Guides · Children
Preventing tooth decay in children: fluoride, fissure sealants and diet
The causes of early childhood caries (bottles, night feeding, snacking), when fluoride varnish and fissure sealants are done, why primary-tooth decay is treated, and a protection timetable by age.
Childhood decay is prevented on three legs: brushing twice a day with fluoride toothpaste under parental supervision, reducing the frequency (more than the amount) of sugary food and drink, and regular check-ups. The dentist applies fluoride varnish every 6 months and seals the fissures of the permanent molars erupting at 6–7. Primary-tooth decay is not left "because it will fall out anyway"; it causes pain, abscesses and defects in the permanent teeth.
Why do children's teeth decay so easily?
The enamel of primary teeth is thinner and less mineralised than that of permanent teeth; decay progresses fast and soon reaches the nerve. Children snack often, their brushing skills are inadequate until 7–8, and milk or formula left in the mouth at night produces acid for hours. The result: most 5-year-olds in Turkey have at least one decayed tooth — and almost all of it is preventable.
Early childhood (bottle) caries
Giving milk, fruit juice or a sugary drink in a bottle during sleep, frequent and long night feeds (after teeth have erupted), and dipping the dummy in honey or sugar lead to rapidly spreading decay of the upper front teeth. Prevention: stop the night bottle after 12 months or give only water; wipe the teeth with a clean cloth after night feeds; move to a cup at 12–15 months.
Protection timetable by age
| Age | At home | In the clinic |
|---|---|---|
| 0–6 months | Wipe the gums with a clean cloth | — |
| 6 months–3 years | Brush from the first tooth; a rice-grain smear of 1000 ppm fluoride paste, twice a day | First examination at the first tooth / age 1; fluoride varnish if at risk |
| 3–6 years | Pea-sized paste; the parent brushes, the child "helps" | Check every 6 months + fluoride varnish |
| 6–7 years | The child brushes, the parent repeats in the evening; flossing starts | Fissure sealants on the erupting 6-year molars |
| 11–13 years | Independent brushing, a mouthguard for sport | Fissure sealants on the 12-year molars; orthodontic assessment |
What is fluoride varnish?
A concentrated fluoride layer painted onto the teeth that sets within minutes. It strengthens enamel against acid and can arrest early lesions (white spots). Application takes 2–3 minutes, is painless and is repeated every 6 months (every 3 months at high risk). No hard food or brushing for 2–4 hours afterwards.
What is a fissure sealant?
The deep grooves (fissures) on the chewing surfaces of the molars are too narrow for a bristle to enter, and most childhood decay starts there. A fissure sealant is a flowable, painless protective filling that needs no drilling and fills these grooves. The best time is the first 6–12 months after eruption: age 6–7 for the 6-year molars, 11–13 for the 12-year molars. Its integrity is checked at visits and it is topped up if worn.
Diet: frequency, not amount
After every intake of sugar the mouth stays acidic for about 20–30 minutes. A chocolate bar eaten once a day is far less harmful than fruit juice sipped all day. The rules: give sweets with the main meal, prefer cheese, nuts and vegetables at snack time, only water between meals, hard fruit instead of sticky sweets (gummies, dried fruit). Remember that toddler milk, fruit yoghurt and "fruit juice" are also sources of sugar.
Why is primary-tooth decay treated?
Primary molars stay in the mouth until 10–12. Untreated decay causes pain, abscesses, difficulty chewing and speaking, sleeplessness and missed school; a primary tooth lost early stops the permanent tooth beneath from finding its place and leads to crowding. An abscess can leave an enamel defect in the permanent tooth developing below. More: Paediatric dentistry, A child's first dental visit.
Checklist
- Brush twice a day, for 2 minutes, with fluoride toothpaste, under parental supervision (until age 8)
- Nothing but water after the last brush at night
- Sugary food/drink at most 1–2 times a day, with meals
- A check every 6 months + fluoride varnish; fissure sealants when the molars erupt
- Don't put the dummy or spoon in the parent's mouth (caries bacteria are passed on)
This article is for general information only; diagnosis and treatment tailored to you require a dental examination.
A child's first dental visit: when, and how to prepare
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Orthodontics for children: when should the first assessment be?
Why a check at age 7, conditions that need early intervention, the effect of habits and treatment timing.
How to teach a child to brush: an age-by-age guide
From infancy to primary school — how much toothpaste at which age, who brushes, which brush; practical tips for children who resist.