Reducing caries risk requires a multi-factorial approach, both to prevent demineralisation and to promote remineralisation. Surveys suggest that 42 per cent of adults only use a toothbrush and toothpaste for their oral care.⁵

Dietary changes which reduce the quantity and frequency of intake of carbohydrate or acidic foods and drinks should reduce decay. Water is the best and simplest recommendation for thirst and a higher intake of milk and (sugar-free) yogurt has been associated with a protective effect.¹⁴ While still capable of causing tooth erosion, soft drinks with a higher calcium content have a lower erosive potential.⁸

Cheese can stimulate saliva production, as well as having the benefits of containing calcium, phosphate, and casein, which protects against demineralisation.¹⁰

Simply restoring oral pH to neutral or alkaline may be insufficient to prevent ongoing bacterial acid secretion, as S mutans and other lactobacilli can store polysaccharides and continue to secrete acids locally.⁷ Removing and inhibiting bacterial activity is also needed.

• Reduce both the amount and how often sugary foods and drinks are given to children
• Don’t add sugar to weaning foods or drinks
• Aim to introduce drinking from a free-flow cup from six months of age and stop feeding from a bottle from 12 months of age
• Start brushing children’s teeth as soon as the first tooth appears and supervise their tooth brushing until they are 7 or 8 years old
• Brush children’s teeth twice daily, including just before bed, using a fluoride toothpaste
• From the age of three, use only a pea-sized amount of fluoride toothpaste, for younger children a smear
• Use only sugar-free medicines