Response to media coverage on ‘5-a-day’ causing tooth decay

In response to news reports about the risk of tooth decay due to the inclusion of pure fruit juice in ‘5-a-day’ recommendations, the Infant & Toddler Forum (ITF) supports increased awareness about the sugar and acid content of juices, and the risk of enamel erosion and subsequent dental caries in young children.

Kathy Harley, dean of the dental faculty at the UK’s Royal College of Surgeons, has been reported as saying that half of five year olds show signs of enamel erosion caused by fruit, particularly citrus fruits. She has called for schools to ban fruit juice and to offer milk and water instead.1

Younger children are also at risk; the first teeth are just as prone to dental caries as permanent teeth. It is important to take special care of a child’s mouth in order to prevent tooth decay and avoid dental extractions and fillings.

Judy More, paediatric dietician and member of the ITF, says: “Parents often think that tooth decay in children’s first teeth is not important as they will grow their adult set in any case. However, the first teeth are just as important as adult teeth, as early loss of the first teeth can lead to overcrowding when adult teeth appear. “Fruit and vegetables are part of a nutritious, balanced diet but fruit is best given as pieces of fruit rather than as juice. Fruit juices are a source of vitamin C, helping with the absorption of iron from plant based foods; however, they are acidic, high-sugar drinks and can cause dental caries. The sugars in sweet foods and drinks are metabolised to acids by the bacteria in dental plaque. These acids, along with the acid already present in drinks like fruit juices, squashes and fizzy drinks, cause demineralisation or softening of the enamel. “If fruit juice is given as a drink it should be well diluted, for example one part juice to about six to ten parts water, and should only be served in a glass, cup or beaker, rather than a bottle. Sucking slowly on sweet drinks in a bottle increases the risk of tooth decay. Well diluted fruit juice, if given, should be with meals and snacks, and 3-4oz or 100-120ml is about right as a single drink portion for 1-3 year olds. Water and milk are the only drinks that should be offered between meals and snacks.”

The ITF provides simple guidance and tips to help avoid tooth decay in toddlers with its Factsheet Protecting Toddlers from Tooth Decay. Endorsed by the British Dental Health Foundation, the Factsheet gives comprehensive advice on how to care for children’s teeth – including fluoride, medicines, diet, snacking, tooth brushing and bottle-feeding.

[1] Sunday Telegraph, Dentists warn: five a day will eat your teeth away, 11 March 2012

Posted in News, Position StatementsTagged

Further Reading

  • By Melanie Pilcher and Dr. Gillian Harris Establishing bedtime routines for toddlers and young children
  • By Dr. Gillian Harris, Honorary Senior Lecturer in Applied Developmental Psychology at the University of Birmingham and ITF member Most parents will struggle at some point to get their toddlers to eat certain foods. Is toddler food refusal a sign of an eating disorder. or is it merely a phase? In the run up to Eating Disorder Awareness Week, Gill Harris provides practical advice to help parents tackle fussy eating in toddlers.  
  • By Lucy Upton, on behalf of the Infant and Toddler Forum On behalf of the members of the Infant and Toddler Forum, I am proud to announce the launch of a new infant feeding educational programme, which includes practical resources for frontline healthcare professionals (HCPs) working with parents and infants.