or seven) to protect them from decay. This is where the chewing surfaces of the back teeth are covered with a special thin plastic coating to keep germs out of the grooves. The sealant can last for as long as 5 to 10 years.
Ask your dentist if your child could benefit from fissure sealing or fluoride varnish.
Prevent tooth decay by cutting down on sugar
Sugar causes tooth decay. Children who eat sweets every day have nearly twice as much decay as children who eat sweets less often. Decay is more likely if teeth are often in contact with drinks, foods or sweets that contain sugar.
This means sweet drinks in a bottle or feeder cup and lollipops are particularly damaging because they bathe the teeth in sugar for long periods of time.
It is safer to keep sweet foods and drinks to mealtimes only as part of a healthy diet, giving them in between meals increases the chances of decay and spoils your child's appetite.
Dextrose, maltose, fructose and hydrolysed starch, invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado and concentrated fruit juices are all sugars. Maltodextrin is not a sugar, but can still cause tooth decay.
The following measures will help you reduce the amount of sugar in your child's diet and prevent tooth decay.
- From the time your baby is weaned, encourage them to eat savoury food. Check if there's sugar in pre-prepared baby foods (including the savoury ones), rusks and baby drinks. It is usually found in fizzy drinks, squash and syrups.
- Only give sweet foods and fruit juice at mealtimes.
- Don't give biscuits or sweets as treats. Ask relatives and friends to do the same. Use items such as stickers, badges, hair slides, crayons, small books, notebooks, colouring books, soap and bubble baths. They may be more expensive than sweets but they last longer.
- If children are having sweets or chocolate, it's less harmful for their teeth if they eat the sweets all at once and at the end of a meal rather than eating them little by little and/or between meals.
- Give the last drink at least an hour before bed.
- If you give a drink during the night, only give your baby milk or water rather than baby juices or sugar-sweetened drinks.
- If your child needs medicine, ask your pharmacist or GP if there's a sugar-free option.
- It's OK to use bottles for expressed breast milk, infant formula or cooled boiled water. However, using them for juices or sugary drinks can increase tooth decay. It's best to put these drinks in a cup and keep drinking times short.
- When your baby is aged between six months and one year, you can offer drinks in a non-valved free-flowing cup.
- Check ingredients to see your whole family's sugar intake and look for ways of cutting down. Sugars can have the following names: Sucrose, glucose, dextrose, maltose, fructose and hydrolysed starch, invert sugar or syrup, honey, raw sugar, brown sugar, cane sugar, muscovado and concentrated fruit juices. Maltodextrin is not a sugar, but can still cause tooth decay.
Choose care at home if...
- Your child's teeth are developing normally
- Follow the advice above and visit the dentist as often as advised
Choose your dentist if...
- Your child needs a check-up - your dentist will tell you how often they need to be seen
- Your child has toothache
- There is any problem with your child's teeth
Call 999 A&E if...
- There are no reasons why you should need to go to A&E for problems with toothache
- A&E is for urgent, life-threatening illness and injury