How to stop your child getting holes in their teeth

How to stop your child getting holes in their teeth

I watched the live twitter feed as #TheDentists was on last night (I know, I need to get out more) and I was struck (but secretly pleased) by the outrage from the general public as child after child was referred for the removal multiple teeth under general anaesthesia. “Refer to social services” said one. “Some people should not be allowed to have children” said another. So if we all think this is appalling, then how come day in day out I refer children for this procedure? How can you stop your child getting holes in their teeth?

Firstly, lets get this straight. Dental decay or caries is 100% preventable. There are a few conditions where the teeth come through poorly formed as a result of a genetic condition or a disturbance which happens around the time of birth but these are in the minority. Most of the children and young people I see have holes which could have been avoided. So is it just a case of eating fewer sweets? Well yes, and no. Yes, because diet is a big factor, but its not the only one.

So, here are my top tips to stop your child getting holes in their teeth:

1) Get grandparents on side

Try to encourage grandparents to use alternative treats to sweets – putting money in their piggy bank or buying a small gift can allow them to spoil grandchildren without wrecking their teeth.

2) Spit, don’t rinse

From the age of 3 your child can use a pea sized amount of adult toothpaste. Encourage them to spit out excess paste, but not rinse their mouth with water. Why? Because rinsing washes away the fluoride which has shown to reduce dental decay.

3) Respect the golden hour

Dentists call the hour before bed, “The golden hour”. Avoid letting your child have anything to eat or drink in this time aside from water. The reason for this is that when whenever we have anything containing sugar to eat, it takes our mouths time to recover and to move from the process of demineralisation (making holes in teeth) to remineralision (rebuilding them again). When we sleep, our mouths dry out and we lose the protective effect of saliva. This is why having sweet things in the hour before bed is a recipe for disaster.

4) Read the label

“No added sugar” does not equal “Sugar free”. Please keep squash to mealtimes and as a treat only. Fizzy drinks should also be kept as a mealtime treat – diet drinks are better than “full fat” equivalents but remember that the acid can still cause erosive damage to teeth.

5) Keep sweet treats to mealtimes

The key things with diet are to minimise the quantity and frequency of sugary foods. I’m not saying don’t give your child any sweet treats, but make sure they are that, treats with a meal. This causes less damage to teeth because it is the same “intake” of food rather than a separate episode of demineralisation. Remember, children aren’t born with a taste for fizzy drinks and sweets. They acquire it. You should be aiming for no more than 4-5 intakes per day.

6) Campaign for water fluoridation

Did you know that adding fluoride to water can reduce dental decay by half and that it costs less to provide a lifetime of water fluoridation for one person than one small filling? So why is the whole of the UK not fluoridated? Sadly, there is a small but vocal antifluoridation lobby which has scaremongered the general public and water companies from progressing with this vital public health measure….and no, it does not cause cancer, damage bones or any of the above.

7) Supervise brushing

Supervise your child’s brushing until they are 8 years old as there is evidence to show that they do not have the manual dexterity to go it alone until this time. By all means let them brush their own teeth, but make sure you go in afterwards to ensure everything is nice and clean. Disclosing tablets can also be helpful for spot checks on older children!

8) Go for check-ups

Take your child for a check up every 6 months, or more frequently if your dentist recommends. These visits will allow your child to get used to the dental environment and for your dentist to spot problems when they are easily fixable. Your dentist can also provide treatments such as topical fluoride (painting fluoride onto the teeth) and fissure sealants (coating of back teeth) to reduce the risk of dental decay. Don’t forget, dental treatment for children is free in the UK 🙂

9) Use a fluoride mouthwash

Once your child can spit out effectively, you can encourage them to use a fluoride mouthwash at a different time of day to when they brush their teeth. Why a different time of day? Because fluoride works best a little and often. Did you know that using a fluoride mouthwash every day can reduce dental decay by 30%. That’s not a bad investment for 2 minutes of work, is it? If your child doesn’t like minty tastes, try Big Teeth Mouthwash – it has a taste not unlike sweets (?!) which seems to be very popular. For older children and adults, I like Fluoriguard but any alcohol-free, fluoride mouthwash will do the trick.

10) Parent your child and lead by example

Finally, don’t be afraid to say no to your child. Parenting is amongst other things about setting boundaries for your children. I’m not saying it is easy and certainly when you are busy and tired it can feel at times overwhelming. Giving in can seem like the easy option for the sake of ‘keeping the peace’ but in my experience it is never the easy option for the longer term. Try, try, try not to create bad habits which your child may take with them into adulthood. You are their role model, lead by example.

Post Author: Claire

13 thoughts on “How to stop your child getting holes in their teeth

    Liz May

    (June 20, 2014 - 6:51 am)

    Help, my son’ s primary school is giving him a Coco Pops Bar once a week before 9.00am as a snack after an early morning school club. I’ve complained and the school have said they don’t consider it a problem as it is only once a week. What can I do to convince the school to change its policy???


      (June 20, 2014 - 1:07 pm)

      Hi Liz, thanks for your question! I totally understand your frustration.
      Coco pops bars are not a great snack as you have already guessed. A 20g bar contains 8g of sugar (or 9% of the 85g Guideline daily amount (GDA) in a 5-10 year old child). I think you have three ways you can play this:
      1) You can ask the school to give your son an alternative and healthier snack. You will know what he will enjoy – Ava loves rice cakes with peanut butter, grapes and bananas. I know some schools give toast and fruit in their breakfast clubs. The only difficulty with this option is that you then set your son aside from his peers, which may or may not bother him.
      2) You can allow your son to have this snack given that it is a once a week treat. A weekly treat within the context of an otherwise controlled diet is unlikely to cause him problems.
      3) You could gauge the views of the other parents. Are they concerned? Would they support a change? If so, there is always greater power in numbers. Make sure you suggest a workable and financially viable solution in your letter of concern.
      Good luck!
      PS Do you think the idea of a Q&A section on toothfairyblog would be helpful?


    (June 20, 2014 - 9:40 pm)

    Brilliant post, I am 19 and have recently had lots of work done on my teeth (numerous fillings and a root canal) and wish my dentist and parents told me all of this stuff. It wasn’t until I went to a private specialist I was given this advice. I have sworn to myself that any children I have will be guided (forced for a fair few years) to have a healthy mouth. I just wish there was more education on mouth hygiene like there is about things such as sex education in schools. I have been given a second chance to improve or lose my teeth and I know what I’d rather!!

    Ps. Q&A would be a good idea 🙂

    Liz May

    (June 20, 2014 - 11:22 pm)

    Thank you for your suggestions. One question remains;- what is the coco pops bar doing to kids teeth if they eat it at 9.00am in the morning before school. I agree about the odd treat isn’t a problem but is it up to the school to decide about balance or their Mum and Dad. I also have issues with the other parents dishing out bags of haribos to my child when its their kids birthday without asking in advance. I’m trying to set a good example to my child and it feels like the school environment is sabotaging my efforts. Any facts and figures about Childrens oral health would really be appreciated to combat the laissez faire attitudes when it comes to tooth decay in kids. Cheers.


    (April 27, 2015 - 7:39 pm)

    I agree completely with everything you have said, I parrot information to all Mums I see in clinics and within the home (I work in community) and have carried out all the right things with my own daughter, who is 8. She has a decayed tooth. I am devastated beyond belief. There is nothing we do that is “wrong” and I really don’t know how it has happened. The dentist dug round it and caused lots of pain as the root is exposed and now I can see me having a fight on my hands the next time we go for just a check up. The dentist did recommend a filling, but she refused to open her mouth. The only saving grace (if there is such a thing) is that it is a baby tooth and will fall out. I literally hate myself and feel so guilty. I have never had so much as a filling, my teeth are in excellent condition.


      (May 1, 2015 - 8:00 pm)

      I really feel for you, Kim. What is your role in the a Community Dental Services? I don’t want to patronise you and tell you things that you already know, but dental decay is such a complex process. It’s not just what we eat but also when and how we eat. Of course, fluoride in toothpastes/water/varnish has a big effect too. Would inhalational sedation be an option for your daughter? Hall crowns are also fantastic (if she is not having symptoms and there is no infection on an x-ray). Might be worth looking at. Make sure you also look at sealing her permanent molar teeth and discussing a higher fluoride toothpaste with her dentist. Hope this helps – it’s very difficult to give you specific advice remotely and without the benefit of a clinical examination.


        (May 1, 2015 - 8:09 pm)

        I work as a community nursery nurse, with health visitors. I’m hoping she will calm down and let the dentist at least look!! Our area has no fluoride in the water, and we have brushed with 1000ppm paste since her first tooth. Thanks for your reply, I appreciate it 🙂


          (May 1, 2015 - 8:59 pm)

          No problem, Kim. Sadly, 90% of the UK is without fluoridated water 🙁 A shame because it does reduce dental decay. Does she use a fluoride mouthrinse? Ideally they should be used at a different time of day to brushing – say when she comes in from school or lunchtimes at weekends. Please keep me posted x


            (May 1, 2015 - 10:36 pm)

            No but I think this may be worth considering. I will definitely look into it, is there a particular brand that you would recommend?


            (May 2, 2015 - 12:22 pm)

            Hi Kim, I’ve put a couple of links in the article (point 9) which are those we use at home. That said, any mouthwash containing fluoride which is alcohol-free will do the job!


    (June 30, 2016 - 9:53 pm)

    Thanks for this useful information. I’m a Nigerian,just today my 3 year old son started complaining of pain on his tooth,though we’ve discovered before now a hole in that same tooth. Now i’m takng him to a Dentist.


      (September 8, 2016 - 8:44 pm)

      Thanks for your lovely feedback. I hope your son is comfortable now.

    Dr. Joe Tagliarini

    (August 4, 2016 - 5:08 pm)

    Eating a diet high in sugar can certainly cause holes in your children’s teeth. However, it is important not to focus on diet alone and make sure that your kids practice good oral hygiene. If you have any questions, you might want to ask your dentist for advice.

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