Are sweets the only cause of tooth decay in childhood?

Tooth decay is a common issue among children and adolescents worldwide, affecting both milk teeth and permanent teeth. In Poland, as epidemiological studies show, the country ranks high in terms of both the incidence and severity of the issue.

Particularly concerning is the fact that tooth decay appears at a very early stage of life, affecting even the youngest children, including those of nursery and preschool age. Between 2012 and 2015, according to data from the Ministry of Health, every second three-year-old in Poland had tooth decay. Among six-year-olds, as many as 85% had decayed teeth. By 2022, more than 50% of three-year-olds were reported to have teeth affected by cavities. Tooth decay is the most common disease of the chewing system in this age group.

As parents, can we influence the reduction of tooth decay in our children?

Home. Early childhood, infancy, and the introduction of first meals are key stages for primary prevention. Parents should receive their initial guidance from a paediatrician regarding the newborn’s oral hygiene, the child’s diet (breast milk or formula until 6 months, without the need to offer additional drinks between feedings), and the appropriate introduction of solid foods after 17 weeks of age, but no later than 26 weeks.

The essential factors required to initiate the process of tooth decay are decay-causing bacteria, the presence of fermentable carbohydrates, the susceptibility of tooth tissues to the disease, and the length of time these factors act. For this reason, diet and oral hygiene are integral to maintaining oral health. Carbohydrates, mainly sucrose, are considered the primary culprits in tooth decay. Sucrose, a disaccharide, is commonly known as sugar (white, cane, brown sugar). Children who regularly and frequently drink liquids rich in simple carbohydrates from bottles or sippy cups (such as sweet teas, juices, sweet yoghurts, and pouch cereals) may be at a higher risk of developing tooth decay, including rampant (bottle) decay. Sticky, sugary foods are more likely to adhere to the teeth, thereby initiating the development of decay. The longer such foods remain on milk teeth, the worse the outcome.

In the diet of children (and adults as well), we aim to minimise the intake of products containing large amounts of sucrose, including: 

• reducing added sugar (during meal preparation),
• eliminating sugary drinks from the diet,
• carefully incorporating 100% juices as part of a balanced meal,
• and limiting snacks in general, especially those high in sugar.

Facility – nutritional standards

As parents of children attending nurseries and preschools, we should be aware of the quality of the meals provided at these facilities. In Poland, these standards are defined by institutions such as the National Institute of Public Health, the Ministry of Health (Regulation of the Minister of Health, 26th July 2016), and the Act of 4th February 2011 on the care of children under 3 years of age. One of the basic requirements for nutrition is ensuring that meals comply with dietary standards (Standards for the Polish Population 2020 and their application) based on gender and age. These nutritional standards specify the necessary content of minerals (including those essential for proper enamel mineralisation), as well as the appropriate amounts of protein, fats, and carbohydrates.

5 Steps to Healthy Teeth

1. I brush my teeth because I know how important it is.
2. I make sure to drink water between meals.
3. I eat regular meals, including fruits and vegetables. I’m not afraid to take a bite!
4. I visit the dentist with a smile, knowing it’s all part of prevention.
5. I am learning to read product labels in order to reduce the amount of simple sugars in my meals.

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Supporting sources for the post:

• Epidemiological data from the “Monitoring the Oral Health Status of the Polish Population” programme from 2012 and 2015:
• https://www.termedia.pl/mz/Klopoty-z-prochnica-wsrod-dzieci,46212.html, Wielkopolska Izba Lekarska 3/2022
• Nowa Stomatologia 2015; 20(4): 142-148   DOI: 10.5604/14266911.1188965 Ewa Chorzewska, Urszula Wasilczuk, Grażyna Marczuk-Kolada, Marta Obidzińska,  Elżbieta Łuczaj-Cepowicz, Anna Kuźmiuk Wpływ nawyków żywieniowych  i wykształcenia rodziców na intensywność próchnicy u dzieci w wieku przedszkolnym.