ROTTEN TRUTH

About those ‘healthy’ dried fruit snacks

There is no ice cream or cake after dinner in Zofeen Tiwari’s home. even fruit and yoghurt are served in moderation. That’s because Zofeen’s nineyearold daughter Sienna has fillings in all her milk molars.

But Sienna never ate sweets or chocolate — except at the odd children’s party. Instead, her mother believes her tooth decay was caused by a seemingly healthy diet of fruit, raisins and cereal, which can deceptively be packed with sugar.

The problems with Sienna’s teeth began when she started school aged four, says the chartered accountant, of Kinoulton, Nottinghamshire, who also has two younger daughters, Priya, five, and eight-month-old Sophia.

‘I looked in Sienna’s mouth one day and saw one of her molars looked as if someone had taken a scoop out of it. Literally, a chunk was missing.’

Zofeen, 39, and her husband Shikhar, an electrical design engineer, 37, took Sienna to an emergency dentist who said the molar was severely decayed and needed filling.

‘he asked about her diet and whether she regularly ate sweets and I said no,’ says Zofeen. ‘We never had food like that in the house. Pudding would be a piece of fruit and Sienna loved her dried fruits.’

But her dentist told Zofeen this dried fruit still contained a lot of sugar. ‘We stopped the dried fruit straight away but it was too late for her other teeth,’ she says. ‘I was very upset that our daughter had such bad tooth decay.’

Many busy parents buy dried fruit, or fruit-based processed snacks thinking they are healthier for their children, but hidden sugars in these ‘healthy’ foods can be just as damaging to teeth as sweets and fizzy drinks, says Professor Damien Walmsley, scientific advisor to the British Dental Association.

‘Sugar is sugar whatever the source,’ he says. ‘Parents know they should limit food and drink that contains sugar, but they often aren’t aware that this includes ones that are said to be healthier, such as dried fruit.

‘Lots of the “squeezy” pouches dubbed as “no added sugar” or “full of veg” are mainly puréed fruit, and are in fact full of free sugars released when the fruit or veg is blended. Snacking on these increases the risk of tooth decay.’ AND

tooth decay among children remains a ‘significant public health issue’, he says — last year the removal of decayed teeth was the number one reason children were admitted to hospital.

Last week senior dentists said schools should ban sugar to tackle ‘incredibly worrying’ levels of child tooth decay, after a report by the Faculty of Dental Surgery — part of the royal College of Surgeons — revealed more than 100,000 children under ten were admitted to hospital because of tooth decay between April 2015 and March 2018.

‘We cannot be complacent,’ says Professor Walmsley. ‘More than 38,000 children were admitted to have multiple teeth extracted under general anaesthetic in 2017/18. Quite apart from the cost to families of time off work and school, this cost the NHS £32 million.’

he says food manufacturers need to stop making misleading claims about fruit-based snacks that contain far more sugar than fresh fruit. Dr Nigel Carter, chief executive officer of the charity the Oral health Foundation agrees.

‘Dried fruits are frequently advertised as a healthy snack, but the negative impact they may have on our oral health often goes under the radar,’ he says.

‘Another good example is cereal bars, many of which use sugar-filled ingredients such as honey or golden syrup, while others contain dried fruits, too.

‘Tighter regulations need to be put in place for products like these marketed as “no added sugar”. This claim suggests to consumers that they are buying a “healthy” option, which can be misleading as many of these products still contain large amounts of natural sugar. ‘In the UK, our children are being exposed to far too much sugar. The consequences are tooth decay, fillings, and in the worst cases, extractions.’

Shockingly, nine out of ten tooth extractions among children under five are due to preventable tooth decay, adds helene Schirmer, a dental therapist at happy Kids Dental, a paediatric dental surgery in London.

‘When a child eats or drinks food containing sugars, the bacteria in plaque feed on it and produce acids that attack tooth enamel,’ she explains. ‘The stickiness of the plaque keeps these acids in contact with the teeth and over time the surface of the tooth can break down and turn into a cavity.

‘Children eating sugary snacks are even more at risk than adults as milk teeth are more vulnerable to decay. ‘The protective layer on milk teeth is thinner and the pulp chamber, the inner part of the tooth, is very close to the surface.

‘This means they are more vulnerable to decay and cavities develop faster. And if a milk tooth develops an infection it can spread to the developing adult teeth underneath. Also if the milk tooth is lost to decay, the other teeth can move into that space resulting in crowded teeth.’

The first visible stage of decay is the development of a white spot on the enamel surface. This is where the surface has become demineralised by the bacteria in plaque-producing acids that attack tooth enamel.

Children may complain about pain in their teeth or about sensitivity to certain foods such as hot and cold drinks, as Clare O’reilly discovered when her son Sammy developed his first rotten tooth aged five, despite a ‘healthy’ diet. ‘he was rolling around screaming: “My mouth, Mummy!” ’ recalls Clare, 40, a writer from South hams, Devon.

She and husband Jon, 46, also a writer, took Sammy to a dentist who diagnosed an abscess caused by tooth decay — bacteria can penetrate decayed teeth, leading to an infection.

Sammy needed the tooth removed there and then. ‘I was so shocked,’ says Clare. ‘Sammy saw the dentist regularly, never had sweets — but he did like snacks such as raisins.’

The dentist told Clare the high amount of sugar in raisins could have caused the decay. ‘ Weeks later Sammy had another decayed tooth removed,’ says Clare. ‘This time he needed surgery under general anaesthetic. I felt terrible.’ NOW

Sammy is ten and Clare says he’s dedicated to his oral health. ‘ he brushes religiously twice a day,’ she says. ‘ he can clearly remember the trauma of the general anaesthetic as well as the needle and the pain and is keen to avoid that.’

Many parents might feel that brushing the child’s teeth more often might help, but helene Schirmer says this is not true. ‘eating and drinking foods containing sugar and acids naturally weakens the enamel on the teeth,’ she says.

‘Brushing straight afterwards can cause tiny particles of enamel to be brushed away, damaging the tooth’s surface. Ideally it is best not to brush a child’s teeth until at least 30 minutes after eating.’

But another factor in children’s tooth decay is our snacking culture. Two generations ago, children stuck to three meals a day.

‘It is better for your teeth and general health if you eat three balanced meals a day instead of seven to ten snacks,’ says helene Schirmer.

Zofeen has stopped her children eating dried fruit entirely, only allowing fresh fruit and wholegrain, sugar-free cereals. And since 2014 when the decay was first discovered, Sienna has gone to her dentist every three months for fluoride paste to be painted on her teeth.

In a warning to other families, she adds: ‘We’re proof that you can be a “good” parent feeding children a “good” diet and they can still get terrible tooth decay.’