Irish children avoid tooth decay through fluoridation, not hygiene

The toothbrushing habits of Irish children are at a level seen in the UK more than 20 years ago, while 70 per cent have experienced…

The toothbrushing habits of Irish children are at a level seen in the UK more than 20 years ago, while 70 per cent have experienced tooth decay by the age of 15, according to a new survey.

The North-South Survey of Oral Health of Children in Ireland cites a recent WHO report which found that Irish children and adolescents were among the worst of 35 countries surveyed when it came to the consumption of sweets and soft drinks and in toothbrushing habits.

Carried out on a sample group of nearly 20,000 children by the Oral Health Services Research Centre at University College Cork, the survey findings may send a wake-up call to many Irish parents.

Given such poor dietary and oral hygiene habits, the level of decay in the Republic is remarkably low and this is likely to be due to the fluoridation of water supplies, according to Dr Helen Whelton, author of the report.

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"Future health promotion programmes need to target the frequency of consumption of foods and drinks sweetened with sugar and the frequency of tooth brushing with fluoridated toothpaste among Irish children and adolescents," she says.

The Cork survey found that over half of the eight year olds and approximately two thirds of 15 year olds in the Republic and in Northern Ireland, consumed sweet snacks twice a day or more often.

The study showed that there has been a substantial increase in the frequency of snacking among eight and 15 years olds in the Republic since 1984.

Frequency of toothbrushing was higher in Northern Ireland than in the Republic, according to the UCC survey.

When looking at the frequency of visits to a dentist, in Northern Ireland, nine out of ten eight year olds and 15 year olds reported visiting the dentist at least every 12 months.

In the Republic, the percentage was much lower, with just four out of ten eight year-olds and half of 15 year olds reporting annual visits to the dentist.

In the Republic, 21 per cent of eight year olds and 18 per cent of 15 year olds had never been to a dentist compared to 1 per cent and 2 per cent, respectively, in Northern Ireland.

The UCC survey shows that decay levels were much lower in 2002 than they were in 1984 among children with fluoridated domestic water supplies.

Tooth decay levels were lower among children who got fluoride in their water supply in the Republic than among children with non-fluoridated water supplies in the Republic and Northern Ireland.

The prevalence of dental fluorosis (a defect in the enamel caused by excessive ingestion of water during early childhood) was higher amongst children and adolescents with fluoridated water supplies.

Dr Whelton said: "As fluoride has beneficial effects, the extent to which enamel fluorosis is considered by a population to be a public health issue will be best evaluated by offsetting the benefits against the risks.

"The risks associated with dental decay are that it may result in the loss of teeth, is costly to treat, can be aesthetically disfiguring, and can be associated with a degree of pain."

Research is currently under way at UCC to assess the cosmetic impact of mild enamel fluorosis in an Irish context.

Recent research suggests a significant relationship between patterns of toothpaste usage in infancy and prevalence of fluorosis at age eight amongst children in Sligo and Leitrim.

Dr Whelton said it was anticipated that the adoption of the recommendations of the Forum on Water Fluoridation 2002 will minimise the occurrence of dental fluorosis while maintaining the important decay preventive benefits experienced to date.

Michelle McDonagh

Michelle McDonagh

Michelle McDonagh, a contributor to The Irish Times, writes about health and family