WE ALL KNOW that sugar and sweets are bad for our teeth. However, every day as a dentist I’m asked by parents why and how their little ones are developing dental decay even though they are restrictive of their sugar intake.

The answer is usually because the public are unaware of the hidden sugars that are in everyday, and often the most popular, food and drinks they consume.

It may come as some surprise but foodstuffs that are labelled “natural” or with “no-added sugar” often contain high amounts of sugar. Not many people realise that a can of fizzy drink equates to the eight teaspoons of sugar, or a smoothie to six teaspoons of sugar as “sugar” is not the word used in the ingredient labelling, not to mention the marketing of these foods.

Hidden sugars usually end in “ose” such as sucrose, dextrose, maltose, fructose, lactose, glucose – and, of course, honey is a sugar. Cereal bars, flavoured yoghurts, juice, cordials and dried fruit are among the biggest offenders of products marketed as “healthy” when in fact they contain high levels of sugar and are causing real damage to the teeth of our children.

Foods you may not realise are high in sugar 

It’s vital that there is increased awareness of the ingredients in the food we feed and allow our children to have. Of course as the saying goes “everything in moderation” but when you consider that cereal bars and yoghurt drinks now form part of many children’s daily diet, we do need to be more conscious of the level of hidden sugars in products.

We all want what’s best for our children so our perception of when we buy yoghurt drinks and dried fruit is that they are healthy snacks containing plenty of vitamins and nutrients, but it’s worth considering how often and perhaps why children love these foods so much? The answer is usually the flavour and sugar content.

As a dentist, I’d recommend that if children are to consume these products that they are limited to mealtimes and avoided in between meals and the persistent drip-feeding of sugar through snacking means that decay builds up slowly but surely over time.

The statistics support this reality as dental caries (tooth decay) is the single most common disease in childhood. A startling 37% of five year olds in Ireland, in fluoridated areas, have experienced dental decay. By the age of 15 years, 75% of children have tooth decay.

An increasing number of small children with levels of dental decay

I’m not only witnessing the effects among the young children who present to my clinic in Carrigaline, Cork but I know, as President of the Irish Dental Association and from speaking to my peers that this is a real issue and problem that needs to be highlighted.

I’ve seen an increasing number of small children present with worrying levels of dental decay. On occasions, young kids have serious sepsis caused from tooth decay that has required hospitalisation and intravenous antibiotics.

It’s shocking to think that the most common reason in Ireland for any child needing a general anaesthetic is for a dental extraction, so it goes without saying that waiting lists for general anaesthetics to remove infected teeth are ever-growing.

Dealing with dental decay

Treating such young children is challenging. If caught early a simple filling can be carried our comfortably. This is why international best practice advises parents to bring their children for their first dental visit by the age of one year and every six months thereafter.

When decay is more extensive I use inhalation sedation or as most people know it by – ‘laughing gas’ to carry our more complex treatments. This is a service that is offered by just a handful of dentists nationwide but I felt it was one that I very much wanted to have for younger and more fearful patients. My older phobic patients are mostly those who had bad experiences as children so they are my biggest client-base of patients who require and benefit from inhalation sedation. In fact between 10 to 15% of my patients require inhalation sedation.

All in all, dental decay is a preventative disease and is best avoided as it causes pain for the child, disturbs eating and sleeping patterns which is not only distressing for the child but the parent also.

It also impacts on the developing dentition, increasing the need for orthodontics and when decay affects the front teeth, it can be devastating from on appearance point of view.

What’s the best solution?

Interestingly, some regions have adopted a more heavy-handed approach to dental decay, for instance schools in the State of New York now request a dental health certificate before a child’s entry to school!

Every now and again the concept of creating a sugar tax is bandied about. However, foods that are high in natural sugar such as raisins and apple juice may escape such a tax.

Alternatively, there is a suggestion of placing warning signs on all foods that are high in sugar such as is done for the tobacco and alcohol industry. However, there is nothing better than parents being armed with the right information to be able to read between the lines on our food labels.

The best advice to parents is to encourage their children to drink plain water and milk. Never put sugary juice in a bottle, keep snacks savoury such as crackers and cheese. We all like treats but to limit these to meal times only. It’s not always easy to keep to these rules but it’s easier to say no to a child if it’s not in the house. Above all, read the labels and watch for those hidden sugars.

Dr Anne Twomey is co-owner of Church Hill Dental Practice in Carrigaline, Cork, and is President of the Irish Dental Association.