A well-balanced diet, low caries risk and nutrient-dense diet for; infants, children, adolescents, and persons with special needs is vital for good oral health development and status.
In this article, we look at how diet can impact a child’s oral health at the infancy, pre-school, transitional, adolescence, and special needs levels.
Diet and oral health at the infancy stage
Diet is a key factor in the development of dental caries together with other factors such as the child, bacteria, and time. Good dietary habits established early in life promote physical growth and development that creates an environment for good oral health.
The infant is commonly fed with milk whether from the breast or the bottle. Cow milk has higher calcium, phosphorus, and protein than human milk. Human milk contains 7% lactose while cow milk contains 4% lactose. Milk has the potential to promote caries development if not administered properly and without proper oral hygiene for the infant.
Improper feeding habits
Improper feeding habits for the infant include giving them a bottle containing milk or a sweetened beverage as a way to calm them down during the day, at naptime, or when asleep. If the infant needs to feed at bedtime the parent should hold the bottle and once asleep the infant should be placed in the bed without the bottle. If there is a need for additional sucking an empty pacifier can be used. If the parent insists on the prolonged use of a bottle, then the contents should only be water.
Breastfeeding is recommended exclusively for 6 months. Breast milk provides abundant and easily absorbed nutritional components, antioxidants, enzymes, immune properties, and live antibodies from the mother. Immunoglobulin A coats the lining of the baby’s immature intestines to promote normal flora production and prevention of attacks from pathogenic bacteria.
However, mothers should not sleep while having the child suckle at the same time. Once asleep the breast should be removed from the mouth. Infants who are breastfed on demand may suckle up to 10-40 times within 24hrs. The mother should try and clean their baby’s teeth frequently with a clean cloth and water to prevent the consequences of prolonged acid contact present in breast milk.
Feeding an infant past 6 months
At 6 months it is recommended to give an iron-fortified cereal with milk then gradually increase one or two home-prepared meals like porridge with milk, and mashed potatoes with greens. Good dietary habits should be started at this age. Forcing an infant to eat when they indicate a desire to stop may lead to overeating, obesity, and frequent snacking in the future.
Snacks given to the infant should be appropriate, nutritious, and safe for the teeth. They include finger foods, eggs, soft fruits, and vegetables without sugar coatings. They should be introduced as the infant develops chewing and swallowing. Avoid foods high in carbohydrates, sugary foods, sticky foods, and acidic substances. Juices should be from natural fruits and not be given in a bottle and not before 6 months.
Fresh juice should be given in a cup and limited to 2 servings. Avoid flavored milk since it has high sugar content. Note that the child needs to have regular dental reviews from her first birthday.
Diet and oral health at the pre-school stage
Dietary sugars are the most important factors in causing dental caries since they provide a substrate for cariogenic diet to flourish and produce acids that demineralize enamel causing caries. All forms of sugar should be avoided. These include sucrose present in corn sweeteners usually used in refined foods, fructose, and glucose commonly found in honey, fruits, and vegetables.
It’s recommended you monitor this kind of food given to the child since they tend to go to different environments such as with a babysitter, grandparents, or daycare therefore they may get confused. Again, children are easily influenced by what they see on TV or what their peers eat.
Presentation of food is key
Colorful foods help to increase the child’s interest to eat the food. They tend to snack more since they have more idle time. It is important for the child to be given healthy snacks. Avoid snacks with a lot of salt, sticky foods, fats, and refined carbohydrates since they can cause dental problems.
Foods with lower cariogenic potential should be encouraged.
Characteristics of these low cariogenic foods include:
- High protein content and moderate fat content to facilitate the clearance of food
- Minimal concentration of fermentable carbohydrates
- Strong buffering capacity with a pH higher than 6
- High mineral content of calcium and phosphorus
Positive habits during family meals
Encourage positive habits with positive reinforcements and eating together with older siblings or parents whom the child can emulate. The approach used must be personalized, depending on the willingness of the family to learn and the specific dental problems affecting the child.
It is preferable to feed the child homemade foods compared to eating take-out. There is a need for the family to eat together at a designated place for the child to learn proper eating habits. Choose the kind of snacks the child eats whether at home or in school. The snacks should be healthy for the body and rich in nutrients.
Ensure you monitor the source of water used in the home. Water used for drinking, cooking, and brushing should be pure water and with fluoride levels of less than 1.5mg/l. the child needs to drink an adequate amount of water about 4-5 glasses of water per day.
Children need to actively engage in sports and outdoor activities so as to help in the digestion and metabolism of the food they take. This also helps them acquire Vitamin D from the sun early in the morning and in the evening while they play.
The 2015-2020 dietary guidelines state five major principles.
- Follow a healthy eating pattern
- Focus on variety, nutrient density, and amount
- Limit calories from added sugar and saturated fats and limit sodium intake
- Take healthier natural foods and beverages
- Encourage healthy eating patterns
Diet and oral health in the transitional years (6-12 years)
Many children in this period are affected by obesity and dental caries. Most of them consume sweetened beverages such as soda, fruit drinks, sports and energy drinks, and sweetened coffee and tea.
At least 64.5% of boys and 61% of girls aged 2-19 years consume at least one sugar-sweetened beverage daily. Avoid these drinks since children with daily rates of sugar-sweetened beverages are more susceptible to dental caries.
There is a need to expose the child to good dietary habits both at school, in co-curricular places, and at home. Parents and siblings should give good modeling of healthy food choices. Monitor the programs and games the child watches since it influences their choice of food to eat. Encourage consumption of home food compared to eating outside.
For all children, 24-hour diet history and 7-day diet history should be taken. Then every exposure to a refined carbohydrate is recorded (those that stick to the teeth and don’t dissolve easily). It is recommended to limit snacks and meals to 3-6 servings a day. Limit sugar-sweetened beverages and eat according to the Choose My Plate guidelines.
Substitute sticky candy with other snacks and if the child takes sweets or sugary foods let them be consumed near meal times. Parents must work with school authorities to provide wholesome and nutritious snacks and meals. The use of vending machines should be controlled. Use sugar-free gum for those children who love chewing.
Water used for drinking should be pure and with fluoride levels of less than 1.5mg/l both at school and at home. Tap water should be boiled before drinking.
Diet and oral health among children with special needs
A parent or guardian should consider the following:
- Addition of supplements to routine foods to increase the calories ingested.
- Creative ways to make the food more appealing and palatable should be considered eg. blending smoothies.
- Ensure the food given to the child is nutritious and healthy for the body and teeth.
- Foods may be altered through mincing or mashing or pureeing to assist the child in swallowing and have less chewing.
- Avoid giving the child lots of pastries, canned foods, puddings, and desserts as a way to appease the child.
Diet and oral health at the adolescence stage
Parents should ensure they understand the components of a balanced diet and its importance. Moreover, they should reduce the frequency of snacking and avoid foods that are sticky to the teeth and soft tissues.
Adolescence, self-awareness, and sports drinks
Adolescents have a desire to look attractive. Daily care of teeth will include proper dietary habits that will ensure the proper health of the teeth and body. Most of them tend to love the use of sports drinks and energy drinks. Important to note – these drinks should be avoided due to their high content of sugar, acid, and caffeine.
Sports drinks have a very low ph. of 3-4 that is sufficient to cause enamel demineralization. They also contain refined sugar than can cause carious lesions on the teeth.
Energy drinks contain a blend of stimulants including caffeine, taurine, ginseng, guarana, l-carnitine, and creatine. Caffeine tends to increase blood pressure, heart rate, gastric secretions, body temperature, cardiac arrhythmias, and diuresis. It is not usually regulated and is available at levels harmful to the body.
Children categorized as high risk in their earlier years should be reviewed regularly by a dentist and proper diet counseling should be done to avoid the same effect on the permanent teeth.
Adolescence and independence
Adolescents have a huge sense of independence. The child needs to be involved more during the dietary consultation. This sense of independence may stimulate them to snack frequently leading to obesity. Snacking should be regulated, healthy and nutritious to the body, and avoid sugary foods and drinks.
You will notice adolescents tend to seclude themselves – making them avoid the family meals. Parental presence has a substantial influence on increasing the adolescent’s consumption of fruits, vegetables, and dairy and reducing the consumption of soft drinks.
Would you mind visiting House of Dentistry for better oral health care for your child? We are always ready to be of service.