Public understanding of good oral hygiene is better than it used to be, but tooth decay is still a major health concern in Australia, especially when it comes to children.
Tooth decay (also known as dental caries) is a disease of the mouth that involves the loss of mineral from teeth. Over time, this can permanently weaken teeth or cause holes (cavities) to appear. If decay isn't treated, it can even lead to tooth loss.
As well as causing toothaches and sensitivity, tooth decay can have a wider impact on children's quality of life if it leads to problems with eating, speaking or sleeping. The good news is that this disease can usually be prevented.
How many children in Australia have tooth decay?
The most recent data available on kids' dental health is the National Child Oral Health Study 2012–14, which surveyed children aged 5 to 14 years and their parents. The study found that:
- 42% of children had experienced tooth decay in their primary (baby) teeth
- 24% had experienced decay in their permanent (adult) teeth
- Tooth decay was untreated in 27% of primary teeth and 11% of secondary teeth
- An average of 1.5 primary teeth and 0.5 permanent teeth per child were either decayed, missing or had fillings as a result of decay
- Rates of tooth decay were roughly similar for boys and girls
- Tooth decay was more common in remote areas and for children of low income and Indigenous families
This suggests that decay in kids' teeth continues to be a public health concern in Australia and is more likely when children don't have convenient access to dental services.
What are signs of tooth decay in children?
If children complain that their teeth feel painful or sensitive, this could indicate tooth decay or another oral health problem and should be checked out by their dentist.
You may also be able to see the signs of decay on the teeth:
- a white or dark spot close to the gum can be an early sign of tooth decay
- a tooth turning yellow-brown or black can indicate more advanced decay
- a hole (cavity) means decay has already damaged the tooth, which can cause pain and sensitivity
However, tooth decay doesn't always have obvious symptoms, and it could be affecting your child's teeth without them knowing it. That's one reason why it's important to have regular dental check-ups so their dentist can spot and treat small problems before they have the chance to get worse.
What causes tooth decay?
To protect kids from tooth decay or treat an existing condition, it's important to know why it happens.
Tooth decay is caused by bacteria that can build up on the teeth in a sticky layer called dental plaque. These bacteria feed on sugar in food and drink, which gives them the energy to multiply. They release acid as a waste product, which can damage the surface of teeth (the enamel) over time.
Children's teeth are more vulnerable to damage from tooth decay, as their teeth are smaller and the enamel is softer and thinner compared to adult teeth. Children will be at higher risk of tooth decay if they consume a lot of sugar in food and drinks and don't take proper care of their teeth.
How do you prevent tooth decay in children?
Tooth decay is usually preventable when you help your kids to follow a good oral hygiene routine. Dentists recommend:
- Brushing teeth twice a day
- Flossing once a day
- Cutting down on sugar
- Drinking fluoridated water
- Regular visits to the dentist
You can find out more about each of these steps below. This is only a general guide – your child's dentist can give you personalised advice based on their individual oral health needs.
Tooth brushing tips
Regular teeth brushing using fluoride toothpaste helps to scrape plaque off the teeth and provides fluoride that helps to protect teeth against further plaque build-ups. Tooth brushing should be done at least twice a day (morning and evening) and should take around two minutes, making sure you clean every tooth.
Toothpaste and toothbrushes should not be used with infants, whose teeth and gums can be wiped with a clean cloth and water. Low-fluoride children's toothpaste can be introduced from around 18 months and regular toothpaste from around the age of 6. Children should be taught not to swallow toothpaste, as this can lead to fluorosis – white or brown flecks on the teeth.
Children will need your help to brush their teeth until they're old enough to move the brush properly themselves. Some kids find an electric toothbrush more comfortable and easier to use, but a manual toothbrush can clean just as well.
Brushing alone isn't enough to remove all traces of plaque and leftover food. You should also begin flossing your child's teeth as soon as their teeth start to come together.
If your child doesn't like flossing, colourful or flavoured floss could make it more inviting. Children can usually start to floss their own teeth around the time they start to brush without help, but you should still supervise them to check that they're doing it the right way.
Cutting down on sugar
When your child eats or drinks something high in sugar, they're also feeding the bacteria in plaque and speeding up the process of tooth decay, so it's important to limit sugary drinks and snacks as much as you can.
Sugar isn't always a bad thing (it's important for giving your child energy), but with sugar being added to so many products nowadays, it's easier to have too much than not enough. And according to the 2011–12 Australian Health Survey, most people do have too much – especially kids.
How much is too much sugar? The WHO recommends that less than 10% of dietary energy should come from free sugars (though preferably even less than 5%). This means between 2 and 6 teaspoons of sugar per day, depending on the child's age and energy needs. In Australia, almost three quarters of children and teenagers aged 9 to 18 exceed this amount.
If you're looking for ways to help your kids cut down, don't just focus on snacks and lollies. The data shows that more than half of dietary sugar comes from drinks, especially soft drinks, energy drinks, fruit juices and cordials.
A balanced diet that contains dairy goods, fresh fruit and vegetables and other sources of calcium and vitamins will help to protect your child's teeth and support their general health.
Drinking fluoridated water
Staying hydrated is important for maintaining saliva, which helps to rinse children's mouths after eating and to neutralise acids on their teeth. That's why it's important that they drink plenty of water throughout the day – especially in the form of fluoridated tap water.
Fluoride is added to most local water supplies in Queensland at safe levels to help protect teeth against decay. If your local water isn't fluoridated, your dentist may recommend that your children brush their teeth more often to get their daily fluoride.
Visiting the dentist
Your child should start seeing the dentist regularly after they get their first teeth. Their dentist can check their teeth, remove plaque, discuss preventive treatments and offer home care advice to help you take the best care of their teeth every day.
Most children in Australia are eligible to receive free dental care through the Child Dental Benefits Schedule (CDBS). Your dentist can help you to find out whether you're eligible.
Check-up and clean
Your child's oral health check-up will normally begin with a visual examination of their teeth to look for any signs of decay or other problems, after which their dentist may discuss treatments.
Low-radiation x-rays may be needed if the dentist thinks there might be a problem and needs to see more of the teeth, but these are avoided for young children unless strictly necessary.
After the check-up, an oral hygienist can gently clean their teeth to remove any plaque that may have built up since their last visit. They may then apply a layer of fluoride for extra protection.
You'll also have the chance to ask your child's dentist anything that's on your mind and to get advice about brushing, flossing, healthy eating and other ways to care for their teeth at home and at school.
If your child's chewing teeth (molars) have lots of little pits and grooves, these can trap food and bacteria and increase their risk of tooth decay. Their dentist may recommend filling these with fissure sealants to help lower the risk.
If your child already has tooth decay and a cavity has formed, dentists will usually recommend placing a filling. This is a simple procedure that involves removing the decayed part of the tooth and restoring it with a composite filling material.
Root canal therapy
If tooth decay has reached the centre of a tooth, a root canal treatment may be the best way to remove the infection, relieve the pain and rebuild the tooth. If a tooth is too badly damaged to repair however, dentists may need to extract it as a last resort.
Talk to a family dentist on the Gold Coast
If your child is due for a check-up or you want some more advice about looking after their teeth, book an appointment at our Gold Coast dental clinic in Robina Town Centre.
Australian Bureau of Statistics. Australian Health Survey: Consumption of added sugars, 2011-12 [Online] 2016 [Accessed June 2020] Available from: http://www.abs.gov.au/ausstats/abs%40.nsf/Lookup/4364.0.55.011main+features12011-12
Australian Institute of Health and Welfare 2020. Australia's children. Cat. no. CWS 69. Canberra: AIHW. Viewed 19 June 2020, https://www.aihw.gov.au/reports/children-youth/australias-children
Better Health Channel. Tooth decay [Online] 2018 [Accessed June 2020] Available from: https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/Tooth-decay
Do LG & Spencer AJ (Editors) 2016. Oral health of Australian children: the National Child Oral Health Study 2012–14. Adelaide: University of Adelaide Press.