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Around 50 per cent of Australian children have cavities by 6 years of age, with one of the main causes being the regular consumption of sugars. (Photograph: Tewan Banditrukkanka/ Shutterstock)
0 Comments Jan 20, 2017 | News Asia Pacific

Interview: “Around 50 per cent of children have cavities by 6 years of age”

Post a comment by Brendan Day, DTI

With recent studies showing that more than four out of ten Australian children aged 5–10 have caries affecting their primary dentition, it is clear that good oral health habits need to be practised from a very early age. Given that oral disease can cause potentially permanent damage, a preventative approach is essential. Dental Tribune Online spoke with Prof. David Manton, Chairman of the Australian Dental Association’s Oral Health Committee, about the importance of dental check-ups for children and why recent legislative changes in Australia may negatively affect this.

Dental Tribune Online: Prof. Manton, how many times should children be visiting the dentist each year?
Prof. David Manton: The regularity of visiting the dentist for children depends on their oral health. To start with, a child should visit a dentist within six months of the eruption of the first tooth, so around 12 months of age. This is to allow the dentist to examine the child’s mouth and discuss with the parents how to maintain their child’s oral health. This would include issues such as diet and oral hygiene. After that, the time between visits usually varies between six and 12 months, although some children may visit more frequently, such as a child at high risk of dental caries.

What are some of the main contributors to the poor oral health of Australian children?

The main factor affecting oral heath in children is dental caries. Around 50 per cent of children have cavities by 6 years of age. The main causative factor is diet—primarily the regular consumption of sugars in the diet. These sugars can be obvious, like sugary sweets and lollies, but can also be hidden in food and drinks, such as soft drinks, dried and processed fruits, soy drinks and flavoured milk. The sugars encourage the overgrowth of decay-causing bacteria in the plaque on the teeth, and these produce acids that weaken the teeth and lead to caries.

Brushing teeth with fluoridated toothpaste decreases the amount of decay that occurs and improves gingival health, so a lack of brushing can lead to the opposite. Around one sixth of children will have teeth affected by developmental defects that may lead to an increased risk of decay, so early detection of these defects can help prevent caries developing.

The Child Dental Benefits Schedule (CDBS), which enables eligible recipients to access dental care for their children, has recently been lowered from a subsidy of A$1,000 per child over two years to A$700. Who will the changes to the CDBS primarily affect?
These changes to the CDBS mean that one in five children will not be able to have all their treatment needs met. For children with high dental care needs, this will mean that their parents will be out of pocket in many cases and may lead to children not receiving the care they deserve. While the Australian Dental Association was supportive of an adjustment to the cap based on the findings in the Report on the Third Review of the Dental Benefits Act 2008, there seems to be no evidence supporting a 30 per cent drop. It is not clear what will happen to children who need treatment costing more than A$700 over two years. Processes need to be put in place to ensure these children do not end up being part of long dental waiting lists in the public dental system.

How important is prevention in seeking a lifetime of good oral health?
The maintenance of oral health is a vital part of overall health. Oral diseases such as dental caries and periodontal disease often have irreversible effects on the teeth and gingivae. That is why early detection of disease risk and prevention before such damage occurs is so important. Once a tooth develops caries, it will be weaker, even after the caries is treated. Deep lesions may lead to problems with the dental pulp and result in root canal therapy or extraction. Periodontal disease that is allowed to progress will lead to the destruction of the supporting bone of the tooth and may eventually lead to the loss of the tooth.

Preventative care includes the establishment of a healthy diet, regular brushing of teeth with a fluoridated toothpaste, flossing, application of pit and fissure sealants, professional cleaning of teeth if required, application of concentrated fluoride varnishes and scheduled dental examinations to detect disease early. This is why establishment of a home orientated to dental health by 12 months of age and development of healthy eating and oral hygiene habits are so important in children, as they lead to healthy habits that can last a lifetime.

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