Teeth - decay and erosion

teeth; tooth; decay; caries; cleaning; brushing; toothbrush; brush; paste; sugar; starch; toothpaste; holes; erosion; smoke; smoking; enamel; juice; bottle; asthma; inhaler; puffer;

Contents

• Sugar - what it can do to teeth
• Tooth decay
• Tooth erosion
• Asthma inhalers and teeth
• Resources
• References

Teeth are some of your children's most important possessions. How you look after their teeth from the time they are babies will make a difference to how they grow and how healthy they are. This means not only how you clean them but also how you protect tham from things that can harm teeth. Tooth decay is preventable.

There are several other topics on this site about teeth and teeth care:

• Teeth – dental care for children
• Teeth - development and teething
• Teeth – fluoride
• Teeth - give your child's teeth a healthy start
• Teeth – when a tooth is knocked out

Sugar - what it can do to teeth

Sugar in food and drink can start the process of tooth decay.

• Tooth decay is caused when bacteria in the mouth combine with the sugars and starches in food to produce acid.
• The acid eats away the tooth enamel leaving holes.
• For more information about sugar including the amounts of sugar in common food products have a look at the pamphlet 'Sugar' produced by the South Australian Dental Service.

Tooth decay

• Tooth decay can start as a small white spot on the tooth, which is hard to see.
• It causes serious damage to teeth and is important even in baby teeth, because baby teeth prepare the way for healthy development of permanent teeth.
• Decay also causes pain and sleep problems.
• It can affect the way the child looks and what she is able to eat.
• If a decayed tooth has to be taken out, it can mean that the remaining teeth move across and there could be less room for the permanent teeth when they come.
• Many children who have serious decay need to have a general anaesthetic to treat the damaged teeth.
• Dental treatment can be expensive.
• If your child has any sign of decay, see a dentist as soon as possible.
• Good tooth care in the early years prevents decay. See Teeth - dental care for children.

Recent evidence suggests that there is more tooth decay in children who are around people who smoke. The more exposure to smoke, the more tooth decay children have.

Tooth erosion

Tooth erosion happens when acids damage and dissolve the layers of enamel that cover the tooth. This can cause permanent damage to the tooth.

• Acids can come from what the child eats, from medicines (such as Vitamin C tablets that are chewed in the mouth) and from stomach acids from persistent reflux.
• Research has suggested that acidic soft drinks, cordials or fruit juices (eg. orange juice) may partially dissolve the surface of tooth enamel. Then the enamel tooth surface is more susceptible to erosion by hard brushing.
• Recent research shows that there is more erosion of the enamel when an acidic drink is drunk more than 3 times a day.
• Solid fruit is also acidic, but chewing causes an increase in the amount of saliva in the mouth. Saliva 'neutralises' the acid.
• Neutral food or drinks do not damage the enamel.

In the hour or so following drinking acidic drinks, the tooth surface hardens again.

• Some people have recommended that teeth not be brushed immediately after drinking orange juice or other acidic drinks. In general this advice is sound.
• However, if children go to school without brushing their teeth, the dangers of damage to the teeth are likely to be much greater than if the teeth are brushed soon after having juice.

On balance, it is advised that parents can minimise the potential harm of acidic drinks that lead to erosion by:

• limiting the number of times juice is consumed each day - solid fruit is better
• drinking the juice with meals, and
• using a fluoride toothpaste.

Remember, water is the best drink.

• Encourage your child to drink from a cup, so that a bottle is not used after about 12 months.
• Encourage children to drink all of their drink at once, not in little sips.
• If you use a 'feeding cup', children are likely to drink more slowly from it, so it is best to put plain water in it.
• Give children fruit and fruit juice at meal times. Don't give them at bedtime after teeth cleaning.
• Drinking juice through a straw can protect teeth. The juice is swallowed from the back of the mouth and does not stay near teeth.
• A drink of water after eating or taking medicines will help to clean the mouth.

Asthma inhalers and teeth

Asthma management plans which involve the use of puffers to prevent and treat asthma symptoms have led to a dramatic fall in asthma deaths, even though more and more people have been diagnosed with asthma.

The benefits for breathing of using puffers are clear, but the powder in the puffers can cause problems with teeth.

• Many of the powders are acidic, and can erode the tooth enamel when used regularly.
• This can cause teeth to be sensitive and can cause holes in the teeth.

The tooth problems can be reduced if children rinse their mouths with water after using a puffer and if they clean their teeth at least twice a day with a fluoride toothpaste. Fluoride protects the surface of the teeth.

Resources

South Australia

• South Australian Dental Service for children.
  Office hours - phone 8222 8222
  After hours emergency dental service - phone 8232 2651
  (Mon-Fri 4.30pm - 9pm; weekends 9am - 9pm)
  Health Promotion Unit, SA Dental Service - phone (08) 8222 9016
  http://www.sadental.sa.gov.au
• South Australian parents can consult the Dental Department at the Women's and Children's Hospital (Ph: 8161 7379 - 8am to 4.30pm Monday to Friday) or their own dentist for more detailed information.

Books for parents

• Pamphlet 'Zero to Six' - obtainable from the South Australian Dental Service, Dental Health Education Unit and Child and Youth Health Centres.

References

South Australian Dental Service - Health Promotion Unit.
Phone (08) 8222 9016.
http://www.sadental.sa.gov.au

Aligne et al. 'Association of Pediatric Dental Caries with Passive Smoking'. Journal of the American Medical Association (JAMA) 2003, 289: 1258-1264.

American Dental Association. 'Tooth eruption charts'.
http://www.ada.org/public/topics/tooth_eruption.asp

National Center for Education in Maternal and Child Health (USA). Knowledge Path re oral health for children:
http://www.mchlibrary.info/KnowledgePaths/kp_oralhealth.html

Sank, Lindy and Hadi, Hayfa. 'Baby Tooth Tales', in Heinz Sight, May 1999 (51).
SIGN 'Preventing dental caries in children at high caries risk: information for non-dental professionals'.
http://www.sign.ac.uk/guidelines/fulltext/47/section5.html

Wake M, Hesketh K. 'Teething symptoms: cross sectional survey of five groups of child health professionals'. BMJ vol 325, 12 October 2002, p1258.
http://bmj.com

The information on this site should not be used as an alternative to professional care. If you have a particular problem, see a doctor, or ring the Parent Helpline on 1300 364 100 (local call cost from anywhere in South Australia).

This topic may use 'he' and 'she' in turn - please change to suit your
child's sex.