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We can helpp Healthy Eating Local Policies and Programs Building community capacity to promote healthy eating www.wecanhelpp.com.au Healthy Eating On A Plate: Module 6 Food and Your Teeth Contents Module 6: Food and Your Teeth .............................................….……….....................................…….………..……............................……................ 3 Learning Outcomes ..............................................…….………..…….....................................…….………..……......................................……...... 3 Key Messages ..............................................…….………..…….....................................…….………..……......................................…….................. 3 Checklist for session ..............................................…….………..…….....................................…….………..……......................................…….... 3 Session outline: Food and Your Teeth ..……..............................…….………..……..............................…….....................................……................ 4 Presenter notes for Module 6: Food and Your Teeth …..…….....................................…….………..……...................................……............. 5 Importance of dental health ……..…….....................................…….………..……........…..……..................................................................... 5 What is tooth decay? ……..……..…….....................................…….………..……........…..……................................................................................ 5 Causes of tooth decay……..……..…….....................................…….………..……........…..……........................................................................... 5 Factors that increase the risk of tooth decay ……..……...........................................…….………..…..............……......................…….... 6 Preventing tooth decay……..……..…….....................................…….……..……........…..……............................................................................7 Tap water ……..……..……..……..……..……..…….....................................…….………..……........…..……................................................................................ 7 Snack Ideas ……..……..……..……..……..……..…….....................................…….………..……........…..……............................................................................ 8 Recap of main points ……..……..……..……..……..……..…….....................................…….………..…….......................................................................... 8 Group Discussion ……..…….....................................…….………..……...................……......................…..............................…….………..…..................... 9 Some things to consider when presenting this module …......................…..............................…….………..…..............…….........9 Website Resources .........……....................................................................................................................................................................................... 10 Appendices Appendix A: Resources ...............................................…….………..…….................…………....…….…................………....…….…....……....................... 11 Activity sheet – ‘Which is the better choice for your teeth?’..................………..…....……........………....….......................…....….…..... 12 Activity sheet; Answers – ‘Which is the better choice for your teeth?’....................………..…....……........…................................. 13 Handout – ‘Keep your teeth healthy’....................………..…....……........….................................................................…................................. 15 Appendix B: Script and Flashcards ……………………………..………………………………………………………………....…….………..……....................... 16 2 Module 6: Food and Your Teeth This module provides basic information on tooth decay and how it can be prevented with an emphasis on children’s dental health. Learning Outcomes; By the end of the session participants will be able to: • Understand the basic process of tooth decay • Identify food and drinks that can cause tooth decay • Which food and drinks are best for teeth health • Identify simple changes to eating habits which prevent tooth decay Key messages: • Breastfeed your baby if possible • Swap snacks high in added sugar for those with no added sugar like fruit and vegetables • Have sugary food and drinks as part of a meal rather than on their own • Eat at set times during the day rather than grazing • Drink plain tap water • Brush teeth twice a day(after breakfast and before bed), and go for regular check-ups with the dentist • Spit toothpaste out, but do not rinse • Once teeth are through - lift the lip of children once a month to check for early signs of tooth decay Checklist for session: • Script and flashcard set for Food and Your Teeth • Tooth decay simulation (you will need to prepare this demonstration at least two days before the session, see page 6) - equipment required: 1 egg, 1 clear jar with lid, white vinegar and a permanent texta • Activity sheet - ‘Which is the better choice for your teeth?’ • Activity sheet – Answers - ‘Which is the better choice for your teeth?’ • Handout – ‘Keep your teeth healthy’ • Optional - order brochures translated in several languages from SA Dental Service http://www.sadental.sa.gov.au/desktopdefault.aspx?tabid=288 • Pens HELPP Healthy Eating on a Plate Module 6 , November 2013 3 Healthy Healthyeating eatingon onaaplate: plate:eating eatingfor forhealth healthfor forCALD CALDcommunities communities Session outline: Food and Your Teeth Session Sessionoutline: outline:Food Foodand andYour YourTeeth Teeth Time Activity Time Activity Healthy eating on a plate: eating for health 2 2mins mins Introduction Introductionand andoverview overviewofofthe thesession session • • Understand the basic Understand the basicprocess processofoftooth toothdecay decay Session outline: Food and Your Teeth Time 2 mins 1010mins mins 10 mins 5 5mins mins 5 mins 5 5mins mins 5 mins 3 3mins mins 35 mins 5mins mins 2 2mins mins 55 5mins mins mins 2 mins 5 mins • • Identify Identifyfood foodand anddrinks drinksthat thatcan cancause causetooth toothdecay decay Activity • • Which Whichfood foodand anddrinks drinksare arebest bestfor forteeth teethhealth health Introduction and overview of the session • Identify changes totoeating habits which Identifysimple simple changes eating habits whichhelp helpprevent preventtooth tooth • • Understand the basic process of tooth decay decay decay • Identify food and drinks that can cause tooth decay Importance Importanceofofdental dentalhealth health • Which food and drinks are best for teeth health Discussion Points: Discussion Points: Identify simple changes to eating habits which help prevent tooth •• • Importance ofofdental Importance dentalhealth health decay • • What Whatisistooth toothdecay? decay? Importance of dental health • • Most tooth decay isispreventable Most tooth decay preventable Discussion Points: Causes of tooth decay Causes of tooth decay • Importance of dental health • • Factors Factorsthat thatincrease increasethe therisk riskofoftooth toothdecay decay • What is tooth decay? • • Food and drinks that cause tooth decay Food and drinks that cause tooth decay • Most tooth decay is preventable • • Simulation Simulationofofhow howacid acidaffects affectstooth toothenamel enamel Causes of tooth decay • Factors that increase the risk of tooth decay • Food and drinks that cause tooth decay • Simulation of how acid affects tooth enamel Prevention Preventionofoftooth toothdecay decay Discussion Points: Discussion Points: • • Breastfeed Breastfeedbabies babieswhere wherepossible possible • • Swap Swapsnacks snackshigh highininadded addedsugar sugarfor forfruit fruitand andvegetables vegetables of tooth decay •Prevention Have sugary food and drinks as part of a meal having sugary drinks, have as part of a meal • If Have sugary foodfood andand drinks as part ofthem a meal Points: and eat at set times •Discussion • Limit Limitgrazing grazing and eat at set times Breastfeed babies where possible water) •• • Drink Drinkplenty plentyofofwater water(especially (especiallytap tap water) Swap snacks high ainday added sugar for fruit and vegetables •• • Brush teeth twice Brush teeth twice a day Havetoothpaste sugary food and drinks as rinse part of a meal •• • Spit Spit toothpasteout, out,but butdodonot not rinse •• Once Limit grazing and eat at set times • Onceteeth teethare arethrough through- lift - liftthe thelipliponce oncea amonth month • Drink plenty of water (especially tap water) Why is water, especially tap water so important? Why is water, especially tap water so important? •Discussion Brush teeth twice a day DiscussionPoints: Points: •• Spit toothpaste out, but do not rinse Cheap and • Cheap andsafe safetotodrink drink •• Once teethcontains are through - liftwhich the lip once a month • Tap Tapwater water containsfluoride fluoride whichprotects protectsteeth teeth Why is water, especially tap water so important? Snack Snackideas ideasfor forchildren children Discussion Points:that won’t harm teeth • • Snack Snackideas ideas that won’t harm teeth •Recap Cheap andpoints safe to drink Recapofofmain main points • Tap water contains fluoride which protects teeth Snack ideas for children In-class activity In-class activity • • Snack ideas that won’t harm teeth • Participants Participantswill willcomplete completethe theactivity activitysheet sheet‘Which ‘Whichisisthe thebetter better Recapchoice of main points for your choice for yourteeth?’ teeth?’ • • Discuss Discussanswers answersasasa agroup group Group In-class activity Groupdiscussion discussion • •• Discuss what participants plan totomake atathome Discuss whatchanges changes participants plan make home Participants will complete the activity sheet ‘Which is the better choice for your teeth?’ • Discuss answers as a group Group discussion • Discuss what changes participants plan to make at home Module Module6:6:Food Foodand andYour YourTeeth, Teeth,June June2013 2013 4 Resources Resourcesrequired required for CALD communities Resources required Flashcards: Flashcards: ‘What ‘Whatisistooth toothdecay?’ decay?’ Flashcards: ‘What is tooth decay?’ Flashcards: Flashcards: ‘Food ‘Foodand anddrinks drinksthat thatcan can cause causetooth toothdecay’ decay’ ‘Factors ‘Factorsthat thatincrease increasethe the risk ofoftooth decay’ risk tooth decay’ Flashcards: Demonstration: Simulation Demonstration: Simulation ‘Food anddecay drinks that can ofoftooth – –eggshell tooth decay eggshell cause tooth decay’ soaked soakedininvinegar vinegarprepared prepared ‘Factors that increase the atatleast leasttwo twodays daysininadvance advance risk of tooth decay’ Flashcards: Flashcards: Demonstration: Simulation ‘Keep your teeth healthy’ your teeth healthy’ of‘Keep tooth decay – eggshell soaked in vinegar prepared at least two days in advance Flashcards: ‘Keep your teeth healthy’ Flashcard: Flashcard: ‘Tap ‘Tapwater’ water’ Flashcard: Flashcard: Flashcard: ‘Tap water’ ‘Snack ‘Snackideas’ ideas’ Flashcard: Flashcard: ‘Keep ‘Keepyour yourteeth teethhealthy’ healthy’ Flashcard: Activity Activitysheet sheet-‘Which -‘Whichisisthe the ‘Snack ideas’ better betterchoice choicefor foryour your teeth?’ teeth?’ Flashcard: Answer sheet - ‘Which Answer sheet - healthy’ ‘Whichisisthe the ‘Keep your teeth better betterchoice choicefor foryour your Activity teeth?’ teeth?’sheet -‘Which is the better choice for your teeth?’ Answer sheet - ‘Which is the better choice for your teeth?’ P Pa ag ge e| 2| 2 Presenter notes for Module 6: Food and Your Teeth Importance of dental health Teeth are needed for eating, talking, and smiling. Humans only get two sets of teeth - baby teeth and adult teeth. Baby teeth are eventually replaced by adult teeth that are meant to last until death. Baby teeth start to fall out from about six years of age. The last baby teeth will be replaced by adult teeth at around 12 – 13 years of age. Approximately 50% of Australian children will have some form of tooth decay by six years of age (Australian Dental Association, 2012). This is problematic given that tooth decay or the premature loss of baby teeth can have implications for the health of adult teeth. When baby teeth fall out, the spaces left behind are filled by the adult teeth. Premature loss of the baby teeth can mean there is not enough space for the adult teeth to come through and this may cause over-crowding of teeth. In turn this can create difficulty in cleaning teeth properly and therefore increase the risk of tooth decay in adult teeth. It is important to care for the baby teeth as they are creating space for the adult teeth. Good oral health is linked closely to overall general health and some of the same factors that influence general health also influence dental health. In addition, pain and discomfort can significantly impact on a person’s ability to socialise, eat, talk, sleep, work and go about their daily lives. What is tooth decay? Display ‘What is tooth decay?’ flashcard Tooth decay happens gradually and can occur in either baby teeth or adult teeth. Bacteria (or germs) live in the mouth and collect around the base of the gums in a sticky colourless film called plaque. Some bacteria are able to covert sugar to acid. If this acid is left on the tooth surface for a long enough period of time the acid may cause the top layer of the tooth (the enamel) to progressively become weak (demineralisation). This can lead to holes forming in the tooth, which may be painful (but not always). The more occasions teeth are exposed to this process over a day, the more likely it is that tooth decay will develop. Saliva and fluoride (in toothpaste and tap water) can help to neutralise acid formed by bacteria. It is important to realise that most tooth decay is preventable! Causes of tooth decay Display ‘Food and drinks that can cause tooth decay’ flashcard There are certain foods and drinks that can cause tooth decay, including: • • Food and drinks that are high in added sugar such as lollies, cake, icecream and soft drinks Acidic drinks such as fruit juice, soft drinks, sports drinks and energy drinks. These include so-called ‘diet’ soft drinks. – Acidic drinks cause erosion which is different to the decay caused by sugary drinks. Sugary drinks such as soft drinks can also be acidic. This includes drinks that contain phosphoric acid, citric acid or tartaric acid (at least one of these ingredients is in most soft drinks – including ‘diet’ soft drinks) • • Sticky foods, such as dried fruit are more likely to stick to the surface of the teeth Allowing the teeth to be constantly coated with food or drink is also a problem, such as when a child takes a bottle of drink to bed (including milk) and is allowed to fall asleep whilst sucking on the bottle. HELPP Healthy Eating on a Plate Module 6 , November 2013 5 Factors that increase the risk of tooth decay Display ‘Factors that increase the risk of tooth decay’ flashcard Bacteria in the mouth use sugar to produce acid. The acid and the sugar can stick to teeth and begin to dissolve tooth enamel. This happens for up to 30 minutes after eating. However, there are certain factors that determine the rate of tooth decay, these include: • acteria B – The number of bacteria in the mouth varies between people, however regular brushing (morning and night) is an important process which helps to remove bacteria which produce acid. • Type of food and drink – The type of food and drink consumed is a significant factor for the development of tooth decay. Food and drinks high in sugar such as confectionery, soft drinks and biscuits are broken down rapidly in the mouth and attract acid-causing bacteria. • Frequency – The greater the number of meals or drinks over a day containing sugar, the more times teeth are exposed to acid. The more times teeth are exposed to this process over a day, the more likely it is that tooth decay will develop • Time – The longer the teeth are exposed to sugar the greater the opportunity to convert the sugar into acid, which then attacks tooth enamel. For example, sucking on a lollipop means that sugar remains in the mouth for a long period of time. • Strength of tooth enamel – The strength of tooth enamel is an important factor in the rate of tooth decay. The weaker the tooth enamel, the faster the rate of decay. Soft drinks (even diet soft drinks) contain phosphoric acid and in some cases citric acid. These acids can cause the erosion of tooth enamel. Demonstrate a simulation of tooth decay ** You will need to prepare this display approximately 4 days prior to the session** How to prepare tooth decay representation Equipment • 1 egg • 1 cup of white vinegar • 1 clear jar with a lid • Permanent texta Method 1. Crack an eggshell in half 2. Place one half of the shell in a clear jar and pour vinegar over the top of the shell until at least half of the eggshell is covered 3. Clean and dry the other half of the egg shell and put aside 4. Place a lid on the jar and label the jar with the date 5. After two days holes should start to appear in the eggshell 6. For the demonstration, compare the vinegar soaked eggshell with the eggshell that was not covered in vinegar NOTE: Vinegar is similar to the acid produced in the mouth after a meal is eaten, especially one high in sugar, and simulates what can happen to tooth enamel over time with regular consumption of foods high in sugar. 6 Display ‘Keep your teeth healthy’ flashcard Preventing tooth decay • • • • • • • • • Breastfeed your baby if possible. Breastfeeding is better for baby’s dental health than bottle feeding. Breast milk contains a substance that kills the bacteria which produce acid. Also breast milk does not coat the teeth like bottle feeding does as the milk is released at the back of the throat. If a baby falls asleep at the breast, the milk flow stops. Whereas if a bottle is in the mouth when the baby is asleep, it continues to drip into the mouth and coat the teeth Swap snacks high in added sugar for foods with no added sugar such as fresh fruit and vegetables. Eat a balanced diet consisting of plenty of whole grains, fruit, vegetables and dairy – Milk, cheese and yoghurt have a protective effect and stop the breakdown of enamel – Limit foods high in sugar – Limit sticky foods such as muesli bars and dried fruit If having sugary food and drinks, have them as part of a meal rather than on their own. This is because our mouth makes more saliva during a meal, and saliva helps to neutralise acid. For example have an orange juice with crackers and cheese rather than on its own Eat at set times rather than grazing. By eating at set times, teeth get a break from acid and bacteria attacks. These breaks help to replace minerals in teeth Drink plain tap water regularly throughout the day instead of acidic or sugary drinks such as soft drinks, cordial or juice Brush teeth morning and night to reduce the bacteria that cause plaque and remove any food pieces from the mouth; however don’t brush teeth straight away after having sugary or acidic food or drinks. Wait for half an hour to give your mouth time to produce enough saliva to neutralise some of the acid Spit toothpaste out, but do not rinse after brushing teeth. The fluoride in the toothpaste helps to strengthen the teeth. Have regular check-ups at the dentist. Everyone has different oral health needs and risk levels. Visit your dentist regularly and discuss how often you need to visit the dentist. Lift the lip. Once teeth have come through, lift your child’s top lip once a month to check for early signs of tooth decay. White lines along the gum line can be the beginning of tooth decay and should be checked out by a dentist Tap water Display ‘Tap water’ flashcard Why is water, especially tap water so important? • Water does not contain sugar and will not damage teeth like other high sugar or acidic drinks e.g. soft drink, juice and cordial • Plain tap water is a good drink to have after snacks as it contains added fluoride which helps to replace minerals in teeth and strengthen enamel • South Australian water has undergone an extensive treatment process and is safe to drink without further treatment or filtering (Government of South Australia, 2010). • Fluoridation of water has been researched extensively and is endorsed by national and international health organisations (Government of South Australia, 2010). • Fluoride is a natural mineral found in fish, tea and natural water sources. It is added to the water supply in very small amounts, at a level to protect teeth. The levels of fluoride are regularly checked to ensure they are at safe levels. • Drinking water can help flush away food or drink remaining in the mouth after eating/drinking – which means less opportunity for bacteria to produce acid • Tap water is also one of the cheapest drinks available HELPP Healthy Eating on a Plate Module 6 , November 2013 7 Snack Ideas Display ‘Snack ideas’ flashcard Examples of snacks suitable for children or adults that are ‘tooth-friendly’: • Dairy foods (milk, yoghurt, cheese): – Milk provides protection against tooth decay – The protein component (casein) coats teeth with a protective film and stops the loss of calcium and phosphorus from teeth, when exposed to acid – The phosphorus and calcium present in milk also protect tooth enamel by assisting with remineralisation (The Dairy Council, 2012) – Lactose, the natural sugar in milk, is the least damaging of all of the sugars – Cheese and yoghurt have the same protective qualities as milk. Cheese has the additional benefit of promoting the production of saliva, which assists in neutralising acid and washing away pieces of food – When selecting dairy products, choose those with reduced or no added sugar and reduced or low-fat varieties. • • • • • Fruit with skins are a good snack Hard fruit and vegetables such as Eggs and nuts are a snack full of protein and no sugar. Choose raw apple, carrot and celery should unsalted nuts. not be given to children under Fruit bread, although it is NOT an everyday food because it is sticky four years of age because of the and high in sugar - is still a better choice than lollies or chocolate. choking risk. Spread it with cream cheese or have it with a glass of milk and rinse with water afterwards Vegetable sticks and reduced-fat dip are a good choice, (tzatziki, hommus, eggplant) Tap water is a good drink to have after snacks as it contains added fluoride which helps to replace minerals in teeth and strengthen enamel. Recap of main points Display ‘Snack ideas’ flashcard • • • • • • • 8 Breastfeed your baby if possible Swap snacks high in added sugar for foods with no added sugar such as fresh fruit and vegetables. Eat plenty of fresh fruit, vegetables and whole grains and include reduced or low-fat dairy products Eat at set times. Grazing or eating often, means that teeth are always exposed to sugars. Teeth need a break from food and drink to replace minerals Drink plain tap water regularly throughout the day instead of acidic or sugary drinks such as soft drinks, juice and cordial. The fluoride in tap water helps to replace minerals in teeth Brush teeth after breakfast and before bed and visit the dentist regularly Spit toothpaste out, but don’t rinse Once teeth are through – lift the lip of children once a month to check for early warning signs of decay Distribute ‘Which is the better choice for your teeth?’ activity sheet to participants Give participants enough time to fill in the activity sheet and then go through the answers. Clarify any points and collect the sheets. Make a note of how many participants complete the activity sheet correctly. Group discussion Group discussion and evaluation What will you take away from the session today? Do you feel more confident about the ways in which you can prevent tooth decay, than you did before the session? • What changes, if any, do you plan to make as a result of todays’ session? Make notes of comments throughout the session and questions asked during completion of the activity sheets and during demonstration. An overall evaluation will be conducted at the end of all the sessions. • • Handout ‘Keep your teeth healthy’ Optional - order brochures translated in several languages from SA Dental Service http://www.sadental.sa.gov.au/desktopdefault.aspx?tabid=288 Some things to consider when presenting this module: Parents may not be aware that children up to 18 years of age are eligible to attend the School Dental Service. Refer them to www.sadental.sa.gov.au or call SA Dental Service 8222 8222 to find their local clinic. HELPP Healthy Eating on a Plate Module 6 , November 2013 9 Website resources Australian Dental Association Information for Parents http://www.dentalhealthweek.com.au/Parents/parents.htm The Australian Dental Association’s website has produced a number of resources in an easy to read style. Follow the links on the webpage for information on a range of subjects, including tooth friendly foods and drinks, tooth development and healthy eating South Australian Dental Service Health Promotion Resources http://www.sadental.sa.gov.au/DesktopDefault.aspx?tabid=27 This site has useful information on a number of topics including: • Information on the School Dental Service in South Australia • Resources for adults, children and teenagers • Resources translated into a number of different languages for download or order The Dairy Council Milk http://www.milk.co.uk/page.aspx?intPageID=96 This site provides a summary of the evidence that milk has a protective effect against tooth decay SA Health Preventing choking on food: Children under 4 years of age http://www.health.sa.gov.au/pehs/srer-award/Preventing%20Choking%20Fact%20sheet.pdf Children under 4 years of age are particularly vulnerable to choking. This factsheet, produced by SA Health provides useful information about modifying food for this age group to minimise the risk of choking SA Health Water and fluoride ‘Water quality fact sheet’ 2008 http://www.sa.gov.au/subject/Water%2C+energy+and+environment/Water/Rainwater+tanks/ Rainwater+testing The South Australian Department of Health has produced a fact sheet on rainwater tanks including the safety of rainwater for drinking and maintenance of rainwater tanks. 2010 ‘Water quality: fluoridation facts’ http://www.health.sa.gov.au/pehs/fluoridation-facts.htm A fact sheet produced by the South Australian Department of Health on the benefits of fluoridation. 10 Appendix A Resources HELPP Healthy Eating on a Plate Module 6 , November 2013 Module 6: Food and Your Teeth 11 12 OR OR OR tap water fresh fruit milk P a g e | 13 eating sticky foods at a main meal crackers OR OR between meals HELPP Healthy Eating Local Policies and Programs wholemeal crackers and cheese Which is the better choice for your teeth? Module 6: Food and Your Teeth, June 2013 bottled water dried fruit orange juice Resources for Module 6: Food and Your Teeth ANSWERS Which is the better choice f or your teeth? OR orange juice milk OR fresh fruit dried fruit Module 6: Food and Your Teeth, June 2013 Fresh fruit contains less concentrated sugar than dried fruit and is not sticky. Plain tap water contains fluoride which strengthens tooth enamel. Bottled water is unlikely to contain fluoride. OR bottled water Milk is the better choice for your teeth because it contains calcium and proteins that protect your teeth. The natural sugar in milk is also the least damaging to teeth of all the sugars. tap water HELPP Healthy Eating on a Plate Module 6 , November 2013 P a g e | 12 13 ANSWERS Which is the better choice for your teeth? OR between meals eating sticky foods at a main meal OR crackers wholemeal crackers & cheese This does not mean you have to eat cheese every time you eat a cracker, it’s about reducing damage to teeth : • The occasional cracker on its own is alight, however if this is something you eat on a regular basis: • Wholemeal is better than white • Having milk, cheese, yoghurt (or cheese or yoghurt based dip) with crackers is better than eating them on the own. Module 6: Food and Your Teeth, June 2013 14 At a main meal more saliva is produced. Saliva helps to neutralise acids produced from consuming sugary food and drinks. When crackers are eaten with cheese more saliva is produced which reduces acid production. Cheese also helps to reduce the loss of calcium and phosphorus from the teeth when exposed to acid. Wholemeal crackers are a better choice than white varieties because they are higher in fibre. Choose reduced-‐fat cheese, most of the time. 15 fruit vegetables forfor fruit andand vegetables for fruit and vegetables Page |6 Module 6: Food and Your Teeth, June 2013 Module 6: Food and Your Teeth, June 2013 have them as part ofon a tmeal meal ather than heir orather wn ratherrthan thanon on their own their own rather than on their own 4 sugary Have sugary food afoods nd das rinks as of a If having and Have foodssugary and drinks partdrinks, ofpaart meal Have sugary foods and drinks as part of a meal Swap snacks and drinks high in added sugar Swap snacks drinks in added sugar 4 Swap snacks andand drinks highhigh in added sugar P a g e | 14 P a g e | 14 once a month HELPP Healthy Eating Local Policies and Programs 4 Once teeth amonth re through -‐ lift the lip month Once teeth are through ‐ lift the lip once a ‐ lift the lip once a Once teeth are through 4 Have regular check-‐ups with the dentist Brush teeth after breakfast and before bed 4 Brush teeth after breakfast and abefore bed bed Brush teeth after breakfast nd before Don’t rinse after brushing 4 Don’t rinse afterafter brushing Don’t rinse brushing Have regular check‐ups with the dentist Have regular check‐ups with the dentist 4 Drink plenty of plain tap water Drink plenty of plain tap water Drink plenty of plain tap water Eat at set times rather than grazing 4 EatEat at set rather thanthan grazing at stimes et times rather grazing Keep your teeth healthy Keep your teeth healthy Keep your teeth healthy Breastfeed your baby if possible Breastfeed your baby possible 4 Breastfeed your ifbaby if possible Resources for Module 6: Food and Your Teeth Appendix B Script & flashcards HELPP Module 6: Telephone: +61 8 7421 9975 [email protected] Food and YourEmail: Teeth 16 17 Page |1 HELPP Healthy Eating Local Policies and Programs This page has been left intentionally blank Script for Module 6: Food and Your Teeth 18 The basic process of tooth decay Which food and drinks can cause tooth decay Which food and drinks are best for your teeth health How you can make simple changes to your eating habits to prevent tooth decay Healthy Eating Local Policies and Programs Module 6: Food and Your Teeth Building community capacity to promote healthy eating We can helpp Page |1 HELPP Healthy Eating Local Policies and Programs Good oral health is linked closely to overall general health and some of the same factors that influence general health also influence dental health. In addition, pain and discomfort can significantly impact on a person’s ability to socialise, eat, talk, sleep, work and go about their daily lives. We get two sets of teeth in our life‐time We get our baby teeth around six months old and start to lose them at around six years of age to make way for our adult teeth Approximately 50% of Australian children will have some form of tooth decay by six years of age It is important to care for the baby teeth as they are creating the spaces for the adult teeth When baby teeth fall out ‐ the spaces that are left behind are filled by the adult teeth. If the baby teeth are lost before they are supposed to be ‐ there may not be enough space for the adult teeth to come through and this may cause over‐crowding of teeth An overcrowded mouth can make it difficult to clean teeth properly and this can lead to an increase in the risk of tooth decay in adult teeth Today we are going to be talking about how food and drinks affect teeth. We’ll be looking at: Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth 19 Script for Module 6: Food and Your Teeth Module 6: Food and Your Teeth Building community capacity to promote healthy eating Healthy Eating Local Policies and Programs We can helpp HELPP Healthy Eating Local Policies and Programs 20 It is important to realise that most tooth decay is preventable! Saliva and fluoride (in toothpaste and tap water) can help to neutralise acid‐forming bacteria. forming in the tooth which may be painful (but not always). HELPP Healthy Eating Local Policies and Programs time the acid may cause the top layer of the tooth (the enamel) to gradually become weak. This can lead to holes Some bacteria are able to covert sugar to acid. If this acid is left on the tooth surface for a long enough period of Plaque is a sticky colourless film. Bacteria (or germs) live in the mouth and collect around the base of the gums in a substance called plaque. It happens gradually and can occur in either baby teeth or adult teeth What is tooth decay? Tooth decay is the damage of tooth enamel Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth 21 What is tooth decay? bacteria in + the mouth + acid HELPP Healthy Eating Local Policies and Programs attacks teeth It is important to remember that tooth decay is preventable! sugary food and drinks Tooth decay is the damage of tooth enamel. What is tooth decay? Tooth decay is the damage of tooth enamel. Script for Module 6: Food and Your Teeth 22 Demonstration – Simulation of tooth decay Page |3 HELPP Healthy Eating Local Policies and Programs Half of an eggshell has been soaking in vinegar for 2 days The other half has not been soaking in vinegar Vinegar is similar to the acid produced in the mouth after a meal is eaten, especially one high in sugar. You will notice that the shell that was soaking in vinegar is discoloured and weaker than the other shell. This simulates what can happen to tooth enamel when we constantly have food and drinks high in sugar. Demonstrate a simulation of tooth decay 5. After two days holes should start to appear in the eggshell 6. For the demonstrations, compare the vinegar soaked eggshell with the eggshell that was not covered in vinegar. There are certain foods and drinks that can cause tooth decay, including: o Food and drinks that are high in added sugar such as lollies, cake, ice How to prepare tooth decay representation cream and soft drinks o Drinks that are acidic such as fruit juice, soft drinks, sports drinks and Equipment 1 egg energy drinks. These include so‐called ‘diet’ soft drinks. 1 cup of white vinegar o Acidic drinks cause erosion which is different to the decay caused 1 clear jar with a lid by sugary drinks. Sugary soft drinks can also be acidic. This includes Permanent texta drinks that contain phosphoric acid, citric acid or tartaric acid (at Method 1. Crack an eggshell in half least one of these ingredients is in most soft drinks, including ‘diet’ 2. Place one half of the shell in a clear jar and pour soft drinks) vinegar over the top of the shell until at least o Sticky foods, such as dried fruit are more likely to stick to the surface of half of the eggshell is covered 3. Clean and dry the other half of the egg shell and the teeth put aside o Allowing the teeth to be constantly coated with food or drink is also a 4. Place a lid on the jar and label the jar with the problem, such as when a child takes a bottle of drink to bed (including date milk) and is allowed to fall asleep whilst sucking on the bottle. Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth 23 Page |4 Honey Food and drinks that can cause tooth decay Script for Module 6: Food and Your Teeth HELPP Healthy Eating Local Policies and Programs 24 Page |4 HELPP Healthy Eating Local Policies and Programs o Strength of tooth enamel The strength of tooth enamel is an important factor in the rate of tooth decay. The weaker the tooth enamel, the faster the rate of decay. Soft drinks (even ‘diet’ soft drinks) contain acid which can cause damage to tooth enamel. o Type of food or drink The type of food and drink eaten is really important for the development of tooth decay. Food and drinks high in sugar such as confectionery, soft drinks and biscuits are broken down fast in the mouth and attract acid‐causing bacteria. o Time The longer the teeth are exposed to sugars the greater the opportunity to convert the sugar into acid, which then attacks tooth enamel. For example, sucking on a lollipop means that sugar remains in the mouth for a long period of time. o Frequency (how many times you eat over the day) The greater the number of meals over the day, the more times teeth are exposed to acid, particularly if meals are high in sugar. The more times teeth are exposed to this process over a day, the more likely it is that tooth decay will develop. o Bacteria The number of bacteria in the mouth varies between people, however regular brushing (after breakfast and before bed) is an important process which helps to remove bacteria which produce acid. Bacteria in the mouth use sugar to produce acid. The acid and the sugar stick to the teeth and begin to dissolve the top layer of the teeth (known as the tooth enamel). This happens for up to 30 minutes after eating. However, certain things can speed up the rate of tooth decay, these include: Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth 25 Page |5 2. Type of food or drink 4. How many times you eat or drink over the day 1. Bacteria and teeth 3. Time 5. Strength of tooth Factors that increase the risk of tooth decay Script for Module 6: Food and Your Teeth HELPP Healthy Eating Local Policies and Programs 26 Page |5 HELPP Healthy Eating Local Policies and Programs Lift the lip. Once teeth have come through, lift your child’s top lip once a month to check for early signs of tooth decay. White lines along the gum line can be the beginning of tooth decay and should be checked out by a dentist Script for Module 6: Food and Your Teeth Spit the toothpaste out, but do not rinse as the fluoride in the toothpaste will help to strengthen the teeth Brush teeth in the morning after breakfast and at night before bed to reduce the bacteria that cause plaque and remove any food residue from the mouth and have regular check‐ups with the dentist. Drink plain tap water regularly throughout the day instead of acidic drinks such as soft drinks, juice and cordial Eat at set times rather than grazing. By eating at set times, teeth get a break from acid and bacteria attacks. These breaks help to put minerals back into the teeth Have sugary food and drinks as part of a meal rather than on their own. This is because our mouth makes more saliva during a meal, and saliva helps to neutralise acid Swap snacks high in added sugar for foods with no added sugar such as fresh fruit and vegetables. Eat a balanced diet containing plenty of fresh fruit, vegetables and whole grains. Also include reduced or low‐fat dairy products Breastfeed your baby where possible. Breastfeeding is better for the baby’s dental health than bottle fee ding. Breast milk contains a substance that kills the bacteria which produce acid. Also breast milk does not coat the teeth like bottle feeding does as the milk is released at the back of the throat. If a baby falls asleep at the breast, the milk flow stops. Whereas if a bottle is in the mouth when the baby is asleep, it continues to drip into the mouth and coat the teeth There are some simple things that you can do to keep your teeth healthy: Script Script for Module 6: Food and Your Teeth for Module 6: Food and Your Teeth 27 for fruit and vegetables for fruit and vegetables for fruit and vegetables Page |6 Module 6: Food and Your Teeth, June 2013 Module 6: Food and Your Teeth, June 2013 havemeal themrather as part of aon meal rather than their own rather than on their own than on their own rather than on their own 4IfHave sugary food and and drinks as part of a having sugary foods drinks, Have sugary foods and drinks as part of a meal Have sugary foods and drinks as part of a meal P a g e | 14 P a g e | 14 once a month HELPP Healthy Eating Local Policies and Programs 4 Once teeth amonth re through -‐ lift the lip month Once teeth are through ‐ lift the lip once a Once teeth are through ‐ lift the lip once a 4 Have regular check-‐ups with the dentist Brush teeth after breakfast and before bed 4 Brush teeth after breakfast and before bed Brush teeth after breakfast and before bbed ed Don’t rinse after brushing 4 Don’t rinse after brushing Don’t rinse after brushing Have regular check‐ups with the dentist Have regular check‐ups with the dentist Drink plenty of plain tap water 4 Drink plenty of plain tap water Drink plenty of plain tap water Eat at set times rather than grazing 4 Eat at set times rather than grazing Eat at set times rather than grazing Keep your teeth healthy Breastfeed your baby if possible Breastfeed your baby if possible 4 Breastfeed your baby if possible Keep your teeth healthy Keep your teeth healthy Swap snacks and drinks high in added sugar 4 Swap snacks and drinks high in added sugar Swap snacks and drinks high in added sugar Script for Module 6: Food and Your Teeth 28 Tap water is also one of the cheapest drinks available! South Australian tap water has been treated and is safe to drink without further treatment or filtering means less opportunity for the bacteria to produce acid HELPP Healthy Eating Local Policies and Programs Drinking plain tap water can help flush away food or drink remaining in the mouth after eating or drinking – which The levels of fluoride are regularly checked to ensure they are safe Plain tap water is a good drink to have after snacks as it contains added fluoride which helps to put minerals back into teeth and strengthen enamel Fluoride occurs naturally and is also added to the water supply in very small amounts, at a level to protect teeth. and cordial Why is water, especially tap water so important? Plain tap water does not contain sugar and will not damage teeth like other drinks e.g. soft drink, juice Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth 29 Page |7 Page |7 Tap water no sugar safe to drink contains fluoride no sugar flushes mouth of food and drink safe to drink low cost contains fluoride flushes mouth of food and drink low cost Script for Module 6: Food and Your Teeth HELPP Healthy Eating Local Policies and Programs 30 Healthy Eating Local Page |7 Policies and Programs It is important to note that hard fruit and vegetables such as raw apple, carrot and celery should not be given to children under four years of age because of the risk of choking Page |7 Page |7 Fruit although itsnack. is NOT everyday food because it is sticky and has sugar sugar ‐ is still better choicechoice Fruit bread, although it is NOT an everyday food because it is sticky and has added sugar ‐ is still a better choice bread, Fruit although itUnsalted is an NOT an everyday foodand because it is sticky andadded has added ‐ isa still a better Fruit with skinsbread, are a good pumpkin seeds roasted chickpeas. or Spread itsugar. with cheese or have it with glass of milk rinse your mouth with with than than lollies or chocolate. Spread with cream cheese or cheese have it orwith a glass of amilk and rinse your rinse mouth with than lollies chocolate. Spread it cream with cream have it awith glass of and milk and your mouth Eggs are alollies snack fullchocolate. oforprotein andit no water afterwards water afterwards water afterwards Fruit bread, although it is NOT an everyday food because it is sticky and has added sugar ‐ is still a better choice Vegetable and reduced‐fat dip cream are a good (tzatziki, hommus, or sushi rolls Vegetable sticks and reduced‐fat dip are a good choice (tzatziki, hommus, eggplant) or sushi rolls Vegetable sticks and reduced‐fat dip are a choice good eggplant) or sushi than lollies or sticks chocolate. 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Vegetable sticks reduced‐fat dip are a good choice (tzatziki, hommus, eggplant) or sushi rolls It is important to notetothat hard fruit and vegetables such assuch rawasapple, carrot carrot and celery shouldshould not be given children under under It is important to note that hard fruit and vegetables such as raw apple, carrot and celery should not be given to children under It is important note that hard fruit and vegetables raw apple, and helps celery be to given to into children Tap water is a good drink to have after snacks as it contains added fluoride which to put not minerals back four years ageof because of the of riskthe ofrisk choking four years of age because of the risk of choking four of years age because of choking the teeth and strengthen enamel. HELPP Note: Reduced or low fatlow dairy notare suitable for children under under 2 years2 of age.of age. Note: Reduced or low fat dairy foods are not suitable for children under 2 years of age. Note: Reduced fatfoods dairy are foods not suitable for children years When selecting or dairy products, choose those with reduced or no added sugar – and look for reduced or low‐fat Plant‐based drinks drinks such assuch rice,asoat, or almond drinks drinks are notare suitable substitutes for breast milk ormilk formula in the in the Plant‐based drinks such as rice, oat, coconut or almond drinks are not suitable substitutes for breast milk or formula in the Plant‐based rice,coconut oat, coconut or almond not suitable substitutes for breast or formula varieties. first 12first months – as they proteinprotein for infants first 12 months – as they lack sufficient protein for infants 12 months – aslack theysufficient lack sufficient for infants Note: Reduced or low fat dairy foods are not suitable for children under 2 years of age. Fruit with skins are a good snack. Unsalted pumpkin seedsseeds and roasted chickpeas. Fruit with skins are a good snack. 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Dairy foods (milk, yoghurt, cheese): Dairy foods (milk, yoghurt, cheese): Script for Module and foods Your Teeth 6: Food Dairy (milk, yoghurt, cheese): forScript Module 6: Food and Yourand Teeth Script for Module 6: Food and Your Teeth Script forScript Module 6:for Food and Your Teeth Module 6: Food Your Teeth 31 Page |8 Script for Module 6: Food and Your Teeth Snack Ideas HELPP Healthy Eating Local Policies and Programs 32 Before we finish today I have an activity sheet for everyone to fill out ‐ but before we do that let’s quickly remember the key things we need to do to keep our teeth healthy: Breastfeed your baby where possible Swap snacks high in added sugar for those with no added sugar like fruit and vegetables If you choose to have sugary food and drinks – have them as part of a meal rather than on their own Eat at set times during the day rather than grazing Drink plain tap water Brush teeth after breakfast and before bed, and go for regular check‐ups with the dentist Spit the toothpaste out, but don’t rinse Lift the lip of children once a month to check for early signs of tooth decay Script for Module 6: Food and Your Teeth Script for Module 6: Food and Your Teeth HELPP Healthy Eating Local Policies and Programs 33 fruit vegetables forfor fruit andand vegetables for fruit and vegetables Page |6 Module 6: Food and Your Teeth, June 2013 Module 6: Food and Your Teeth, June 2013 have them as part ofoan meal meal rather than their rather own rather than on their own than on their own rather than on their own 4 sugary Have sugary food and dand rinks as of a If having sugary foods drinks, Have foods and drinks as part ofpaart meal Have sugary foods and drinks as part of a meal Swap snacks and drinks high in added sugar Swap snacks drinks in added sugar 4 Swap snacks andand drinks highhigh in added sugar P a g e | 14 P a g e | 14 once a month HELPP Healthy Eating Local Policies and Programs 4 Once teeth amonth re through -‐ lift the lip month Once teeth are through ‐ lift the lip once a ‐ lift the lip once a Once teeth are through 4 Have regular check-‐ups with the dentist Brush teeth after breakfast and before bed 4 Brush teeth after breakfast and abefore bed bed Brush teeth after breakfast nd before Don’t rinse after brushing 4 Don’t rinse afterafter brushing Don’t rinse brushing Have regular check‐ups with the dentist Have regular check‐ups with the dentist 4 Drink plenty of plain tap water Drink plenty of plain tap water Drink plenty of plain tap water Eat at set times rather than grazing 4 EatEat at set rather thanthan grazing at stimes et times rather grazing Keep your teeth healthy Keep your teeth healthy Keep your teeth healthy Breastfeed your baby if possible Breastfeed your baby possible 4 Breastfeed your ifbaby if possible Script for Module 6: Food and Your Teeth Script forfor Module Food Script Module 66: : Food and and Your Your Teeth Teeth Policies and Programs than lollies or chocolate. Spread it with cream cheese or have it with a glass of milk and rinse your mouth with t is important to note that hard fruit and vegetables such as raw apple, carrot and celery should not be given to children under Page |9 Fruit bread, although it is NOT an everyday food because it is sticky and has added sugar ‐ is still a better choice our years of age because of the risk of choking Dairy foods (milk, yoghurt, cheese): Explain to activity to participants Milk provides protection against tooth decay ß There are pairs of food The protein in milk (casein) coats teeth with a protective film and stops the loss of two and drink choices. Put a important minerals (calcium and phosphorus) from teeth, when teeth are exposed to acid circle around the one in cript for Module 6: Food and Your Teeth Lactose ‐ the natural sugar in milk, is the least damaging of all of the sugars each pair that you think is a hat are some healthy snack options for children and adults that are ‘tooth‐friendly’? Cheese and yoghurt have the same protective qualities as milk. Cheese has the additional benefit of promoting better choice for your Dairy foods (milk, yoghurt, cheese): the production of saliva, which assists in neutralising acid and washing away pieces of food teeth Milk provides protection against tooth decay When selecting dairy products, choose those with reduced or no added sugar – and look for reduced or low‐fat ß Give participants about 3 coats teeth with a protective film and stops the loss of two The protein in milk (casein) varieties. minutes to complete the ote: Reduced or low fat dairy foods are not suitable for children under 2 years of age. important minerals (calcium and phosphorus) from teeth, when teeth are exposed to acid Plant‐based drinks such as rice, oat, coconut or almond drinks are not suitable substitutes for breast milk or formula in the activity and then discuss Lactose ‐ the natural sugar in milk, is the least damaging of all of the sugars first 12 months – as they lack sufficient protein for infants the answers as a group (as Cheese and yoghurt have the same protective qualities as milk. Cheese has the additional benefit of promoting Fruit with skins are a good snack. Unsalted pumpkin seeds and roasted chickpeas. discussion per aGroup nswer sheets) the production of saliva, which assists in neutralising acid and washing away pieces of food Eggs are a snack full of protein and no sugar. What will you t‘ake away ß Give participants Keep your from the session? When selecting dairy products, choose those with reduced or no added sugar – and look for reduced or low‐fat Fruit bread, although it is NOT an everyday food because it is sticky and has added sugar ‐ is still a better choice healthy’ handout teeth varieties. Do you feel more Spread confident bout cream the ways in which ou can revent than lollies or chocolate. it awith cheese or yhave it pwith a glass of milk and rinse your mouth with ote: Reduced or low fat dairy foods are not suitable for children under 2 years of age. decay, than you did before the session? tooth water afterwards Plant‐based drinks such as rice, oat, coconut or almond drinks are not suitable substitutes for breast milk or formula in the Vegetable sticks and reduced‐fat dip are a good choice (tzatziki, hommus, eggplant) or sushi rolls What changes, if any, do you plan to make as a result of todays’ session? first 12 months – as they lack sufficient protein for infants Tap water is a good drink to have after snacks as it contains added fluoride which helps to put minerals back into Fruit with skins are a good snack. Unsalted pumpkin seeds and roasted chickpeas. Give participants ‘Keep your teeth healthy’ handout HELPP Healthy Eating Local the teeth and strengthen enamel. Eggs are a snack full of protein and no sugar. Distribute the ‘Which is the cript for Module 6: Food and Your Teeth better choice for your teeth’ activity sheet to participants hat are some healthy snack options for children and adults that are ‘tooth‐friendly’? 34 35 bottled water dried fruit orange juice OR OR OR fresh fruit milk crackers OR OR eating sticky foods at a main meal Which is the better choice for your teeth? tap water Script for Module 6: Food and Your Teeth HELPP Healthy Eating Local Policies and Programs wholemeal crackers & cheese between meals 36 P a g e | 1 This page has been left intentionally blank Script for Module &OODAND9OUR4EETH HELPP Healthy Eating Local Policies and Programs 37 HELPP Healthy Eating Local Policies and Programs HELPP Healthy Eating Local Policies and Programs Developed by Health Eating Local Policies and Programs (HELPP) Funded by SA Health and managed by Nutrition & Dietetics, Flinders University Contact: Food Safety and Nutrition Branch, SA Health Telephone: (08) 8226 7100 Nutrition & Dietetics, Flinders University Telephone: (08) 8204 4715 38