Bad teeth in Ozzie kids worries dental health experts

By Dr. Ananya Mandal, MDAug 4 2011

According dental health experts, changes in diet, un-flouridated bottled water and the habit of “constantly bathing” ones teeth in sugary drinks is to blame for the rising number of decaying and rotten teeth found in children

Stuart Gairns, chief executive at the Australian Dental Association, said the common habit of always having a drink at hand is fine if it is water, but unfortunately, it is usually a sports drink or bottled, un-flouridated water. He explained, “Despite the protections of fluoridated water in most areas, it is the change in diet that has caused most of this disease. When this is combined with no fluoride, as in parts of the Northern Territory, the additive effect is obvious. Here in WA [and] in Bunbury, which remains un-fluoridated, these effects can be seen.”

This report was in addition to another report that was released yesterday that revealed that four out of 10 Australian children under six years of age have had a tooth removed due to decay. The Australian Institute of Health and Welfare's report Dental Decay Among Australian Children found that in Western Australia, dental decay was 22 per cent higher for five to six-year-olds in disadvantaged areas compared to the highest socio-economic areas. Figures from the ADA revealed that in Bunbury, in WA's south west where tap water is not fluoridated, the rate of decaying, missing teeth for children aged over 12 is nearly double that of that same group in Perth. For five-year-olds, the rate is about 1.5 times that of the equivalent in Perth. Dr Gairns said, “Whilst these figures might not at first glance seem large, they indicate an enormous difference in disease experience between Perth and Bunbury.”

He added that his own figures did not reflect the socio-economic comparison revealed in the AIHW report, “dietary opinion is that there is a huge increase in the consumption of sugars and in the early care and prevention of dental disease in disadvantaged areas”. “Some of this is down to inadequate toothbrushing habits…Perversely parents of these children had little dental disease to worry about as they had both the benefit of fluoride and a lower fermentable carbohydrate (sugars) diet…This has meant that the awareness of dental disease has dropped amongst the parents and the familial pressures regarding adequate dental care have deteriorated…The habit of people carrying drinks with them now and continually sipping from them is fine if the fluid is water, but sports drinks and the black cola drinks ravage tooth enamel if they are used in this fashion…Yes, it's about the total amount of sugar but it's mostly about frequency of ingestion. Constantly bathing teeth in this way destroys the enamel,” he explained.

Dr Gairns said the AIHW report's findings linking lower socio-economic areas to higher incidence of dental disease were something the ADA had been anecdotally aware of for some time. “The issue is multifactorial and partly to do with community changes as well as personal dietary modification…What is needed most of course is immediate primary care but more importantly, preventive support for these vulnerable groups. This costs money and finally governments are switching to preventive models of care but the results of this will only be seen in the next generation,” he said.

Professor Kaye Roberts-Thomson from the AIHFW says the poor oral health of Australian children is putting unnecessary strain on the health system. “Oral health in children has been getting worse in recent years…The proportion of children who are brushing their teeth twice a day is declining and more children are brushing only once a day. If you look at six-year-old children - five to six-year-old children, about half of those children have tooth decay and it's a similar figure for children aged 12,” she said.

Professor Roberts-Thomson says the research looked at five to six-year-old children to measure the decay of baby teeth (deciduous teeth), and 12-year-olds children to measure decay in permanent or adult teeth. And even if children use low-fluoride toothpaste, Professor Roberts-Thomson says brushing twice a day provides important exposure to the mineral. But she says soft drinks, cordial and juice are also causing problems. “Many of these drinks that are now being substituted for tap water are in fact high sugar drinks…So they get a double whammy if you like. They're not getting the benefit of the water [and] they're getting exposed to the sugar,” she said.

Australian Health Care Reform Alliance chair, Tony McBride, says Australia has a very patchy dental system. “If you're well-off you can afford to go and have treatment - that works pretty well as an adult…If you're not well-off then you've got to pay relatively high amounts of money for dental care. And if you're on a low income and eligible for public services you can get them free but - relatively low cost - but you have to wait a long time.”