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Oral Health for primary school children

When do permanent teeth begin to appear?

Children will lose their milk teeth and permanent teeth will usually start to come through around the age of 6 years. It is expected that all permanent teeth will have come through by the time a child is 12-14 years old.  There are 32 adult teeth in total.

Between the ages of 6-12 years, children will have a mixture of adult (permanent) and baby (milk) teeth.

father child tooth brushing
a child with a missing front tooth

How can you look after your child’s teeth when permanent teeth are coming through?

When milk teeth are wobbly or missing, and permanent teeth are coming through, tooth brushing can be difficult. It is important though that your child continues with their toothbrush routine, taking extra care around the loose teeth or sensitive areas.

Although it can be tempting to wiggle loose teeth or pull them out, letting them fall out on their own is the best idea. Pulling out a tooth before it’s ready to fall out, can injure the gums and teeth, but also cause pain and infection.

How should I brush my child’s teeth?

If they are 3 to 6 years old:

At the age of 3, children should have a complete set of milk teeth. It is important to keep the milk teeth has healthy as possible in preparation for the permanent ones to appear. Brushing teeth removes plaque. Plaque contains bacteria which covers the gums and teeth. Brushing plaque- a white sticky film- away, helps to keep teeth and gums healthy.

A good tip is to show your child you brushing your own teeth. When they are a toddler, they can then copy you and have a try at brushing their teeth themselves. Parents should still supervise tooth brushing until their child is at least 7 years old to make sure they are cleaned correctly.

Children aged between 3 and 6 years should be using toothpaste that contains more than 1000 ppm fluoride. You can see the amount of fluoride in a toothpaste written on the side of the tube. Children of this age should be using a pea-sized amount of toothpaste. It is important to not let a child lick or eat the toothpaste out of the tube.

Show your child that they need to brush their teeth in small circular movements, making sure that each tooth is covered. Ask them to spit the toothpaste out afterwards. There is no need for them to rinse their mouths with water as this will wash away the fluoride in the toothpaste.

It is important to get your child to brush their teeth twice a day. One time should be just before bed so the fluoride can continue working while your child is asleep. The other can be on another occasion throughout the day,

There are many different children’s toothbrushes on the market, designed to fit in a smaller hand and with soft, nylon bristles. There are often bright and colourful to make tooth brushing more fun.

If they are 7 years old or over:

Children over 7 should be able to brush their teeth themselves. However, it is a good idea to still supervise the toothbrushing routine to make sure it is done correctly.

Children over 7 should be using a small pea-size amount of toothpaste when brushing their teeth. The toothpaste should contain Use fluoride toothpaste containing between 1,350ppm and 1,500ppm of fluoride. This amount of fluoride is in regular adult toothpaste. Check the label if you are unsure.

It’s important children do not swallow the toothpaste, but spit it out instead. It is also suggested that children do not rinse their mouths out with water. Both of these things will make sure a small amount of fluoride is kept in a child’s mouth which helps to protect their teeth.

It is important children brush their teeth at least twice daily for about 2 minutes. This should be last thing before bed and another time in the day.

It is a good idea to get your child to brush their teeth in front of the mirror. This will help them to see exactly where the brush is cleaning their teeth.

Using an egg timer, playing their favourite song or using a toothbrushing app can help make sure they are brushing for the right now.

It is important children do not run around when brushing their teeth. If they do, they may not clean their teeth properly, but also they may have an accident and hurt themselves.

a glass of water

How can sugar in food and drinks affect tooth decay?

The biggest cause of tooth decay is sugar consumption. When we eat or drink sugary items, plaque in our mouths, feed on it and makes acid. This acid easily erodes the enamel on a child’s teeth because it is so thin.

Not only is it important for the number of sugary foods or drinks eaten to be reduced, but also for teeth to be cleaned twice a day so that the time teeth are exposed to sugar is reduced.

As a child gets older it can be more difficult to control what they eat or drink, so educating them the early years is important to instil healthy habits.

What should my child be drinking?

Primary school children should drink tap water throughout the day. Tap water has fluoride in it which helps protect teeth from decay.  Remember that usually shop-bought bottled water does not have fluoride in it, so it is recommended that tap water is drunk whenever possible.

Fruit juice and sweet drinks can increase the risk of tooth decay. Sweet drinks that should be avoided include soft drinks, fruit juice, sports drinks, cordial, tea drinks, fruit drinks and energy drinks. Even if a product is labelled as ‘no added sugar’, it is important to know that fruit juice still will contain natural sugar, which can cause tooth decay. Similarly, diet soft drinks contain acids which can also damage teeth.

child dental check up

When should I take my child to the dentist?

Dental check-ups are important for children because tooth decay can happen faster with milk teeth. They also make sure milk and permanent teeth are growing as they should and can help spot any issues early.

It is important this check-up is seen as positive experience for your child, so if you are particularly anxious yourself about the dentist, it can be helpful to get another adult to go with you also.

Dental treatment is free for children under 18, or under 19 and in full-time education, It is also free if you are pregnant or have had a baby in the last 12 months. It is important your child sees a dentist regularly. It is advised the time between appointments is no more than 12 months whilst your child is under 18.

If you don’t have a dentist, you can use the Find a Dentist website.

If anyone in your family needs to see a dentist urgently, please contact a local NHS dentist or call NHS111.

Healthy eating:

Encouraging your child to eat a balanced and healthy diet with lots of vegetables, fruit, protein, dairy and carbohydrates, but low in fats, sugar and salt can help to lower your child’s risk of having tooth decay.

Food packaging can be confusing because sugar is written in a lot of different ways. These could include glucose, fructose, sucrose, dextrose, maltose, honey or syrups to name a few. Even if products are advertised as natural sugars, they can still be harmful to teeth.

For 4–6-year-olds the recommended maximum intake of free sugars is no more than 19g per day. This is equal to 5 sugar cubes.

For 6–10-year-olds the recommended maximum intake of free sugars is no more than 24g per day, which is equal to 6 sugar cubes.

For children 11 years over, the recommended maximum intake of free sugars is no more than 30g per day, which is equal to 7 sugar cubes.

It is important to avoid children having sugary food and drink before bedtime and to only give fruit juice or sweet foods at mealtimes. Although fruit juices count as one of your child’s 5 a day, even unsweetened fruit juice is sugary, so it is advised that consumption should be limited to no more than 150 mls a day.

What tooth friendly snacks would we recommend?

  • Fresh fruit, such as an apple
  • Raw vegetables
  • Pieces of cheese
  • Breadsticks
  • Pitta breads or crumpets
  • Plain popcorn
  • Sandwiches filled with cheese, ham, chicken, houmous or cream cheese and cucumber
fruits and vegetables market

Please go to Eat well, Meal planning or Healthy luchbox ideas for more top tips and information.