Oral health information for children and babies Information for health visitors and Child Care Staff

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1 Oral health information for children and babies Information for health visitors and Child Care Staff

2 Oral Health for Children Babies and toddlers should never be put to bed with a bottle. This can lead to tooth decay or bottle caries. Diet Sugar between meals causes tooth decay. Restrict the frequency of sugary foods and drinks, as much as possible. Aim to progress from a bottle to an open cup from 12 months old. Any prolonged contact from a bottle or sipping cup containing sweetened drinks can cause decay. The safe drinks to choose between meals are water and milk. Grandparents, Child Minders, Nurseries and friends should be made aware of the facts of tooth decay when choosing a snack for a child. Toothbrushing Start brushing a child s teeth as soon as they appear. Use a soft, small headed toothbrush. Fluoride toothpaste should be used from when the first tooth appears. For children under 3 years old, a smear of 1,000ppm (parts per million) fluoride should be used. For children aged 3 years and over, a pea sized amount of 1,350-1,500ppm fluoride toothpaste should be used. Teeth should be brushed twice a day including just before bedtime. This is important as the fluoride will then remain in the mouth for as long as possible to strengthen the teeth. When brushing teeth do not use a mouth wash or water SPIT DONT RINSE to keep toothpaste on the teeth as it is a topical application. Children need to be helped and supervised with brushing until at least 7 years of age. 1

3 Tooth Eruption Remember these dates are only approximate and can vary considerably. Teeth start to form in the womb and whilst some babies are born with teeth others may not have any until they are a year old. Most children don t have a full set of teeth until around 3 years of age. Permanent teeth start to come though at about 6 years if age remember the 1 st permanent molar (back) teeth come through behind all the baby teeth T the back of the mouth. 2

4 Common signs of teething include: flushed cheeks dribbling sore red gums restlessness irritability disturbed sleep patterns desire to chew Teething rings either chilled or water filled may help soothe a teething baby. If you have any concerns you are advised to speak to your health visitor or dentist. Symptoms not linked to teething are: rashes bad temper runny noses extra dirty nappies vomiting high temperature/fever Permanent teeth sometimes erupt slightly displaced, or before the baby tooth is pushed out. The dentist can advise on this at the next check up. 3

5 Hidden sugar in food A Little Sugar = ½ Teaspoon per 100g A Lot of Sugar = 2 ½ Teaspoons per 100g All measurements in spoonfuls mean a rounded teaspoon One rounded teaspoonful of sugar weighs approximately 4 grams frequent consumption of sugary foods and drinks is linked to tooth decay Product Quantity Teaspoons of sugar Frosted wheat (Kellogg s) 1 serving = 40grams 1 ½ teaspoons Weetabix 1 serving = 2 weetabix ¼ teaspoon Farley s bear biscuit (Heinz) Chocolate buttons (Cadbury) 1 serving = 1 biscuit ½ teaspoon 1 serving = 187 grams 4 teaspoons Tomato ketchup 1 serving = 2 tablespoons 1 teaspoon Fruit shoot (still) 1 serving = 200ml 5 teaspoons Raisins (dried) 1 serving = 14 grams 2 teaspoons Petits Filous (Fromage frais) 1 serving = 50 grams 1 teaspoon 4

6 Sugar in drinks Water Flavoured water Plain milk Carton flavoured milk (1 cup/250 ml) Carton fruit juice (1 cup/250 ml) Fizzy drink (1 can/355 ml) none 2.5 teaspoon None (NB contains Lactose) 3 teaspoon 7 teaspoon 10 teaspoon Ph (acid level) in common drinks: ACID used in fizzy drinks, energy drinks; juices and squash will dissolve the enamel of teeth and cause EROSION. Tooth enamel begins to be destroyed when acid levels in the mouth drop below 5.5 on the ph scale, which has 7 as neutral and 1 as strong acid. Water 7 (ph neutral) Plain milk 6.8 Apple juice 3.3 Grapefruit juice 3.2 Orange juice 3.7 Fizzy drinks 2.4 to 3.2 5

7 Sugars that occur naturally These are the sugars that are found in whole, unprocessed foods. They are known as intrinsic sugars and are found in the cell walls of whole fruit, vegetables (fresh and frozen) and also in cow s milk. They do not break down in the mouth but in the stomach so are less likely to cause tooth decay. These include naturally occurring: Sucrose Fructose Glucose Lactose Added sugars Theses are sugars that are found hidden in processed food and drinks for flavour and taste. They are known as Extrinsic sugars and have already been released from their cell structure when being processed. They are then broken down in the mouth by an enzyme and can cause tooth decay. These include added: Sucrose/Fructose/Glucose Dextrose Maltose Syrups Honey Raw sugar 6

8 Only drink water or milk between meals. Water makes up 70% of body weight and is essential for life. Milk also contains essential nutrients i.e. calcium which is good for the body. Remember Reduce all snacks containing added sugar Find healthy alternatives for between meals Keep sugary foods and drinks to a meal time Aim to drink only milk or water between meals Do not add sugar to foods or drinks Sugar free medicines should be used if needed Brush teeth morning and night with fluoride toothpaste Visit the dentist regularly Tooth brushing and Fluoride Always read the instructions on your child s toothpaste tube. This will always give you the dose and the amount of fluoride contained in the toothpaste. Brush twice a day, last thing at night and at one other time during the day using a small headed toothbrush. Use a smear of toothpaste for babies and very young children, progressing to a pea-sized amount when your child is about three years old. Children under the age of about seven usually need help to clean their teeth effectively. Spit out but do not rinse after brushing as this removes the fluoride. 7

9 Limit the frequency of food and drinks containing sugar. Visit a dentist regularly. Fluoride toothpastes for young children Fluoride helps strengthen tooth enamel to make it more resistant to decay. It will help repair or slow the development of early decay. It can also lessen the ability of plaque bacteria to produce the acid which decays teeth. In Somerset no fluoride is added to the water supplies, so we need to use toothpastes which have sufficient fluoride added. Current guidelines recommend that young children up to 3 years old should use a smear of toothpaste containing approximately 1,000 ppm (parts per million) fluoride. From the age of 3 a pea-sized amount of adult toothpaste, containing between 1,350ppm and 1,500ppm fluoride, should be used. Below is a list of some toothpaste which you may find helpful. This is by no means a comprehensive list. Check the list of ingredients on the tube, and you will find the figure for the amount of fluoride in the toothpaste. 8

10 Age 0-3 years of age 3-6 Years of age Brand name Aqua fresh Product description 0-3 yrs Milk Teeth Amount of fluoride 1,000ppm Asda great stuff Berry Sparkle 1,000ppm Thomas and Friends Boots Smile Aquafresh Fruity Gel 2-6 yrs & 6+Spearmint Little Teeth & Big Teeth 1,000ppm 1,000ppm 1,400ppm Pronamel 6-12 years 1,450ppm Boots Smile Freshmint 1,450ppm Sensodyne Dailycare Mint 1,450ppm Colgate Total Mint 1,450ppm Broken Tooth - First Aid for Dental Injuries 1. If it is a baby tooth Leave as it is 2. If it is an adult tooth, try to find the broken bit the dentist can sometimes glue it back on. The person should ideally see a dentist within 24 hours 3. In both cases if there is a cut to the lip it is advisable to see a dentist in-case there are parts embedded in the lip 9

11 Remember Always deal with any serious or life threatening injuries first. Knocked out Tooth 1. If it is a baby tooth leave it. Baby teeth are not reimplanted 2. If it is an adult tooth Pick it up by the shiny end (crown) Make sure it s the right way around Push it into the hole (socket) Get the person to bite on a hankie Get the person to the dentist or A&E ASAP 3. If you are unable to do this put the tooth into milk and get the patient to the dentist or A&E 10

12 Useful websites A guide to the Somerset Primary Care Dental Service The British Health Foundation lots of useful information about oral health eating info@dairycouncil.org.uk Information about healthy living for children of all ages Scottish website with lots of practical oral health information BBC Health Online dental and general health information Healthy eating information search for Delivering Better Oral Health An evidencebased toolkit for prevention - definitive straightforward advice The British Fluoridation Society 5 minute guide booklets. Tiny Teeth, Tiny Tums, Baby Nosh and Bump to Baby Teeth the Musical DVD for use as a fun resource for children to learn about oral health 11

13 Fluoride schemes in Somerset for children in early years Fluoride Varnish We are currently working with Nurseries, mainly at Children s Centres in Somerset, to deliver Somerset Smiles. This is a fluoride varnishing scheme aimed at 3 year olds. What? Fluoride Varnish is a golden sticky gel. This is applied professionally twice a year to help prevent dental caries in childrens teeth. How? Fluoride varnish is painted onto the tooth surface with a small applicator. It sticks to the teeth so the child should not eat or drink for at least an hour afterwards. It has a pleasant taste and fruity smell. Where? Please ask at your Children s Centre Nursery for information and dates of application. Toothbrush and Toothpaste Packs Your child will receive a free toothbrush and toothpaste with an oral health information leaflet at their 12 month health check. These will be distributed by your Health Visitor on the visit. 12

14 Visiting the Dentist Families are advised to register with a dentist for regular check ups. Your child is never too young to visit a dentist. Take your child with you to your own check-up appointments will help familiarize them with the setting. For help with registering with an NHS dentist please ring the Dental Advice Line Somerset Dental Advice Line The Advice Line will also assist with booking emergency appointments for those patients who have pain and do not currently have a dentist. Advice on urgent care can be accessed daily from Weekends and bank holidays from Patient Referral to Dental Access Centre The Primary Care Dental Clinics can provide advice/treatment for any children about whom you may have particular concerns regarding their oral health. This is especially important if a child has a medical condition which increases the importance of preventative dental advice. Please refer directly to the Primary Care Dental Service using the details supplied below. 13

15 Contact addresses and phone numbers for our Dental Access Centres Bridgwater Dental Access Centre Southwood House 2-4 Taunton Road Bridgwater Somerset TA6 3LS ( TA6 3LU for sat nav) Tel: Satellite clinics for Burnham & Minehead Taunton Dental Access Centre Parkgate House East Reach Taunton TA1 3ES Tel: Fax: Satellite clinics for Chard & Wellington Glastonbury Dental Access Centre The Health Centre Wells Road Glastonbury Somerset BA6 9DD Tel: Fax: Satellite clinics for Frome & Wells Yeovil Dental Access Centre Summerlands Hospital Site Preston Road Yeovil Somerset BA20 2BX Tel: Fax: Somerset Primary Care Dental Service Head Quarters Southwood House 2-4 Taunton Road Bridgwater Somerset TA6 3LS (TA6 3LU for sat nav) Tel: Oral Health Promotion Peter Holmes Annexe Burnham Community Hospital Love Lane Burnham On Sea Somerset TA8 1ED Tel: Dental Advice Line Tel: Dental Access Centre for the Somerset Primary Care Dental Service 14

16 Information from the Somerset Primary Care Dental Service Please visit our web site for current information on the Somerset Primary Care Dental Service. It contains useful information on accessing our service and has a range of leaflets that can be downloaded. This leaflet is available in other formats, including easy read summary versions and other languages upon request. If this would be helpful to you, please speak to a member of staff. Date Issued: August 2016 Review Date: August 2018 Impact Assessed: March 2013 Author: Somerset Primary Care Dental Service Ref: SS DENT 001 v4 For any further information on your child s oral health please contact The Oral Health Promotion Team OHPOffice@sompar.nhs.uk Headquarters: Somerset Partnership NHS Foundation Trust 2nd Floor, Mallard Court, Express Park, Bristol Road, Bridgwater TA6 4RN Tel: Fax: foundationtrust@sompar.nhs.uk Web: Copyright Somerset Partnership NHS Foundation Trust (2016)