The Tooth Fairy is visiting more young children's homes than she should be, judging by a new report which shows many three-year-olds have tooth decay.

The Public Health England (PHE) study showed that an average of 12% of three-year-olds have rotten baby teeth, with some areas of the country having 34% of the age group with tooth decay, and other areas just 2%.

The study also found that affected children had an average of three decayed teeth.

While some parents may think that because the decay's in baby teeth, it doesn't matter, dentists warn that if children don't learn to look after their teeth at a young age, they are likely to have dental problems throughout their lives.

As tooth decay is caused by consuming too many sugary foods and drinks too often, dentists say parents need to limit the amount children are given, and get them to brush their teeth for two minutes, twice a day.

Dentist Ben Atkins, clinical director of the Revive Dental Care practices in Manchester, and trustee of the British Dental Health Foundation, says: "It stores up problems for the future if parents don't ensure their children's teeth are looked after when they're young.

"There's evidence that once you've got decayed teeth, you will get more. Looking after baby teeth is a really good preventative regime for when adult teeth come through."

The PHE study found that in some cases there was a particular type of decay called Early Childhood Caries, which affects the upper front teeth and spreads rapidly to other teeth. Such decay is related to the consumption of sugary drinks in baby bottles or sipping cups.

PHE advises that instead of sugary drinks, breastfeeding provides the best nutrition for babies, and the best drinks for children aged one to two years are full-fat milk and water. From two years old, semi-skimmed milk and water is fine, as long as children are good eaters.

However, Atkins says knowing which food and drink has a lot of sugar in it can be hard for parents.

"Our job in the dental profession is to educate all our patients about brushing with the correct toothpaste, and identifying food and drink that has sugar in it.

"That's a real challenge, as things like tomato ketchup have a phenomenal amount of sugar in them, but you wouldn't think you were having something sugary with your chips."

The only way to be sure of how much sugar is in food or drink is to read the label.

As well as reducing both the amount and how often sugary foods and drinks are given to children, PHE is encouraging parents of young children to take the following steps to keep their teeth healthy:

:: Don't add sugar to weaning foods or drinks.

:: Introduce drinking from a free-flow cup from six months of age and stop feeding from a bottle from 12 months of age.

:: Start brushing children's teeth as soon as the first tooth appears and supervise their tooth brushing until they're seven or eight years old.

:: Brush children's teeth twice daily, including just before bed, using a fluoride toothpaste.

:: From the age of three, use only a pea-sized amount of fluoride toothpaste, for younger children a smear.

:: Use only sugar-free medicines.

Atkins points out that tooth decay has dropped dramatically since fluoride toothpaste was introduced in 1976, and says children aged under three need to use toothpaste with 1,000ppm fluoride, and after the age of three they can use adult toothpaste.

He also suggests that parents bring children with them to dental appointments while they're still babies, pointing out: "It makes a big difference, because if there's anything wrong later on, they're used to coming to the dentist, rather than coming in only when there's a problem and they might have to have something done that hurts.

"They need to come more frequently to avoid the fear factor."

He says that while decay is on the whole reducing: "We need to focus on the harder-to-reach people in the lower socio-economic areas.

"We've still got 25,000 children every year having teeth removed in hospital unnecessarily, as tooth decay is unnecessary. Often in the lower socio-economic areas there's a high tooth decay rate.

"We have to be realistic - kids want sweet things. But if you're going to give them, do it at a meal time instead of at other times during the day, so the mouth is dealing with one solid hit of sugar, instead of children having a sugar solution in their mouth all day."

Atkins suggests that to make sure children brush for two minutes, parents should either use an egg timer, or play a song that lasts for that long. In addition, after brushing, children should just spit out the toothpaste, rather than rinsing with water which gets rid of much of the fluoride.

Dr Sandra White, director of dental public health at PHE, points out that while there have been "significant improvements" to the nation's oral health, some areas still experience problems with tooth decay among young children.

"Tooth decay is an entirely preventable disease, which can be very painful and even result in a child having teeth removed under general anaesthetic, which is stressful for children and parents alike," she says.

"Thankfully, tooth decay in children can be prevented by following a healthy lifestyle; by parents and carers reducing the amount of sugary foods and drinks they give their children, and supporting them to brush their teeth twice a day.

"It is also important to take your child to the dentist, which is free of charge for children, as the dentist will be able to advise you about how to keep your child's teeth and gums healthy."


Q: "My children always want to drink fizzy drinks. How can I get them drinking more water without it being too boring for them?"

A: Food scientist and children's TV presenter Stefan Gates, who's working on a new campaign to get children more interested in drinking water, says: "Let's be honest - telling kids 'you'll be healthier if you drink more water' is doomed to failure, just like all adult finger-wagging.

"Recent research from the Natural Hydration Council showed that only half (51%) of children questioned said they drank water at school, with four out of 10 (40%) having to be told to drink water by their parents, so we need to find ways to make it fun and interesting.

"Encourage your children to decorate their own personalised water bottle, so they feel ownership over their own drinking habits, or ask them to count how many bottles or cups of water they drink each day. Tips and tricks like these will help them go from seeing water as a boring necessity, to a fun challenge.

"We also know that children copy their parents behaviour, so make sure you get into the habit of drinking water in front of your children. If you want your child to start thinking about hydration at school, The Children's Food Trust and Natural Hydration Council have teamed up to run the Wise up with Water Challenge, asking schools to design a challenge or experiment to try and make drinking water more fun. The winning school will be treated to a Wacky Water Workshop with yours truly."

:: To take part in the Wise up with Water Challenge, visit


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