Keeping Teeth Healthy

Kiwi kids have a shocking rate of decay and tooth extractions. What is it that’s rotting our children’s teeth and what can we do about it?  Dr Beaglehole explains.

As a nation, we are consuming sugar at an alarming rate. This is having a damaging impact on our children’s health, especially on their teeth. Dental caries (also known as tooth decay) is the most prevalent chronic disease in New Zealand, and one of the most common reasons for children’s admission to hospital.

It’s heart-breaking to see preventable caries and rotten teeth in our young New Zealanders. These children, who are often only 2 or 3 years old, are admitted to hospital and need a general anaesthetic to remove one (or often many) of their teeth due to decay or infection. Last year, 5050 children under the age of 7 years underwent this procedure in New Zealand hospitals, making it the number one reason for admission to hospital for this age group. The latest report from the Ministry of Health states that last year, 35,000 ‘tots to teens’ had one or more teeth extracted due to pain or infection. This is not a statistic to be proud of.

There is a strong link between the amount and frequency of sugar consumed and tooth decay. The primary cause is a diet high in sugar – and the number one source of sugar in children’s diets comes from sugary drinks. These are products that we must prevent our children drinking. Sugary drinks have no nutritional value whatsoever. Sugary drinks are cheap, readily available and accessible, and are one of the most widely advertised products, particularly to children, adolescents, and low-income people.

The World Health Organisation recently released a daily sugar recommendation of 6 teaspoons of sugar for adults and just 3 teaspoons for children. Consuming one can of fizzy drink (which contains 9 teaspoons of sugar) will tip an adult over the daily limit. Shockingly, a can of fizzy drink contains 3 days’ worth of sugar for a child.

And remember, it’s not just the sugar in fizzy drinks that damage your child’s teeth. Phosphoric acid (appears in Coke and other soft drinks as food acid 338) is added to fizzy drinks and is the reason why these drinks are even more damaging to teeth than other sugary drinks, such as juice or flavoured milk. This is because phosphoric acid is extremely acidic and has a low pH (the lower the pH the more acidic it is). Acidic foods and drinks lead to erosion of the tooth surface as they dissolve calcium from the enamel (the hard part of the tooth). Of note, Coke is only slightly less acidic than vinegar and lemon juice!

It is important to realise that all sugary drinks will contribute to tooth decay (not to mention obesity and type II diabetes). This includes soft drinks, sports drinks, energy drinks, flavoured milk and juice. Ideally, children should be drinking water or plain milk. However, I am a parent myself and understand that every now and then children want a treat, so on occasions I give my boys a small glass of diluted juice (half water half juice). Interestingly, there is more sugar (natural as it is) in a glass of juice than there is in a can of fizzy drink.

Anything that is placed in a baby bottle (besides breast milk) and given to babies to drink has the potential to rot the child’s tooth. I take out far too many teeth from young children who have been given juice, Milo or soft drink in a baby bottle!

As parents, we all have a voice, particularly collectively. It is up to all of us to demand change to our environment so that our children are protected from the ravages of sugary drinks, just like with tobacco and alcohol. We can speak with our local mayor and councillors about instigating a policy where no sugary drinks are sold at council venues or events; we can speak with our school principals asking for guidelines to be put in place where sugary drinks are no longer sold or brought into school premises; and we can raise the issue with our local MP asking for taxes on sugary drinks, advertising and sponsorship bans. And what about a campaign asking the All Black management to consider dropping Coke and Powerade as their key sponsors? We need to speak up, for the sake of our children.

ways for parents to ensure their kids have healthy teeth

  1. Brush your child’s teeth twice a day (kids can use adult strength toothpaste)
  2. Avoid sugary drinks (best to drink water or unflavoured milk)
  3. Avoid sugary snacks, including dried fruit
  4. Have regular dental checks with a dental therapist.

are diet soft drinks any better for teeth?

The term ‘diet’ beverage is used to describe drinks that are sweetened with artificial sweeteners. Aspartame is one of the most common forms of artificial sweeteners. Some people may think that diet soft drinks are a healthier alternative because they contain no sugar, but artificially sweetened drinks still displace healthier beverage options such as water and plain milk. And importantly, ‘diet’ soft drinks are also considered a poor choice because they maintain a taste for sweetness which often leads to future unhealthy diet choices as the child learns to prefer sweeter, less healthier foods. Plus, they also still contain the acidic phosphoric acid which erodes the tooth surface, just like normal fizzy drinks. So although they are free of calories, they are not free of bad consequences, especially to the teeth.

do baby teeth even matter?

Some parents think of baby teeth as ‘practice’ teeth and that it doesn’t matter if they decay and  get taken out early because they are all going to fall out eventually anyway. However, baby teeth matter for a number of very good reasons. They are extremely important for speaking, eating and aesthetic reasons. If baby teeth are extracted before they are ready to fall out, they may erupt into the mouth in different positions, often leading to complex and expensive orthodontic treatment in the future. Abscessed baby teeth also have the potential to damage unerrupted permanent teeth beneath them. And don’t forget how painful abscessed teeth and mouth infections can be. Inflammation, as we know, is harmful; infection and bacteria entering your child’s bloodstream from around their decayed tooth can affect the rest of their body, including the brain and heart.

did you know?

The number one bestselling item in a NZ supermarket is a 1.5 litre bottle of Coke, containing a whopping 40 teaspoons of sugar. And the number three bestselling item is a 2.25 litre bottle of Coke, containing a staggering 60 teaspoons of sugar.


By Rob Beaglehole


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