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Standard Prevention for all children
- Give toothbrushing advice at least once a year.
- Brush thoroughly twice daily, including last thing at night.
- Use the age-appropriate amount of a toothpaste containing 1000 to 1500 ppm fluoride (see diagram here for details).
- ‘Spit, don’t rinse’.
- Supervise children until they can brush their teeth effectively.
- Demonstrate brushing on the child (~3 minutes) annually.
- Give dietary advice at least once a year, advise or remind the child and/or parent/carer about how a healthy diet can help prevent caries, including the following points.
- Limit consumption of food and drinks containing sugar
- Drink only water or milk between meals
- Snack on healthier foods, which are low in sugar, such as fresh fruit, carrot, peppers, breadsticks, oatcakes and occasionally a small amount of lower fat cheese.
- Do not place sugary drinks, fruit juices, sweetened milk or soy formula milk in feeding bottles or pacifiers
- Do not eat or drink, apart from tap water, after brushing at night
- Be aware of hidden sugars in food and of the acid content of drinks
- Place sealants in all pits and fissures of permanent molars as soon as possible after eruption.
- Resin-based sealants are the first choice of material.
- Ensure the buccal pits of lower first permanent molars and the palatal fissures of upper first permanent molars are sealed.
- On fully erupted teeth where the child is uncooperative, use glass ionomer fissure sealants and ensure that fluoride varnish application is optimal.
- Check existing sealants for wear and integrity/leakage at every recall visit.
- ‘ Top up’ worn or damaged sealants.
- Apply sodium fluoride varnish (5%) twice a year to children aged 2 years and over.*
*Many varnishes contain colophony (e.g. Duraphat®). A child who has been hospitalised due to severe asthma or allergy in the last 12 months or who is allergic to sticking plaster may be at risk of an allergic reaction to colophony. In these cases, consider using a colophony-free varnish (licenced for caries prevention in the UK) or suggest the use of alternative age-appropriate fluoride preparations (e.g. fluoride mouthwash or higher concentration fluoride toothpaste).