Saving Kids’ Teeth: Part three

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Consultant Mike Harrison explains what sugar does to children's teeth and why doctors should care more

Mr Mike Harrison (below with Dr Linda Greenwall) is a Consultant in paediatric dentistry at Guy’s Hospital. He has special interests in dental genetic disorders, diagnosis and treatment, and dental surgery under general anaesthesia. During his talk at the Saving Kids’ Teeth 2017 Conference he outlined his problems with the prevalence of sugar in children’s diet – and the dangers of Coca Cola. Dental Review reports.

It all began in the 17th Century when sugar was used as a preservative and flavouring for food and we developed a craving for it. In 1761 the Sugar Act was brought into force, which set down in law that although plantation owners’ slaves could grow and cut sugar cane out in the colonies, the sugar itself must be refined in the UK. The Government taxed the import of unrefined materials. This created uproar in the Americas, other factors made the situation worse, and the slogan “No taxation without representation” heralded a revolution, which eventually led in 1787 to the adoption of the American Constitution. Some 230 years later Donald Trump was sworn into the office of President of the United States. If it had not been for sugar such a thing would never have happened. The stuff is politically toxic as well as a poisonous food.

Then in 1875 a man called Henry Tate bought the patent rights to the technology that makes sugar cubes – and made a fortune from the nations’ sweet tooth. The Tate Gallery exists because of Tate’s profits from sugar. The Tate & Lyle sugar refinery is still in operation today, in Silvertown on the Thames just two miles from London Bridge. It is the architecture of an empire built on sugar lumps, golden syrup, and rotten teeth.

Sugar and the politics of sugar are at the heart of the current epidemic of childhood obesity and caries. Even so, the once blue London Eye now shines red at night because sponsorship has moved from British Airways to Coca Cola, “Belly expanding, tooth rotting, pancreas shrinking, yum, yum, make mine a Coke!” What message is that glaring red eye sending out to the world?
And it’s not just fizzy pop that’s to blame. Mike cited an advertisement he had seen in a bus shelter that asked: “Ever thought of Coco Pops after School?”
This cereal is 35% sugar. It is forbidden to be advertised on TV before the 9 o’clock watershed, which therefore lists it with full frontal nudity and graphic sex acts. Coco Pops are sugar porn, yet there they are in a bus shelter where kids can read it and ask for a bowl of sugar when they get home.

We have lost our relationship with food

Food manufacturers have a cash incentive to say one thing and do another. They pay lip service to health. Look at diet drinks, they still make you obese – and they don’t rot your teeth, they dissolve them. The UK has lost its relationship with real food. A modern youngster will pop into the kitchen for a snack and come out again empty-handed saying: “Mum, there’s no food in the house, only ingredients.” And so-called value-added processed food is a blatant rip-off. Manufacturers add sugar to the mix – amongst other things - and then sell the end product for quadruple the cost of the raw ingredients. Hear that sound? It’s the sound of their profit margins expanding as quickly as their customer’s waistlines.

Sugar, also known as sucrose, releases endorphins, the feel-good factor, and so has been used as an analgesic for infants. Why are we prescribing under-12s the one thing certain to see them undergoing general anaesthesia? Because, for children at that age, undergoing dental extraction means nitrous or nothing at all. In fact we have reached the point where dental extraction is now the number one reason for under-12s undergoing general anaesthesia; and that can’t be right.

The chances of a child dying under gas are vanishingly small, but what about the psychological after-effects? What about post-operative morbidity after an extraction that sees the child wake-up in pain with a mouthful of blood? What about dental anxiety, and long-term cognitive behaviour disruption? Studies demonstrate that the trauma of dental extraction under general anaesthesia still affects children’s school work years after the event.

How can we avoid this?

How can we avoid this? By taking advantage of teachable moments; and that’s not just aimed at dentists but at every other health professional. And look more closely at what we prescribe: asthma treatments contain sugar and lead to an increased risk of caries. Lactulose, a medication for childhood constipation, is non-absorbable in the gut but contains tooth rotting glucose.

We need to educate parents to demand better oral healthcare for their kids, and to be aware of these teachable moments. We need to educate paediatricians better. For them dental problems tend to be at the bottom of the to-do list, they need to be brought up to speed about delivering better oral health outcomes and education. All mid-level providers need to better understand how dental disease can impact patients. They must become more aware of the wonderful recent initiative DCby1, Dental Check by 1. Caught early enough caries can be treated without putting the child under gas.

Humans crave sugar, salt, and fat. We need to change the landscape to protect people from themselves. Get political. Be aware that the cheapest medication for children is always the sugar-based one. Prescriptions for children should always be marked “SF”, sugar free. Write to your MP; make a change, in fact, demand change!

Healthy eating campaigns are very unpopular – remember what happened with Jamie Oliver’s healthier school dinners initiative? Mums were filmed thrusting burgers and chicken nuggets at their kids through the school railings. It was mad, but we have to keep trying. Through the Dental Wellness Trust Dr Linda Greenwall is considering ways for getting sugary carbonated drinks banned for under-12s. Support her. We must also work harder to dispense education and honest advice. But all that time spent on cross-curricula education across health disciplines will result in the square root of damn all if we don’t also reach out to parents and make them understand what sugar does to their children’s teeth. And it has to start now.

Note: The above is based on Mr Harrison’s impassioned talk at Lord’s on Friday 3rd November. Any mistakes are the author’s.

Next: Dr Sandra White says “More fluoride and less sugar”.