Tap water [illustrative].
(photo credit: INIMAGE)
We have a two-year-old child and were disturbed to read that Health Minister Yael German decided on her own, in contravention of professional advice, to prohibit fluoridation of drinking water all around the country. We would like to know what to do, as we depended on fluoride to protect our daughter’s teeth beyond giving her healthy food and brushing her teeth twice a day. We asked our dentist, but he said he didn’t know because since he went to dental school, there had always been fluoridation of our water supply. – B.N., Or Akiva
Judy Siegel-Itzkovich replies:
When the health minister announced her decision, the ministry said it would spend millions on a program to give fluoride drops to young children in tipat halav (well-baby) centers. Since then, when I recently asked the ministry’s public health head, Prof. Itamar Grotto, what parents should do, he offered no details on such a program and could only advise them to “go to the child’s dentist.”
However, Prof. Ted Tulchinsky, who is among those who filed an appeal to the High Court of Justice to overturn German’s decision, has advice for parents.
Tulchinsky was head of public health at the ministry for years, is a longtime lecturer at the Hebrew University-Hadassah School of Public Health and Community Medicine, and is the newly appointed dean of Ashkelon Academic College’s department of health sciences.Prof. Ted Tulchinsky replies:
Academic dentists and public health experts are very upset about Yael German’s inane decision to ban fluoridation without even allowing an option for all mayors and heads of local authorities to provide fluoride in the drinking water.
Her decision was taken against the advice of ministry staff and academic and professional experts in the field.
Stopping fluoridation is, of course, going to punish the poor and periphery populations, but the advice below must be given and promoted by all health providers and health journalists.
For a great majority of children, a sensible, low-sugar diet and at least twice-daily brushing with appropriately fluoridated toothpaste will help prevent dental caries.
The sugar issue is more important now than ever before. Sweets are bad for kids and also promote obesity. All children should regularly be taken to a dentist, who will prescribe additional measures if necessary; this should be covered under the child dental health plan.
Dental experts note that tooth decay in early childhood occurs most often in the upper and lower front teeth (incisors).
Young children need strong, healthy baby teeth, which help them chew food, speak and have enough space in their jaws for the adult teeth to grow in straight.
Tooth decay can happen when your child’s teeth come in contact with too much sugar and trigger the growth of bacteria. Acids produced by the bacteria cause tooth decay.
Many of the liquids that your child drinks, including milk, formula and fruit juice, contain sugar. Eating sugared snacks also leads to more sugar on the teeth.
How often your child drinks sugary liquids and how long the sugar stays in the mouth are also important. Never allow your child to sleep or walk around with a bottle or “sippy cup” in her or his mouth, as the sugar coats the teeth for long periods of time, causing them to decay more quickly.
Breast milk by itself is the healthiest food for babies’ teeth. It tends to slow bacterial growth and acid production, but when breast milk is alternated with sugary foods or drinks, the rate of tooth decay can be faster than with sugar alone.
Let children drink only water at night.
Parents of younger children, aged six months to a year, should be given only formula or water to drink in bottles. They should remove the bottle or stop nursing when the baby has fallen asleep. Avoid letting children walk around using a bottle of juice or milk as a pacifier. Avoid prolonged use of pacifiers, and do not dip the pacifier in honey, sugar or syrup. Begin teaching babies to drink from a cup at around six months of age. Try to stop using a bottle by 12 to 14 months.
After each feeding, gently wipe the baby’s teeth and gums with a clean washcloth or gauze to remove plaque. Begin toothbrushing as soon as your child has teeth. Initially place a small amount of non-fluoridated toothpaste – no more than the size of a pea – on a washcloth and rub gently on their teeth. You can switch to fluoridated toothpaste when you are sure that your child spits out all of the toothpaste after brushing. Older children can use a toothbrush with soft, nylon bristles. Use a very small amount of toothpaste (no more than the size of a pea). Begin flossing kids’ teeth when all of the baby teeth have erupted (usually around age two-and-a-half). Inspect the teeth regularly and begin dental visits when all of the baby teeth have erupted, or at age two or three, whichever comes first.Rx for Readers welcomes queries from readers about medical problems. Experts will answer those we find most interesting. Write Rx for Readers, The Jerusalem Post, POB 81, Jerusalem 91000, fax your question to Judy Siegel-Itzkovich at (02) 538-9527, or email it to [email protected], giving your initials, age and place of residence.