The epidemic of tooth decay in our children has increased over the past 30 years. In fact, a study by the American Academy of Pediatric Dentistry shows that tooth decay is now the most common chronic childhood disease in the U.S.
As a dentist, my approach focuses on diet first—even more than brushing and flossing. Investigation into how cavities form reveals that simple dietary habits can lead to almost 100 percent cavity prevention.
Parents have long thought that if they brushed their child's teeth long enough, flossed them regularly, and kept soda and candy to a minimum that their children wouldn't get cavities.
But it's possible to get cavities without ever touching candy or soda. Beyond any genetic predisposition to tooth decay, cavity-causing snack foods with high concentrations of simple carbohydrates are the true culprits. Snack foods we commonly give to young children, such as dry cereal, crackers, and dried fruit, convert to lactic acid, which wears away tooth enamel and causes cavities.
But parents with youngsters know it isn't practical to completely restrict carbs from their child's diet. And the good news is they don't have to. This is because it's not the amount consumed but the frequency with which simple carbs make contact with the teeth. For example, drinking a smoothie in one sitting is better than taking drinks from a sippy cup over several hours. A zero-cavity program doesn't require a complete family diet overhaul if you know how to work the system.
To achieve zero cavities for your child—as well as older children and adults—here are the five prevention principles I recommend:
1. Protect baby teeth.
Don't fall for the myth that baby teeth don't matter because children will lose them at a young age. While baby teeth may begin falling out at age 5 or 6, children keep their back molars until ages 10 to 12. Cavities in baby teeth need to be treated. Preventing cavities through diet, even at a young age, removes the trauma for everyone involved.
2. Offer teeth-friendly foods.
Fat, protein, and fiber do not cause cavities. Simple or processed carbohydrates do. This means, counterintuitively, you are better off feeding your child a piece of 70 percent dark chocolate than a pretzel, cracker, or handful of raisins.
Starches, including not only sugar but all dried, processed flours, cling to the teeth and cause a large percentage of cavities. For this reason, eating bread and fresh fruit is better than eating crackers and dried fruit. You don't have to eliminate all carbs from the diet—you just have to change the quality of the carbs and how they're consumed.
3. Promote organized eating instead of grazing.
If you floss your child's teeth twice a day but let him drink chocolate milk all day long, your child will still get cavities. How your child eats is as important as what your child eats.
Think of it like this: carb-rich foods + time on teeth = cavities.
This means that allowing your child to graze on snacks or sip juice or milk throughout the day is a recipe for a mouth full of cavities. Teeth stay coated in cavity-producing acid for too many hours. Establish six "mini meals" a day and feed your child only at these organized meal- and snack times, with water in between.
4. Make water your ally.
The adage "The solution to pollution is dilution" holds true in the mouth. Drinking water with, or immediately after, meals and snacks is a simple way to reduce cavity worry. Offer water instead of juice or milk when your child is thirsty between meals.
5. Teach good brushing and flossing.
Bacteria in the mouth breaks down simple carbs into cavity-causing lactic acid. Removing bacteria and reducing simple carbs is key to cavity prevention. Until children reach the age of 5 or 6, they need help from a parent to brush their teeth properly.
Parents should give their child a "perfect" brushing before bed, with nothing to eat or drink except water afterward. With young children, a great brushing may only take 20 or 30 seconds, as long as the parent is doing the brushing. After age 6 or 7, have them transition to brush on their own for two minutes, twice a day. You only need to floss the teeth that are touching.
The bottom line: Instilling good habits for 100 percent cavity prevention means establishing organized snack times, giving your child teeth-friendly foods, and maintaining daily brushing and flossing routines.