Chomp, Bite, Chew – the Ultimate Guide to Nourishing a Healthy Mouth

By: Lucy Jones, RD

November 6, 2017

More and more children now have dental caries (tooth decay or cavities), recently described as the most common chronic childhood disease of children aged 5 to 17 years by the United States Surgeon General’s report1. In fact, dental caries are five times more common than asthma and seven times more common than hay fever (seasonal allergies)1. In the United States, more than 50 percent of 5-9 year-old children have at least one cavity or restoration, and that proportion increases to 78 percent among 17 year-olds2. These statistics are echoed across the globe; in the UK; more than 40 percent showed signs of obvious decay by the age of 5 years, while over half (57 percent) of 8 year-olds had obvious decay3. In fact, recent headlines in the UK show that the number of children aged 4 and under being hospitalized for tooth extractions has increased by almost a quarter in the last decade4.

Poor oral health affects children’s nutrition, growth and development. Childhood oral disease can lead to pain, toothache, dental abscess, destruction of bone and spread of infection via the bloodstream1. Dental caries can affect a child’s eating habits and nutritional intake, potentially influencing growth and early childhood development and school readiness. Pain and infection from dental caries can lead to poor school attendance and problems in eating, speaking and learning1.  Tooth decay or early loss of teeth can result in malnutrition and other health problems. Early childhood caries may dramatically increase a child’s risk for future dental caries2. Shockingly, more than 51 million school hours are lost every year to dental-related illness1.

Tooth decay is the destruction of tooth enamel. It happens when foods containing carbohydrates (sugars and starches) such as milk, fizzy drinks, raisins, cakes or sweets are frequently left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.

Thankfully, there are lots of things we can do to limit the risk of dental caries and support a healthier mouth…right from the very beginning.

0 to 6 Months

Baby teeth tend to arrive between 3 and 12 months, with the average around 6 months. Teeth are formed before birth, so diet in pregnancy including key minerals like calcium and phosphorus play a role in your baby’s tooth development.

Get into the habit of wiping your little one’s gums with a finger brush, a piece of gauze or a clean washcloth. Before a tooth breaks the surface, there may be a small opening in the gum where bacteria can hide and cause a cavity. When that little tooth does poke out, clean it with a washcloth or baby toothbrush moistened with water and just a smear of training toothpaste6. Do it after your baby’s morning meal and before bed so it becomes part of their regular routine. Ideally, the last thing in your baby’s mouth before bed should be a toothbrush or water.

Schedule a visit to the dentist within six months of the appearance of the first tooth.

6 to 12 Months

Most babies have at least a couple of teeth and perhaps as many as eight by the time they turn 1.

If the emerging teeth seem bothersome, offer your finger or a chilled teething ring, gently massage their gums with gauze or a washcloth, or if needed, give a dose of an infant pain reliever.

Research shows that children who begin dental care by age 1 have fewer fillings than those whose parents wait until age 2 or 3. Getting to know a dentist at this age will also help your baby be more comfortable with them in the future.

12 to 18 Months

This is the time to start using a child’s soft-bristle toothbrush. Use a small amount of baby toothpaste as excess amounts can cause fluorosis. Let your child “help” with the brushing — you brush a bit, and then they do the same.

If your child has not yet seen a dentist, make the appointment now. The dentist will answer any questions you have about your child’s teeth and may put fluoride varnish on their teeth to keep them healthy.

Sugar causes tooth decay. It’s not just about the amount of sugar in sweet food and drinks, but how long and how often the teeth are in contact with sugar. Lollipops and sweet drinks in a bottle are particularly damaging, because they bathe the teeth in sugar for long periods of time. The acid in drinks like fruit juice can harm teeth as well.

The sugars found naturally in whole fruit and milk are less likely to cause tooth decay, so you don’t need to cut down on these types of sugars.

How to cut down sugar in your child’s diet

One of the top tips is to avoid sugar-sweetened drinks – the best drinks for young children are their usual milk and water. When your baby starts eating solid foods, encourage them to eat savory food and drinks with no sugar. Check if there’s sugar in pre-prepared baby foods (including the savory ones). Take the time to read nutritional labels and ingredients lists.

Sugar can often be disguised with alternative names such as:

  • sucrose
  • glucose
  • dextrose
  • maltose
  • fructose
  • honey
  • concentrated fruit juices
  • hydrolysed starch

If you choose to give your child sweet foods or fruit juice, only give them at mealtimes. Remember to dilute one part juice to 10 parts water. Your child should have no more than one drink of fruit juice (150ml) in any one day (5).

Try to keep to fruit and/or vegetable based snacks occasionally with a dip like hummus or dairy options like cheese or yoghurt. Cakes and other sweets need to be limited, given only as an occasional treat, rather than regular snack. Don’t give your child sweets as rewards either and ask family and friends to do the same. Offer things like stickers, crayons, coloring books and bubbles instead.

Reducing the frequency that sugar comes in contact with the teeth and getting into a healthy routine with mouth care can really help to support overall oral health.


1.  United States Department of Health and Human Services (USDHHS). Oral Health in America: A Report of the Surgeon General. National Institute of Health, 2000.
2.  Bagramian RA, Garcia-Godoy F, Volpe AR (2009) The global increase in dental caries. A pending public health crisis. American Journal of Dentistry. Vol 1: no.1 pp 3-8
3.  United Kingdom National Technical Reports. Children’s Dental Health in the UK, National Statistics, 2003.
4.  Independent (2017) Tooth decay: Number of children under 4 hospitalised to have teeth removed up nearly a quarter in 10 years. Accessed from Last accessed 13/8/17
5.  NHS Choices (2015) Looking after you baby’s teeth. Accessed from Last accessed 13/8/17
6.  Clark MB, Slayton RL (2014) Flouride use in Caries Prevention in the primary care setting. American Academy of Pediatrics. Vol134, issue 3. Accessed from Last accessed 18th August 2017.

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