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Tricky decisions at Halloween

What do you think of when you hear the word “Halloween”? My guess would be bright orange pumpkins and children dressed as witches or ghosts out doing “trick or treat”. It may be an American construct, but Halloween becomes more popular every year and shops seem to start stocking costumes, pumpkins and treats the minute the children go back to school after the summer holidays.

As a dentist, the things I associate with Halloween are all teeth related. I can see the snaggle-toothed smile of the carved pumpkin with crooked teeth and gaps a plenty. And the pile of sweet treats  crammed into plastic buckets triumphantly carried home after a successful evening’s “trick or treating” – not to mention those consumed on the way, to keep flagging spirits up – all point towards future tooth problems.

We all know that sweets are bad for our teeth and can lead to tooth decay – as well as obesity which can lead to Type 2 diabetes and a whole host of other problems – but at a time like Halloween when sweet treats appear to be everywhere it can be hard to put that knowledge into practice.

Therefore, I have come up with three useful strategies for parents, carers, grandparents and householders besieged by small ghosts, zombies and witches carrying plastic buckets; avoid, substitute and manage. I will look at each in turn.

If you can avoid giving away sweet treats then this is the best plan. It can, however, be difficult to think of an alternative that is both appealing (to avoid being tricked) and practical. One way is to leave the house lights off and sit in darkness until the witching hour has past, but I’m assuming a more generous nature. I can recommend that apples go down well, especially if you can find some nice shiny red ones. Satsumas can also work, even though they have more yuletide connotations. One memorable year I had a stash of small toothpaste samples I had been given. Whilst these may have gone down well with the parents, the doorstep faces told a different story.

If you can’t avoid sugar altogether due to being overruled by your own offspring, who may say that fruit and toothpaste will heap everlasting embarrassment on them and most likely ruin their lives – you need to look at substituting it for a least damaging option.

Here comes the science bit… Teeth start to decay when the hard enamel coating is dissolved by acid in the mouth. Sugar is converted into acid by bacteria in the plaque on teeth and the dissolution carries on for about 20 minutes after the last bit of sugar is eaten. So the longer the sugar is in the mouth the more dissolving takes place and the weaker the enamel becomes. This means that the worst types of sweet are those that can be sucked for a long time (like lollipops for example) or chewy sticky sweets (such as toffees or jelly sweets). The best time to eat sweet things is as part of a meal, so that the acid is buffered by other foods. So if you have to give something sweet, then go with something that will be quickly eaten and avoid lollipops or chewy sweets. Chocolate, homemade biscuits or cake might work. With homemade offerings at least you know what the ingredients are and can look for something without too much sugar. There are some clever low sugar recipes out there.

And finally, when your child comes home with that bulging bag of sweets, how do you manage this? You could follow the example of a friend of mine who confiscated them all and nobly ate them herself, but this is not recommended for a tranquil home life. So, set some rules that they can eat a certain amount that evening and then the rest go into a treat jar and are eaten as the pudding or sweet part of a meal. You may wish to have this discussion before the event, so that it is anticipated and the youngsters have a chance to get used to the idea. Remember to ensure teeth are brushed for two minutes that night (and every night and morning) with fluoride toothpaste and spit rather than rinsing all that lovely protective fluoride down the plughole. And if you are worried about your children’s teeth at all, make an appointment with your dentist so that any problems can be picked up early.

Then breathe a sigh of relief when it’s over and try to forget that Christmas is under two months away….

Janet Clarke

Janet Clarke qualified in the 1980s from Birmingham University and went on to work in general practice, but primarily the community dental service in and around Birmingham. She has significant involvement with the British Dental Association, firstly as Chair of the Central Committee for Community and Public Health Dentistry and then as BDA President in 2011. She was a member of the Steele Review team in 2008 and led the production of the Commissioning Guide for Special Care Dentistry that was published in 2015. She is currently Deputy Chief Dental Officer for England, chairs the Local Professional Network for dentistry in the West Midlands and was awarded an MBE for services to dentistry in 2010.

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