New guidelines say scots kids can brush away tooth decay before the age of 2

Parents throughout Scotland are being advised to focus on early prevention of childhood tooth decay in new NHS guidelines launched today (24^th November). Problems with decaying milk teeth often trigger a lifetime of dental treatment.

Children in the most deprived communities are three times as prone to the disease and also a third less likely to have decay-free mouths at five years-of-age than those from wealthier areas. Overall, young children in Scotland still have one of Europe’s highest rates of dental decay.

However, the study shows that if parents start children brushing twice a day with a smear of medium-strength fluoride toothpaste (1000 parts per million of fluoride) this is about 25 per cent more effective in preventing decay than non-fluoride brushing and can prevent decay. Children older than 2 years are less likely to swallow toothpaste and should brush with a pea-sized amount at the same strength. Spitting rather than rinsing with water also helps the fluoride keep working, especially after bed-time brushing.

Evidence uncovered shows that if parents supervise their children’s tooth-brushing this lessens both the amount of toothpaste used and swallowed, and further lowers the risk of decay. Brushing should start as soon as teeth start appearing which is also the key time for a child’s first visit to the dentist.

These guidelines confirm that avoiding sugary snacks and drinks between meals in favour of milk or water really does diminish the likelihood of decay significantly. The phrase “say cheese” – and smile with confidence – takes on a new twist as research suggests this food may actively protect toddlers against dental disease.

Only two-thirds of three to six-year-olds are registered with a dentist, and campaigns aimed at preventing tooth decay need to make sure that dental services are easy to use and that good advice is available. Practical preventive approaches include providing free toothpaste to parents of youngsters at risk. The guideline also recommends that advice for parents on youngsters’ dental health should be given as early as pregnancy.

The guidance developed by the Scottish Intercollegiate Guidelines Network (SIGN) for the NHS is available on the SIGN website and includes information for parents and carers.

Commenting as the guideline was published, the chair of the development group Dr Dafydd Evans, Consultant in Paediatric Dentistry, Dundee Dental Hospital and School said:

“Tooth decay in young children is a problem that can be beaten. Our guidelines show that starting brushing early and making good decisions about what we eat and drink will mean more of our youngsters can avoid a cycle of dental treatment and repair. There are strong links between deprivation and greater risk of early tooth decay, and we have made several recommendations based on evidence that well-planned prevention work backed by good advice, easily used dental services and support through nurseries and infant schools can make a lifetime’s difference.

Our message to parents or carers who want to stop decay at the key stage of baby teeth is help your child to brush their teeth twice a day, with a smear or pea-sized amount of adult toothpaste depending on their age, and encourage them to spit out and not rinse after brushing. It’s important to remember that children are best having water or milk to drink between meals, and that sugary snacks should be limited to mealtimes. And please take your child to the dentist regularly.”

Areas covered in this guideline: pathogenesis and diagnosis; epidemiology and impact; predicting caries risk; diet and nutrition; toothbrushing with fluoride toothpaste; community based prevention; practice based prevention; practice based management; implementation and audit; information for parents and carers.

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The Scottish Intercollegiate Guidelines Network (SIGN) develops national clinical guidelines aimed at reducing variations in clinical practice and in outcomes for patients. Founded in 1993, SIGN became part of the national clinical effectiveness body, NHS Quality Improvement Scotland (NHS QIS) on 1^st January 2005. NHS QIS oversees a range of complementary activities on translating research into practice, setting and monitoring standards, and promoting clinical excellence in NHSScotland.

SIGN media contact: Patrick Maitland-Cullen on 07968 494 164

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