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What is this leaflet about?
This leaflet tells you about how to best care for your child’s teeth as they are at higher risk of getting tooth decay.
Why is my child at higher risk of developing tooth decay?
Your child will be at higher risk of tooth decay if they have:
- already had a decayed tooth
- suffer from a medical problem
- have a behavioural challenge which can make it difficult to look after their teeth
- suffer from a dental condition which makes their teeth weaker and prone to decaying.
Dentists call this high caries (decay) risk. Dental caries is also known as tooth decay or dental cavities.
It is important to look after your child’s teeth as if tooth decay is not treated it can lead to your child:
- developing a severe infection which could put their health at risk
- having pain and swelling
- affect their eating, speaking and smiling
- missing days at school.
How can I reduce my child’s risk of getting tooth decay?
Take your child to see a dentist regularly.
Make sure your child is registered with a dentist and has their first dental visit by the time they are one year old. It is important for your child to go for regular dental check-ups every three months. NHS dental treatment is free for children.
Oral Hygiene (cleaning teeth)
Your child should brush teeth twice a day (Bedtime and one other time) for at least 2 minutes with 1350-1500 parts per million (ppm) fluoride toothpaste. Spit out toothpaste after brushing (do not rinse) to leave a protective layer of fluoride over their teeth.
When should I start brushing my child’s teeth?
Start brushing your child’s teeth as soon as the first baby tooth comes through (usually six months of age). Use a toothbrush with a small head. Brush the gum line and every part of the tooth. Replace your child’s toothbrush when the bristles are worn (about three months).
Disclosing tablets show up plaque which helps you brush in the right places. The best time to do this is straight after brushing then brush again for a really good clean.
Disclaimer: we do not endorse any particular brand of product; these are all examples of what has been described.
How often should I brush my child’s teeth?
Teeth should be brushed at bedtime and one other time during the day, with fluoride toothpaste, for at least two minutes.
Do I need to help my child to brush their teeth?
Yes, you do need to support your child’s toothbrush. Adults will need to help brush teeth for children less than seven years of age.
What toothpaste should I use to provide the maximum protection for my child’s teeth?
As your child is at higher risk of getting tooth decay you should use fluoride toothpaste with 1350-1500 ppm fluoride in it.
The dose of fluoride will be written on the front or back of the toothpaste packet.
Make sure your child spits out the toothpaste and does not rinse after brushing, so a bit of fluoride is left behind on their teeth. This maximises tooth protection.
How much toothpaste should I use on my child’s toothbrush?
For children aged 0 to three years: smear-sized amount.
For children aged three or more years: pea-sized amount.
My child does not like the taste or the feeling of toothpaste in their mouth. What can I do?
You can buy unflavoured and non-foaming fluoride toothpaste which they may prefer to regular toothpaste.
Disclaimer: we do not endorse any particular brand of product; these are all examples of what has been described.
I find it impossible to brush my child’s teeth. Is there anything that could make it easier?
Choose a time when they are more relaxed like in the bath. Give them their own toothbrush to hold while you are brushing their teeth or use a brushing app that makes cleaning teeth fun, can all help.
Mobile apps such as the Brush DJ app is suitable for all ages.
A three headed toothbrush makes it easier to get to every tooth surface for children with behavioural challenges.
Diet advice
A healthy, balanced diet with food and drink LOW in sugar will help to reduce your child’s risk of developing tooth decay.
Only give your child food and drinks higher in sugar at mealtimes. This includes fruit, fruit puree, smoothies and dried fruit, cereal bars, flavoured fromage frais, milkshakes and yoghurt drinks, or adding jam, marmalade, honey or syrup to foods and drinks.
Frequently eating and drinking things high in sugar will increase the risk of your child getting tooth decay.
The safest drinks for your child’s teeth between meals are water or plain milk.
Do not put sugary or acidic drinks into your child’s feeding bottle. When your child is six months old, give them a drinking cup rather than a feeding bottle.
When your child is ill give them sugar-free medicine. If they are prescribed liquid medicines by their doctor ask for them to prescribe a sugar-free syrup.
My child will only drink drinks containing sugar. What do I do?
Putting water into the fridge or a fun drinking bottle or having a special drinking straw can help to encourage children to drink water.
You can also buy a special drinking bottle called an air up® bottle to put water in. This bottle tricks your senses into thinking you are drinking a flavoured drink when you are drinking only water.
What savoury foods can I give my child between mealtimes as a snack?
Here are some suggestions for snacks LOW in sugar:
- fresh sticks of carrots, cucumber or pepper
- Twiglets, poppadoms and nuts (but not for under fives)
- unsweetened and savoury crackers
- crispbread
- unsweetened, plain or savoury rice cakes
- bread rolls
- pitta bread
- chapattis
- buttered toast fingers
- bread sticks
- cheese (Babybel, cheese strings, cheese triangles)
- cottage cheese
- cheese spread
- marmite
- houmous
- savoury sandwiches (cheese and carrot, tuna and cucumber, chicken and tomato, egg and cress, chicken and sweetcorn, sardine and tomato).
How do I maximise protection for my child’s teeth?
The table below shows you other things that can be used to protect your child’s teeth as they get older.
Age: 0-3 years
Amount of paste on brush: smear
Fluoride concentration in toothpaste: 1350-1500ppm
Age: 3-7 years
Amount of paste on brush: pea sized
Fluoride concentration in toothpaste:1350-1500ppm
Age: 8 years
Amount of paste on brush: pea sized
Fluoride concentration in toothpaste: 1350-1500ppm
Daily fluoride mouth rinse (use at a different time to brushing): 0.05 percent sodium fluoride rinse
Age: 10 years
Amount of paste on brush: pea sized
Fluoride concentration in toothpaste: 2800ppm
Daily fluoride mouth rinse (use at a different time to brushing): 0.05 percent sodium fluoride rinse
Age: 16 years
Amount of paste on brush: pea sized
Fluoride concentration in toothpaste: 5000ppm
Daily fluoride mouth rinse (use at a different time to brushing): 0.05 percent sodium fluoride rinse.
Your child’s doctor or regular dentist will need to prescribe your child the concentrated toothpastes (2800ppm and 5000ppm).
What are the main things to remember about looking after my child’s teeth?
- Brush your child’s teeth at bedtime and one other time during the day, for two minutes, with 1350-1500 ppm fluoride toothpaste.
- Get your child to spit out after brushing their teeth: no rinsing.
- Give your child less sugar and only have sugary food and drink at mealtimes.
Where can I find more information and advice?
Find more information here on the NHS website: Children’s teeth – NHS (www.nhs.uk) and British Society of Paediatric Dentistry.
The information in this leaflet is for guidance purposes only and is in no way intended to replace professional clinical advice by a qualified practitioner.