Big Red Tooth – Dr Candice Schwartz

Where teeth and health meet

What is preventative dentistry?

What is preventative dentistry?


The days of false teeth and dentures are in the past. It is now expected to retain all your natural teeth throughout your lifetime, and every measure is taken to prevent the loss/extraction of an adult tooth. The care and awareness of the mouth and teeth needs to start from birth. Children who have a healthy, cavity free primary dentition, usually have a strong, healthy adult dentition with fewer problems. One of the key elements in maintaining healthy teeth starts with good preventive strategies. It is important to find a dentist that practices preventative dentistry and focuses on the prevention of dental decay.

Does your dentist practice preventative dentistry measures?

Birth – 1 year of age


During the first year of your baby’s life is an exciting time of learning and experiencing the world. Your baby will encounter new sensory experiences every day. From birth you must clean your baby’s gums and sulci (the space where milk collects between the cheek and the gums) and the tongue. Using a soft piece of gauze in the mouth in conjunction with a xylotol based (fluoride free) age appropriate toothpaste to clean the mouth twice daily will reduce the risk of Candida infection (thrush) and will reduce the amount of bacteria living in the mouth. At 6 months of age (or when the first tooth appears) it is time to move onto a natural rubber finger brush. Massage your baby’s gums and brush their newly erupted teeth with Xylotol based toothpaste.


Why Xylotol?


Frequent eating of foods high in sugars and starches promotes tooth decay. Xylitol may reduce the risk of tooth decay if used whilst maintaining a low sugar diet. Many large-scale clinical studies have shown it to have long-lasting dental benefits. Over 25 years of clinical testing confirms that Xylitol is the best sweetener for teeth, which has led to official endorsements by dental associations in Finland, Norway, Sweden, England, Ireland, Estonia and the Netherlands of products containing high levels of this sweetener. A toothpaste containing Xylotol is one of the proven methods of reducing acidity in the mouth and reducing the incidence of dental decay.


What’s next?


Your child’s first visit to their dentist should coincide with their first birthday. Do not expect too much from your child at this stage, however it is an important time for your pediatric dentist to educate you about the dos and don’ts of taking care of your child’s teeth. Let your baby play in the dental chair, spend time getting to know their new dentist and become familiar with the dental setup at the practice. Every positive experience at the dental surgery will reinforce a good relationship with their dentist and build trust.


At one year of age it is time to bid farewell to your baby’s nighttime feeding habits. At this age, infants no longer require any milk for additional nutrition, as their nutritional needs should be met in full with solid meals during the day. Milk bottles after one year of age serve only as a pacifier and this habit is extremely difficult to break. Milk bottles/breast feeding before bed or during sleep time will wreak havoc on your child’s immature, newly erupted teeth. Nursing bottle caries occurs in infants who are left to suck on a milk bottle/breast fed throughout the night. Sugary drinks (fruit juice, honey sweetened tea) given in a bottle/sippy cup will also result in rampant decay of your infant’s teeth. Give only water at night. Never dip your baby’s pacifier in honey or any other sweetener.


2 -3 years old


By the time your child reaches 2 years of age, they should be familiar and completely comfortable with their dentist. They should feel happy to sit alone in the dental chair and experience having their teeth polished and inspected by their dentist. Children should visit their dentist every 5 months throughout their childhood. At approximately 2 ½ year of age, you should initiate a flossing routine. Flossing the teeth should be done every night after brushing. If practiced regularly, it will setup a lifelong habit of flossing for your child.


Fissure sealants


The fissures are the grooves present on the top surface of molar teeth. These run deep within the tooth’s structure and their full depth cannot be penetrated during brushing by toothbrush bristles. For this reason, your pediatric dentist will place sealants to close up these fissures. This prevents dental decay occurring in the fissures- one of the most common sites of dental decay in children’s teeth. Fissure sealants can be placed as early as 2 ½ years of age, if your child is compliant and relaxed in the dental chair.




It is essential to brush your child’s teeth in the morning and at night. Regular removal of plaque from the teeth is the only way you will effectively prevent dental decay. If your child puts up a fight when it is time to brush teeth, nothing sends the message home faster than a dental check up, cleaning and a chat with the dentist. Your pediatric dentist has many tricks up their sleeves when trying to convince and teach children the importance of brushing. Once again, a good relationship between your child and their dentist will prove highly beneficial when trying to motivate and improvement in their brushing habits.




Many thousands of years ago, dental decay did not exist. The reason for this lies in the diet of prehistoric man. Early man had a diet high in raw fruits and vegetables and a relatively low protein content. Food was also very fibrous with zero refined carbohydrates and very low sugar content. They drank only water.

Minor dietary changes will make a great impact on the health of your child’s mouth. Fruit juice is extremely acidic and destructive. Children should drink only water. Limit the intake of refined carbohydrates like potato crisps, bread, muffins, cake, and cookies. Do not allow unhealthy between meal snacking. Give only sugar free between mean snacks. Steer clear of sticky sweets like fizzers, toffees and suckers.


Prevention is better than cure


Above all else, develop a trusting, positive relationship with your dentist. If you and your child trust your dentist and visit regularly, the road ahead will be a smooth, cavity-free journey.

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Diet and teeth.

How does diet affect your children’s teeth?


Diet is the key to a healthy, cavity free mouth. Many parents believe that choosing the best toothpaste will protect their young one’s mouths from holes and problems. This is unfortunately not the case. In order to fully understand the concept of diet affecting our teeth, you will need a short biology lesson.


Streptococci Mutans and Lactobacilli are the most common bacteria in the mouth responsible for tooth decay. When sugar is present in the mouth, these bacteria thrive off it, but unfortunately for us, through their own digestive process of these sugars, the waste products produced are acid. Specifically known as lactic acid, these by products leach out the calcium present in the teeth, thereby slowly weakening it. Over time, this demineralization (leaching out of calcium) of the tooth surface produces a hole. When sugars are present in high amounts, plaque forms. Plaque is the white/yellowish fur that we brush off our teeth every day. If plaque is left to ferment on the tooth surface, a cavity will result.


The goal in controlling plaque formation and cavities is to ultimately reduce the total intake of dietary sugar. It must be stressed however, sucrose (found in all sweets) is not the only sugar which damages teeth. Glucose (found in breads and rice), fructose (found in fruit), maltose (found in cereals and pastas) and lactose (found in milk) are all easily digested by mouth bacteria to form acid and destroy teeth. Dietary changes to alter the acidity of the mouth will directly reduce amount of plaque build up on the teeth, thereby reducing the chance of dental decay.

Our bodies do have a natural defense against acidity and this is saliva. Saliva acts as a natural cavity fighter. One of the key strategies in cavity reduction/elimination is to keep your mouth at a more alkaline pH (reduce bacterial acidity) throughout the day for longer periods. You do this by increasing saliva production and encouraging saliva production between meals.

This is how it works: When we eat a meal the pH of our mouths change in accordance to the type of food we have just eaten. Food containing higher amounts of carbohydrates and sugars will leave the mouth with an acidic pH, ranging from 1- 5. Increased saliva production will kick in and our saliva will buffer this acidity, slowly raising it back to the resting pH of approximately 7.5. If immediately after eating your main meal you have a sweet treat (piece of chocolate or a dessert), the acidity of your mouth does not change by much. Saliva is still produced and your mouth will quickly recover back to an alkaline pH, which does not allow sufficient time for bacterial colonization and acid production. The problem encountered, particularly with children, is sugary snacks given in between meals. Sugary snacks given an hour after a main meal will bring the pH of the mouth back down to an acidic level and bacteria will begin to thrive and produce more acid. It does not give the mouth time to recover from the acid overload and the mouth remains acidic for most of the day. This gives bacteria plenty of time to produce acidic waste and demineralize the teeth.

Give your children sugar free snacks between meals. Example: whole fruits and vegetables, nuts, sugar free (xylotol containing) chewing gum, cheese. Beware of dried fruit; this is very acidic and very high in sugar and not a good choice for in between meal snack.

Quick easy steps to making your child’s diet a tooth friendly diet


–     Allow sugar intake (sweets and treats) directly after main meals only. When sugar is given between meals as a snack, this leads to a high incidence of decay. The frequency of sugar intake has more impact than the amount of sugar intake. Between meal snacks should contain no sugar.


–      The best type of sweet for a child is chocolate. Sticky sweets like toffees/fizzers/jelly sweets/suckers stick in between and around the teeth and result in destruction of the teeth for a much longer duration as the sugar lies in and around each tooth. It is difficult to clean this sugar off the teeth and they are extremely acid producing.

–      Beware of dried fruit; this is not a good snack. It has a very high sugar content and high acidity. It not only causes dental decay but acid erosion of the teeth.

–      End each meal with a small piece of cheese/some milk/xylotol chewing gum. This neutralizes the mouth and stimulates saliva production.

–      Limit fruit juice intake to ½ a cup per day (if needed). I always advise parents to try to eliminate all juice and sodas from the diet. They do not give hydration. Children should only drink water. If your child does drink a soda/fruit juice, ensure they drink it through a straw, so it bypasses the mouth and the teeth and is swallowed immediately.

–      All babies must be weaned off their nighttime milk bottle/breast feed by the age of 1. At 1 year old they no longer require the nutrition of the milk during the night, as their diet is predominantly solid food. If your child still enjoys the bottle as a pacifier at night, put only water in this bottle. Rampant dental decay results if children are kept on a bottle/breast past one year of age.

–      Never add sugar/honey to rooibos tea. This sugar will rapidly decay teeth, especially if given through a bottle/sippy cup.

Dental decay is a preventable disease. Diet is at the centre of this preventative concept. Without a lower sugar intake, you cannot expect a cavity free mouth. The acidity produced by sugar does not only affect the mouth. This type of acidic environment in the body allows viruses/bacteria/infections to thrive and leaves the body more susceptible to disease. Reducing/eliminating sugar from your child’s diet will have positive effects in all the bodily systems. Change their eating habits today.




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