More health warnings on food are needed to reduce tooth decay, says BMABMJ 2018; 361 doi: https://doi.org/10.1136/bmj.k2177 (Published 16 May 2018) Cite this as: BMJ 2018;361:k2177
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More health warnings on food are needed to reduce tooth decay in infants and children (1). New front-of-package symbols are being proposed for foods high in sodium, sugar and saturated fat by the Canadian government (2). Diet has an important role in dental caries according to World Health Organization and this is a major cause of tooth loss (3). Foods that cling to teeth for a longer time like milk, ice cream, honey, sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips can cause dental decay. Increased snacking or sipping of sugary soft drinks also increases dental decay.
When babies are given bedtime bottles filled with milk, formula, juice or other sugary drinks dental decay can occur as these beverages can remain on teeth for longer hours while sleeping. Bedtime infant feeding also increases chances of dental decay (4).
Eating yoghurts between meals also increases the likelihood of decay and eating fruit reduces the risk of dental caries. (5) After feeding the infant, each time and before bedtime the gums of infants should be cleaned with a soft moistened washcloth, and the gum tissues should be gently massaged. This aids the removal of food particles from the oral cavity. (6) The longer duration of retention of food particles (milk and sugar) and decreased salivary flow at night can increase the risk.
The brushing of teeth will not remove more than 40% of plaque, even by a well-trained person.
In addition to effective brushing the other methods of oral hygiene like dental floss, inter-dental brush and oral rinses, are important for better oral health. (7). In older children water swishing 2-3 times after each meal /snack and before bedtime will help the removal of residual food particles.(8,9). Thus all the above measures will be of help in reducing risk of dental caries in infants and children.
1. Thornton J. More health warnings on food are needed to reduce tooth decay, says BMA. BMJ 2018;361:k2177
2. Government proposes new health warning labels for food New front-of-package symbols are being proposed for foods high in sodium, sugar and saturated fat. The Canadian Press | February 09, 2018
3. dental diseases and oral health - World Health Organization www.who.int/oral_health/publications/en/orh_fact_sheet.pdf
4. Cavities/tooth decay - Symptoms and causes - Mayo Clinic https://www.mayoclinic.org/diseases-conditions/cavities/symptoms-causes/... Jul 19 2017
5. Skafida V, Chambers S. Positive association between sugar consumption and dental decay prevalence independent of oral hygiene in pre-school children: a longitudinal prospective study. J Public Health (Oxf). 2017 Dec 29. doi: 10.1093/pubmed/fdx184. [Epub ahead of print]
6. Infant and Children's Oral Health - Birth to 5 years of age https://www.health.ny.gov/prevention/dental/birth_oral_health.htm
7. Hayasaki H, Saitoh I, Nakakura-Ohshima K, Hanasaki M, Nogami Y, Nakajima T, et al. Tooth brushing for oral prophylaxis. Japan Dent Sci Rev. 2014;50(3):69–77.
8. Math MV & Balasubramaniam P. Water swishing. BDJ 207, 304 (10 October 2009)
9. Math M V, Balasubramaniam P. Oral health and water. Indian J Nutr Diet 2008; 45: 388–391.
Dr. Mahantayya V Math
Dr. Yashoda R Kattimani
Department of Physiology
Navi Mumbai 410209, Maharashtra State, India
Competing interests: No competing interests