SMILING FOR LIFE - with the help of the Health Education Authority.

Cathy Stillman- Lowe, dental health campaign manager at the HEA, has reassuring advice to parents of under 5s who'd like their children to grow up with as healthy teeth as possible .

Practical tips on healthy eating for under 5s

• Bread other cereals and potatoes
• Fruit and vegetables
• Meat, fish and alternatives such as pulses and tofu .

Foods such as chocolate, confectionery, biscuits, crisps and salty snacks can be added as occasional treats, preferably at mealtimes, but they shouldn't replace the foods listed above .

Sugars in your child's diet vary in their ability to cause tooth decay, depending on the type of sugar, The sugars that are potentially damaging to teeth are found in table sugar, sugar added to manufactured foods, fruit juice and honey.

These can damage teeth if eaten frequently throughout the day and so they should ideally be kept to mealtimes. They are found in many variables of biscuits, cakes, soft drinks and confectionery - and so these do not make good choices for snacks and drinks eaten between meals. Sugar containing drinks served in feeding bottles are particularly damaging as the teeth are bathed in sugary liquid for long periods of time, which can lead to nursing decay ('bottle rot'). They are especially likely to cause to hold in the pushchair or overnight.

Manufacturers have produced a wide range of foods, confectionery and drinks that contain an artificial sweetener rather than, or in addition to, xylitol, spartame, acesulfame K, or saccharin. Artificial sweeteners won't cause tooth decay but that doesn't mean that foods and drinks sweetened in this way make ideal choices because:Check labels for the following sugars which can all harm children's teeth
if consumed frequently :

• Dextrose
• Fructose
• Glucose
• Honey
• Invert sugar

The safest drinks for teeth, between meals, are water and milk.

• Water is an ideal choice for quenching thirst at any time, for example after outdoor play. Chilling or adding ice can increase its appeal to children.
• Still, bottled spring waters are a satisfactory alternative to tap water, though they may contain high levels of some minerals and so be unsuitable for regular consumption.
• Fizzy water is not recommended as it can be acidic.
• from 12 months of age, whole cow's milk is the most nutritious option for a snack time drink . If milk isn't popular as a drink, however, try to include cheese, milk based sauces and puddings eg custard, yoghurt.
• full - fat cow's milk should be used until the age of two; after this, semi - skimmed milk is suitable for children who are 'good eaters '. Skimmed milk is not suitable for under 5's.

Served as a mealtime drink, well - diluted fresh fruit juice is a good choice but :

• Never serve fruit juice, or any sweetened drink, in a baby's feeding bottle - 'baby' juices are not recommend.
• For under 2's, dilute one part juice with 10 parts water.
• For older children, dilute five parts juice to 10 parts water.

Artificial sweeteners won't cause tooth decay but that doesn't mean that foods and drinks sweetened in this way make ideal choices because:

• 'Diet' drinks such as colas and fizzy fruit drinks can be acidic and, if consumed frequently throughout the day.
• Some sweeteners, for example sorbitol or xylitol, which are used in sugar-free sweets can have a laxative effect if eaten in large quantities.
• Giving artificially sweetened drinks may encourage a 'sweet tooth' which could cause problems with tooth decay later in life.

Drinks containing artificial sweeteners therefore shouldn't be consumed in large amounts by infants and young children. Drinks such as squash, containing saccharin, should be diluted well with water - using to parts water to one part concentrate - if they are given to young children.

Ideas for nutritious snacks with no added sugar include :

• peeled and chopped fruit and vegetables, served alone or with a dip of natural fromage frais .
• dairy foods, such as cubes of cheese ( which is particularly good for teeth), or plain yoghurt with added fresh fruit .
• plain biscuits such as water biscuits and crackers, with fat spreads which are preferably high in unsaturates .
• sandwiches or rolls filled with meat or fish, cheese spread, or egg. Salad vegetables can be added to these .
• any type of bread, including toasted finger, pitta bread, and rice cakes

Tea, coffee, fizzy drinks and colas (both the regular and 'diet' varieties) if milky tea is served to encourage a child to drink milk, it should be very weak, iron and other minerals and reduces their absorption .

Tips on brushing - Twice daily tooth brushing with a fluoride toothpaste is also important in preventing decay because it applies fluoride regularly to children's teeth:

• The benefits are greatest if parents help their children to brush at least until the age of seven .
• A smear of paste should be used for babies, and a small pea - sized amount for toddlers and older children .
• After brushing, the child should spit out the toothpaste if he/she is old enough to do so, but not rinse

Your dentist can advise on whether a low fluoride toothpaste will give a child enough protection against decay or whether an adult paste would be more suitable.

Would you like more information

The HEA leaflets - 'Keeping Baby Teeth Healthy' and 'Caring for Your Children's Teeth' are free and available by sending an address label to :

Cathy Stillman-Lowe,
Denplan Offer,
HEA,
Trevelyan House,
30 Great Peter Street,
London
SW 1P 2HW