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Early years oral health - the problems and solutions

Every childcare professional will recognise the thrill children experience when they lose their first tooth. For many children, this can mean the eager anticipation of the tooth fairy or a special treat under their pillow. However, for far too many children, the loss of a tooth doesn’t mark the natural process of gaining secondary teeth, but can be a sign of largely preventable tooth decay.

In England, tooth decay is remains a serious problem. Worrying findings from Public Health England’s survey of 5 year old children showed that a quarter (25%) of 5 year olds had experienced tooth decay, having on average 3 or 4 teeth affected.

What is even more worrying is the wide variation in the prevalence of tooth decay. The areas with poorer dental health tend to be in the north and in the more deprived local authority areas. The highest level of tooth decay was found in Blackburn and Darwen, where 56% of children aged 5 have tooth decay, compared to the lowest level of just 4% in South Gloucester.

We know that tooth decay can have a negative impact on not only the child’s health, but also their wellbeing, and that of their family. Children with tooth decay can experience much pain and discomfort – this can affect their ability to eat, sleep, and play, all of which can disrupt their learning and development.

The good news is that childcare providers can play a huge role in supporting good oral health in children.

Cutting down on sugar

One of the most important ways of reducing tooth decay in children is reducing the consumption of foods containing free sugars, especially between meals. Each time we eat food and drinks high in sugar, the bacteria in dental plaque produce acid that attacks teeth. If we consume eat or drink high-sugar products frequently throughout the day we have more acid attacks, which can lead to tooth decay.

Childcare providers already know the importance of providing healthy food for children in their settings – that includes only giving sweet foods, including dried fruit, with meals and only serving water or milk to drink. We were pleased to have the assistance of PACEY members’ help in pulling together the new guidance and sample menus for early years settings.

Brushing teeth technique

Childcare providers also play a vital role in educating children about the need to brush their teeth at least twice daily with fluoride toothpaste (including last thing at night). We know many settings have successfully introduced daily toothbrushing sessions– with toothbrushes and fluoride toothpaste labelled with the child’s name. It can provide a great opportunity for supervising children’s toothbrushing technique. A quick guide to good technique can be found on our factsheet.

Regular visits to the dentist

Childcare providers are well placed to talk to parents about supporting oral health and reminding them of the importance of children visiting the dentist when their first tooth appears, and then on a regular basis. Childcare providers can also help prepare children for visiting the dentist. For many children, this can be a fun and educational experience, with many relishing the opportunity to sit in the dentist’s magic moving chair!

Many childcare professionals find it helpful to participate in one of the national awareness campaigns for oral health, including National Smile Month in May. Organised by oral health charity, the Oral Health Foundation , the campaign raises awareness of oral health and produces a range of resources that childcare providers can use in their settings.

Prevention is the key – once a permanent tooth has been filled, this will require care and maintenance throughout life with replacement fillings, or if the filling is large may require more advanced care requiring root fillings or crowns. All of these will incur a cost to adults later in life.

Dental decay can be a sign of a poor diet – in particular excess sugar consumption – which can cause obesity. Overweight or obese children are more likely to be overweight or obese adults, which can cause many preventable conditions like heart disease, type 2 diabetes and some cancers.

It is well established that obesity and poor oral health are more prevalent in our most deprived areas, so addressing these issues is vital if we are to combat health inequalities. Preventing tooth decay is aligned with the government’s Childhood Obesity Plan and supports PHE’s vision of a fairer society

Ultimately, oral health is everyone’s business – including national and local health policy-makers, healthcare, childcare and early years settings, families and the food and drink industry.

By working together with parents, childcare providers can play a vital role in protecting the teeth of our children.

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