Preventive care

Preventing tooth decay – some information to help!

You can prevent tooth decay. Prevention of dental decay and gum problems is possible with some simple, but important steps.

Here are five key messages:

1. Give teeth a rest between meals, snacks and drinks

Give teeth a rest from food and drinks for about 1.5 - 2 hours between snacks and meals. Think about eating patterns – teeth dissolve (demineralise) every time food containing most carbohydrates or sugars comes into contact with the germs in plaque on the teeth. This is because the germs make acid in the presence of these substances, and the acid attacks the teeth. Saliva hardens (remineralises) the teeth again, but this takes time, which is why it is so important to give teeth a rest. It is important to drink enough to make plenty of saliva too, and to eat or drink calcium and phosphate containing foods daily, like cheese and milk. Water or milk is the best drink.

Children do need to eat snacks between meals, and research suggests it is safe for teeth to eat breakfast, morning tea, lunch, afternoon tea and dinner each day. Constant or frequent eating or drinking is not necessary, nor desirable.


 

2. Brush the teeth morning and night with the correct strength of fluoridated toothpaste (usually not less than 1000 parts per million fluoride) and spit out excess toothpaste after brushing, but don’t rinse with water

Brush the teeth morning and night using fluoride toothpaste. This is to remove plaque and to apply fluoride.

How? Use a soft small-headed nylon toothbrush. Parents/caregivers need to do the tooth brushing for children until the children are able to do this well for themselves. Children vary greatly in their fine motor skills development. A good way to judge when the time is right to allow children to brush by themselves is when they can easily tie shoelaces. Even then, parents are still involved in checking that the teeth have been well cleaned, especially at night, and that toothpaste is being used appropriately.

Which toothpaste? Children’s toothpastes usually contain about half the amount of fluoride as regular toothpastes (450-500 parts per million), and may not prevent tooth decay as well as regular tooth pastes which contain 1000 parts per million (ppm). Recently some toothpaste with more fluoride (1450 ppm) has come onto the supermarket shelves. However, the children’s toothpastes with the lower levels of fluoride may reduce the risk of dental fluorosis (usually seen as white mottling of permanent tooth enamel) in children under the age of 6 years. You need to choose which toothpaste suits your child’s needs. If your child finds the flavour of toothpastes too spicy/hot/minty, look out for some flavoured toothpastes marketed for children, but with the regular amounts of fluoride (usually the side of the toothpaste tube says for over 6 years of age on these). If the toothpaste tube states 0.76% monofluorophosphate (MFP), or 0.22% sodium fluoride (NaF) then this is the level of 1000 ppm fluoride. Many types of toothpaste also contain ingredients to help reduce plaque and tartar (calculus) build-up, and this is indicated on the labelling on the toothpaste tube.

How much toothpaste? Use only a smear of toothpaste on the toothbrush for pre-school children, and a small pea sized amount for school-aged children.

Spit but don’t rinse

After cleaning the teeth, encourage your child to spit out the bubbles and excess toothpaste, but not to rinse with water. This is so that the toothpaste ingredients can continue to work and are not all washed away too soon.


 

3. Floss daily

Flossing teeth after brushing helps to remove plaque from between the teeth where toothbrushes do not reach. It also helps carry toothpaste between the teeth. As with tooth-brushing, parents need to do this for children until they can manage to do this by themselves. Ask to be shown how to floss your child’s teeth. It is important to be careful not to cause injury to the gums.


 

4. Use mouthwashes or tooth mousse plus if advised by your dentist

Talk with your dentist about whether any mouthwashes or tooth mousse or gel are recommended. Mouthwashes either contain fluoride to help strengthen teeth, or agents such as chlorhexidine or triclosan to reduce the numbers of decay causing germs in the mouth. Tooth mousse contains a substance called CPP ACP which helps to strengthen the teeth. Some gels contain both antibacterial and fluoride, for example Cervitec Gel.


 

 5. Have regular dental check-ups

Until decay is under control – that means no new decay has developed or spread since the last check-up – 3 to 6 monthly visits are recommended. Once decay is under control visits are usually 6-monthly to yearly, but longer intervals are sometimes sufficient in individuals with very low risk of decay and no other dental problems. Check-ups detect if any fillings or sealants need maintenance, look for new decay or progress in early decay, and check how the teeth and jaws are growing.