Every evening as I get my two-year-old son Felix ready for bed he will look at me reproachfully – and then run away. I chase after him with pleas and bribes, before resorting to threats about what will happen should he refuse to do as I say. When that, too, fails, I corner him in a headlock, prise his mouth open and force his toothbrush inside. Afterward, there are crosswords and tearful recriminations – from me as well as my toddler.
I have always found cleaning my children’s teeth an emotionally-charged nightmare – as do millions of other parents. A report last month found that 42 percent of parents have to force their children (aged up to 11) to brush their teeth, with 80 percent of youngsters throwing temper tantrums as they do so. Only a quarter of the 1558 parents surveyed by Aquafresh believe their children are brushing their teeth properly and one in 10 are so demoralized by the process they send their offspring to bed without cleaning them at all.
But our acquiescence comes at a cost. A national dental health survey published in May revealed almost half of eight-year-olds have signs of decay in their milk teeth, while a recent report by the Royal College of Surgeons (RCS) found that tooth decay was the most common reason five to nine year olds were admitted to hospital. Nearly 26,000 children in that age group were admitted in 2013-14, an increase of 14 per cent from 2011.
Professor Nigel Hunt, Dean of the Royal College of Surgeon’s dental faculty, says the state of our children’s teeth has reached “crisis point” adding that“ it is absolutely intolerable that in this day and age, in a civilised country, children are having so many teeth out for decay, which is over 90 per cent preventable.”
Sugary treats and drinks – cheaper and more readily available than ever – cause decay by reacting with bacteria in the mouth to produce acid that weakens tooth enamel. Prof Hunt has called for the amount of sugar in food and drink to be better labeled, and last month Tesco took the unprecedented step of banning some of its most popular sugar-laden drinks – including Ribena and Capri-Sun – from its supermarket aisles – ostensibly to tackle childhood obesity but presumably the company is aware of their effects on children’s teeth too.
But substandard brushing and infrequent dentist visits are also to blame for rising child tooth decay – and I am complicit in all three. I find it hard to resist Felix and his four-year-old sister Rosie’s incessant demands for sweet treats and our fraught tooth brushing sessions usually fall short of the NHS recommended twice daily two minutes. And shamefully, until very recently I had yet to take either child to the dentist. A fear of how they would react was the deterrent. With every passing month I grew more worried that my neglect would lead to lasting dental problems, and retreat further into denial.
However, the spate of news stories on the state of our children’s teeth jolted me into action, and so it was that one day last month, Rosie and Felix were sitting in my dentist’s reception awaiting their first check-up. I tried to build enthusiasm for the visit, but both were nervous. “Are you scared of the dentist, too, Mummy?” asked Rosie, and although I didn’t admit as much to my daughter, my own fear has almost certainly exacerbated my children’s reluctance. Indeed, research by a US dental insurance company found that over a third of kids were frightened of the dentist and that this was often a learned behaviour, picked up from parents.
Problems with my own teeth have also left me distrustful of NHS dentistry – which I feel has failed me – so I took my children to my dentist, Dr. Mervyn Druian, who runs a private practice in North London. Dr. Druian encourages parents to bring their children in from the age of two. “As long as parents are brushing their baby’s teeth, I can’t see the point of bringing them to the dentist any younger,” he says. “It’s unnecessary until they have grown around 75 percent of teeth.”
Antonia Hoyle with her children Rosie and Felix who hate brushing their teeth
But, he warns: “Many parents mistakenly believe that milk teeth don’t matter because they are going to fall out anyway. But they act as ‘space maintainers’ for the permanent teeth that replace them. If a decaying milk tooth has to be removed the ‘wrong’ tooth may come forward in its place.”
After a few minutes of the children riding up and down in Dr Druian’s chair, Rosie was relaxed enough to have her check-up. On the pretence of “counting her teeth” Dr Druian used a hand-held mirror to inspect her molars as Felix looked on. It took a matter of minutes and afterwards Dr Druian told a delighted Rosie (and her mum) that her teeth were “absolutely fine.”
Felix, however, had by this time hidden in the corner of the room and was resolutely refusing to open his mouth. Dr Druian was reluctant to force him but after bribes of Spiderman stickers Felix eventually permitted a brief flash of his bottom front teeth, during which , eventually causing tooth decay.
My heart sank but he told me: “It is unlikely to have led to damage at this stage. I sometimes give children a scale and polish to get rid of it,but because this is his first visit it would be too overwhelming for him.”
We arranged another appointment for six months’ time, in the hope Felix would be more compliant then.
If his junior patients need extensive dental work, Dr Druian sends them to specialist children’s dentist (also in private practice) Jeremy Kaufman who is experienced in performing fillings on children as young as two. I asked Dr Kaufman how I can make brushing my children’s teeth less traumatic. “Use star charts, bribery and begging – all the strategies to get a child to do something they didn’t want to,” he advised. “Try and make it fun – let your children choose their toothbrush. Let them use an electric tooth brush if they want. Stand behind them with your hand under their face and give them a cuddle as you clean their teeth. Allow them to start brushing if they want to, before you carry on.” While child-friendly toothpastes like strawberry are also available although somewhat bizarrely, my kids like them even less than the standard mint.
The evening after our visit to the dentist – chastened by the plaque developing on my son’s teeth – I was determined to embark on an adequate cleaning session. Rosie – enthused by the princess-decorated toothbrush Dr. Druian had given her, managed to endure a full two minutes. Felix, alas, ran away before I resorted yet again to the headlock technique. But he insisted on taking his new pirate toothbrush to bed and his last words before falling asleep were “I go to the dentist again soon.” I live in hope.