Sugar consumption is a major risk factor for tooth decay (also referred to as dental caries). 8 The Scientific Advisory Committee on Nutrition (SACN) recommends that the average population intake of free sugars C should not exceed 5% of total dietary energy from two years of age.9 Current estimates of UK sugar intake from the National Diet and Nutrition Survey (2008/09-2011/12) for school-aged children (4-18 years) suggest this is around 15% of energy intake, three times the maximum recommended level. 10 PHE has estimated that almost 250,000 cases of dental caries could be avoided each year if the SACN target was achieved over the next five years. 11

National research reveals that soft drinks (excluding fruit juice) are the largest single source of sugar for children aged 11-18 years, providing 29% of daily sugar intake on average. 12  Measures to reduce the consumption of these drinks could have a major impact, not only in improving dental health but also in tackling child obesity.

Another method of preventing dental decay is through the use of fluoride, a naturally occurring mineral that is found in tea, fish and some water supplies that can be added to a range of products to strengthen tooth enamel.D  Most toothpastes have added fluoride (to varying extents). Children up to age six are advised to brush their teeth at least twice daily with toothpaste containing more than 1000 parts per million (ppm) fluoride. Older children (and adults) are advised to brush their teeth at least twice daily with a toothpaste containing 1350-1500ppm fluoride. 13

One of the best options for increasing the availability of topical fluoride, regardless of the levels of fluoride in the water supply, is fluoride varnish applied by a dentist or trained dental nurse. [53] It is recommended that children should be offered fluoride varnish treatment at least twice a year from the age of three (younger children may be offered treatment if deemed necessary by a dentist); it has been shown that two or more applications per year produces an average reduction in dental decay progression of 37% in the primary (‘baby’) teeth and 43% in the permanent (‘adult’) teeth. 14

 

Notes

  1. ‘Free sugars’ comprises all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices. Under this definition lactose, when naturally present in milk and milk products, is excluded.
  2. Approximately 10% of England’s population benefit from a water supply where the fluoride content (natural or artificial) is at the optimum level for dental health – this is predominantly in the West Midlands and the North East of England.
  3. ‘Free sugars’ comprises all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and unsweetened fruit juices. Under this definition lactose, when naturally present in milk and milk products, is excluded.
  4. Approximately 10% of England’s population benefit from a water supply where the fluoride content (natural or artificial) is at the optimum level for dental health – this is predominantly in the West Midlands and the North East of England.

References

  1. A. Sheiham and P. James, “A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake,” BMC Public Health, vol. 14, no. 863, 2014.
  2. “Carbohydrates and Health,” Scientific Advisory Committee on Nutrition, London, 2015.
  3. “National Diet and Nutrition Survey: Results from Years 1-4 (combined) of the Rolling Programme (2008/09 – 2011/12),” Public Health England, 2014.
  4. “Sugar Reduction: The evidence for action,” Public Health England, 2015.
  5. “Sugar Reduction: The evidence for action,” Public Health England, 2015.
  6. “Fluoride,” Gov.uk, [Online]. Available: http://www.nhs.uk/Conditions/Fluoride/Pages/Introduction.aspx. [Accessed January 2016].
  7. “Delivering better oral health: an evidence-based toolkit for prevention (third edition),” Public Health England, 2014.
  8. A. Sheiham and P. James, “A reappraisal of the quantitative relationship between sugar intake and dental caries: the need for new criteria for developing goals for sugar intake,” BMC Public Health, vol. 14, no. 863, 2014.
  9. “Carbohydrates and Health,” Scientific Advisory Committee on Nutrition, London, 2015.
  10. “National Diet and Nutrition Survey: Results from Years 1-4 (combined) of the Rolling Programme (2008/09 – 2011/12),” Public Health England, 2014.
  11. “Sugar Reduction: The evidence for action,” Public Health England, 2015.
  12. “Sugar Reduction: The evidence for action,” Public Health England, 2015.
  13. “Fluoride,” Gov.uk, [Online]. Available: http://www.nhs.uk/Conditions/Fluoride/Pages/Introduction.aspx. [Accessed January 2016].
  14. “Delivering better oral health: an evidence-based toolkit for prevention (third edition),” Public Health England, 2014.