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When tiny teeth turn bad

Rotten luck ... baby teeth are especially vulnerable to tooth decay.

Rotten luck ... baby teeth are especially vulnerable to tooth decay. Photo: Domino Postiglione

Sugary foods and over-processed carbs take much of the rap for chronic disease and overweight, but here's another casualty that makes fewer headlines – baby teeth. We might live in the age of fluoride and flash cosmetic dentistry, but the latest report card on children's dental health showed a surprising number of little kids with holes in their first teeth. Almost 50 per cent of  six-year olds attending school dental services had one or more teeth that was either decayed, missing or had been filled, the Australian Institute of Health and Welfare's Child Dental Health Survey revealed this year.

So what makes little teeth decay so quickly?

This thinner enamel is no match for the acid attack that happens when an overload of sugar and refined carbohydrates change the environment in the mouth to favour the bacteria that cause tooth decay. 

Baby teeth begin with a disadvantage – because their enamel is less robust than that of the permanent teeth that replace them, they're less decay resistant, explains Associate Professor Wendell Evans of the University of Sydney's Faculty of Dentistry.

This thinner enamel is no match for the acid attack that happens when an overload of sugar and refined carbohydrates change the environment in the mouth to favour the bacteria that cause tooth decay, he says.

"Plaque is the film of bacteria that builds up on the teeth but it's not plaque that causes decay – it's the acid produced when bacteria ferment sugar and refined carbohydrates. This acid dissolves the tooth enamel – and the more sugar and refined carbohydrates there are in the mouth the more dominant these bacteria become," he explains. The mouth does have its own brilliant anti-cavity repellent – it's called saliva and it works in two ways. One is by rinsing away the acid and the other is by helping to reverse the early stages of tooth decay - saliva also contains calcium that can help remineralise damaged enamel.

"But if there's too much sugar in the mouth too often the saliva can't keep up. If the mouth has three or four hour breaks in between eating sugary food the natural repair process can take place, but when babies have bottles filled with cordial, soft drink or sweetened milk, or children graze on lollies, biscuits and cakes or snacks made from refined carbohydrates through the day, there's no opportunity for periods of remineralisation to take place," Evans says.

"Another contributor to this early  decay may be  that children are also drinking more flavoured drinks rather than tap water containing fluoride."

Decay is also surprisingly swift, he adds. In research from a Danish dental school in the 1960s, a group of students rinsed their mouths frequently with a sugar solution but didn't brush their teeth – and within three weeks their teeth showed little white spots, the early signs that demineralisation had begun dissolving the enamel.

"Teeth can be decimated in weeks, but the good news is that demineralisation can be reversed by regular brushing with fluoride toothpaste," Evans says.

Does it really matter if baby teeth come to grief if they're replaced by permanent teeth?

Well, yes. Not only can decayed baby teeth hurt, but losing them too early can cause problems with the alignment of the second teeth – one of the jobs of the first teeth is to hold the position for the permanent teeth. However, if first teeth are lost prematurely, dentists can use stainless steel or plastic space maintainers to help prevent alignment problems.

Besides regular brushing and avoiding over-grazing on sugary foods and refined carbohydrates, how else can parents keep tiny teeth decay free?

Teaching them to drink from a cup by the age of one is good, says Evans – with a bottle children are  more  likely to suck on a drink for longer, exposing teeth to any sugary fluids such as juice for longer periods. And look out for the arrival of more teeth in need of brushing - the permanent molars that can sneak in unnoticed at the back of the mouth sometimes as early as four and half or five years of age.

What's your approach to rationing sugar in your children's diet?

45 comments so far

  • my girl had two front teeth decaying because all these while she had been lying to me about brushing her teeth...

    alternative method, brushing teeth with baking soda plus a few healing dentist, NO FLORIDE!!! now her front teeth, new as ever. thanks for listening. vendetta says hi.

    phillip bay
    Date and time
    August 22, 2012, 11:45AM
    • Maybe if you had been a responsible parent and watched her brush there wouldn't be any decay.
      And dentist's are there for a reason, as are fluoride additions to our water supply.
      Alternate lifestyles & kids are a scary mix.

      Responsible Father Figure
      Wearing a fez
      Date and time
      August 22, 2012, 12:49PM
    • you are not a responsible father figure, as your name suggests, if you don't do your own research into water fluoridation, what it actually is, where it comes from, how it came into being put into our water, who is making money from this (including Dentists and Doctors), and all the health issues that it causes.

      If you are a father, as I am, then you need to be informed as to the truth. I too had been told that fluoride was beneficial, until I did my own digging...

      for the health of your children and yourself, you owe them that much.

      Date and time
      August 22, 2012, 1:27PM
    • Your child lied to you about brushing her teeth? This is unheard of... you should write an article about it because it's such an unexpected thing for a child to do.

      What next? She'll lie about having eaten her vegetables? Maybe some baking soda for breakfast will help that... no need for a doctor then and we can do away with them, just like dentists.

      an article about lazy parenting wouldn't be a bad idea either, gives the rest of us an idea of what not to do.

      Date and time
      August 22, 2012, 2:09PM
    • Sorry Mossy, I'd look it up but I seem to have misplaced my tinfoil hat.

      Responsible Father Figure
      Wearing a Fez
      Date and time
      August 22, 2012, 2:38PM
    • @Mossy
      " I did my own digging"

      Where did you "dig";

      (1) In PubMed or an equivalent database of the peer-reviewed medical literature abstracts?

      (2) In the primary peer-reviewed medical literature?

      (3) In conspiracy theory Web sites?

      (4) Some of the above?

      (5) All of the above?

      (6) None of the above?

      Dr Kiwi
      Date and time
      August 22, 2012, 3:54PM
    • Hey Mossy,

      Just a quick do dentists actually benefit from promoting a public health issue like water fluoridation? If the WHO (World Health Organisation) itself acknowledges the overwhelming scientific evidence of the benefits against tooth decay, why would dentists knowingly promote something that kills their business??...???!!

      Date and time
      August 22, 2012, 4:19PM
    • @Dr Kiwi and others who wanted evidence...

      Some background:
      Qld Health has removed the a page from their fluoride website that I had previously saved (they hid the evidence?) but they admitted the fluorides used are sodium fluoride, fluorosilicic acid, sodium hexafluorosilicate. A Google search on each of these chemicals reveals that they are not found naturally but are in fact very toxic waste products from aluminium, pesticide and fertilser production industries, and what the effects of these poisons are on the human body. For example, Sodium fluoride is also used as a rat poison, pesticide and insecticide. Fluorosilicic acid is corrosive to glass and metals and also used as a pesticide.

      The Dental associations admit that fluoride causes dental fluorosis, but it also linked to skeletal fluorosis, bone cancer, and has limited benefits when swallowed; fluoride should be used topically instead of being taken internally:

      Articles and research:
      The Lancet, Nov 2006 - Fluoride is an emerging neurotoxin

      Neurotoxicology and Teratology Journal 1995 - "Neurotoxicity of sodium fluoride in rats"
      This showed that fluoride accumulated in the brain and caused behavioural disorders.

      There are hundreds of similar research papers that are published, look for yourself.

      One reprinted article from the Journal of American Physicians and Surgeons, Volume 10 Number 2, Summer 2005, includes the history of fluoridation, cites many studies done and concludes that fluoride is NOT safe, does NOT provide any benefit other than to industrial companies who get paid to dispose of their waste products, instead of paying to dispose of them:

      Fluoride is not an essential nutrient and tooth decay is not caused by its deficiency.

      Tooth decay is caused by poor dental hygiene and poor nutrition (acidic and sugary foods).

      Fluoride does not fix the cause of tooth decay. Simple

      Date and time
      August 23, 2012, 12:43AM
  • Oddly enough it was the conspicuous difference in the amount of decay in two nearby towns that led to the discovery that fluoride can help in the prevention of decay. In the town with the least amount of decay the water was naturally fluoridated by mother nature.

    The goodies that are in milk that are useful for your teeth have also been identified. A dentist is likely to happy to talk about TCP.

    Milo is flavoured sugar and unnecessary crud. Adding milk to it doesn't make it healthy despite advertisers best efforts to fool us otherwise. It tastes good though...grrr

    Juices can be full of added sugar even if it says there isn't. Far better off eating the entire fruit and getting the fibre as well as the sugars that the fruit came with.

    Energy drinks are rubbish as is Vitamin water...does anyone not remember simply sticking your head under your neighbours front tap when you were a kid? Plain old H2O

    Roll-ups and dried fruits are also terrible due to all the stickiness and added sugar. Definitely sometimes food.

    Beware of 'acidity' in drinks/foods as well as the sugar.

    @CJ..good for you. Unfortunately advocating your personal experience isn't one that would be supported scientifically and definitely not legally. Your choice always...but only for your kids. Until of course you do avail yourself of enough vetted scientific literature to sensibly debate otherwise.

    Go Wendell
    Date and time
    August 22, 2012, 1:32PM
    • Since my 3.5 year old son sat on my lap at the dentist and watched a "clean" being done, he has been unbelievably compliant about tooth brushing as he "doesn't want to go to the dentist". And seeing his mate's little 14 month old sister very competently brushing her own teeth was also inspiring! As was getting to choose his own toothbrush at the chemist.

      Friend's (yes really) little girl had horrendous problems which turned out to be honey sandwiches and the residue left on the tooth. I'm scarred from the story and my little one has honey maybe twice so far..

      Date and time
      August 22, 2012, 1:34PM

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