Tooth Decay and Teaching Kids Dental Hygiene

What are the causes of tooth decay and how can it be prevented? The experts from Punch & Judy explain why this is so significant for children

What are the causes of tooth decay in children?

Many of us in society do not realise that tooth decay is the world’s most common disease with 60-90% of school children worldwide having experienced dental cavities.1,2

Our teeth are coated with plaque, which is a sticky layer of bacteria. When this bacteria comes into contact with sugar, they produce acid which slowly starts to dissolve the protective enamel of our teeth away, which can cause cavities.3

The most common factors for tooth decay in children include the following: 3

  • Frequent daily sugar intake (food, drink, medicine)
  • Snacking between meals. These bacteria acids can attack teeth for up to an hour after eating.
  • Oral intake of sugar-containing food, drinks or medication last thing at night
  • Not brushing twice each day with fluoride toothpaste (morning and night)
  • Bottle feeding for a prolonged time (especially overnight)
  • Not visiting the dentist for regular check-ups

When should we start brushing children’s teeth?

We advise that children should start brushing their teeth as soon as the first milk tooth breaks through (usually at around 6 months, but it can be earlier or later).

A previous clinical study conducted concludes that the younger children are when they start brushing their teeth, the lower the proportion that will have tooth decay. 88% of children who started toothbrushing before the age of one year, remained free of dental caries.4

What is the best method to use?

We recommend these 5 easy steps for the best way to brush your children’s teeth:

  • Always apply the correct amount of toothpaste (as per NHS and British Society of Paediatric Dentistry {BSPD} guidelines):5,6,7
    • A smear (approximately 0.1ml) for children up to 3 years old
    • A pea-sized amount (0.25ml) for children 3 years and over
  • Angle the toothbrush at 45º and the bristles should be facing towards the gums of the upper or lower teeth
  • Using small circular motions, brush all sides of each tooth and the gums. Brush backwards and forwards on all chewing surfaces. Brush for 2 minutes.
  • Spit out after brushing and don’t rinse – if you rinse, the fluoride won’t work as well.
  • Avoid giving your child sugary foods or drinks. Don’t give your child a bottle of breastmilk or formula when they go to bed. Always take away bottles after feeding.

There is no evidence to show that powered toothbrushes are more effective than manual toothbrushes in preventing dental caries in children. Children’s teeth can be brushed with either manual or powered toothbrushes as an effective means of administering fluoride.7

What sort of toothpaste is best for children?

Both the NHS and BSPD guidelines state that children should use a children’s fluoride toothpaste containing no less than 1,000ppm of fluoride (check label) to protect the enamel and prevent dental caries:

  • under 3 years: Toothpaste that contains a minimum of 1000ppm fluoride
  • 3 to 6 years: Toothpaste between 1000ppm – 1450ppm of fluoride as standard prevention
  • over 6 years: Toothpaste with 1450ppm fluoride.

Please consult your dentist if your child is at risk of developing caries and may require Enhanced Prevention.

What’s different about Punch & Judy’s Trainer Toothpaste?

Punch & Judy Trainer toothpaste is formulated to contain 1000ppm of fluoride, as per NHS and BSPD guidelines. Its great sugar-free Strawberry flavour will help you win the brush-time battle.

What’s the fluoride content of Punch & Judy toothpaste?

The Punch & Judy Trainer and Natural Toothpastes all contain 1000ppm and can be used as standard prevention in children from the development of their first milk teeth until 6 years of age.

The Original Punch & Judy Toothpastes give added protection as they contain 1400ppm and are recommended for use in children over the age of 3 years.

What flavours are available in Punch & Judy toothpaste?

Punch & Judy Toothpastes are available in the following amazing flavours:


Baby Strawberry (0-2 Years)

Simply Strawberry (3+ Years)

Hint of Mint (3+ Years)

Fun Bubblegum (3+ Years)


Natural Strawberry (6+ Months)

Mild Mint (6+ Months)

How long does Punch & Judy toothpaste last after opening?

Punch & Judy can last for up to 12 months after opening.

What’s the story behind Punch & Judy products?

Choosing the right toothpaste for kids comes from understanding the science behind it. When we are born, we have 30,000 tastebuds spread all around our mouth, however by the time we reach adulthood we only have 10,000 (mainly concentrated on our tongues). So kids are SUPERTASTERS.

They experience flavours more intensely than adults with a preference for sweet flavours – not because they like sugar particularly but because good things, like mother’s milk, are sweet and most toxic foods are bitter. So being ultra-sensitive to bitter tastes is nature’s way of stopping kids from consuming something that is likely to be poisonous.


Punch & Judy toothpaste was launched in the 1950s in Hull in the UK, as an alternative to strong mint toothpastes, recognising that kids needed a milder flavoured toothpaste which was gentler on their super sensitive palates.

It’s aim was to be “The Children’s Toothpaste” and was one of the first to offer a flavoured (Raspberry) and SUGAR FREE alternative.

Kids don’t like the harsh/bitter flavour of mint and so when it comes to trying to get them to brush their teeth it can turn into a battleground.

Recent surveys have suggested that 35% of the Mums who were questioned said they were having difficulty getting their Little Ones to brush their teeth; ranking in difficulty close to getting them to eat their vegetables and getting them to go to bed!8

95% of Mums who chose Punch & Judy and who reviewed the product, reported that their Little Ones loved the taste thus changing the brush time battle into fun time.9

Our philosophy has not changed. Punch & Judy is still “The Children’s Toothpaste” because no other UK kid’s toothpaste brand has more experience and understanding of kids and what they need.

Where can I find out more about Punch & Judy?

You can find out more about how the history and philosophy of Punch & Judy, access some of our fun bedtime stories and product information on:


  1. Kassebaum NJ, Bernabe E, Dahiya M, Bhandari B, Murray CJ, Marcenes W. Global burden of untreated caries: a systematic review and metaregression. Journal of Dental Research. 2015;94:650-658.
  2. Marcenes W, Kassebaum NJ, Bernabe E, et al. Global burden of oral conditions in 1990-2010: a systematic analysis. Journal of Dental Research. 2013;92:592-597.
  3. Tooth Decay Guidelines compiled by The Child and Family Information Group for Great Ormond Street Hospital for Children. Accessed: 10 March 2023.
  4. Hinds k, Gregory JR. National diet and nutrition survey: children aged 1.5 to 4.5 years. volume 2: Report of the dental survey. London: HMSO; 1995.
  5. Children’s teeth. Accessed 10 March 2023.
  6. Prevention and Management of Dental Caries in Children. Dental Clinical Guidance Second Edition. Scottish Dental Clinical Effectiveness Programme. May 2018.
  7. Dental interventions to prevent caries in children. A national clinical guideline. Healthcare Improvement Scotland. March 2014.
  8. Source: 1,150 mums with kids 2-12yrs old: Toluna Quicksurvey Online Feb 2017.
  9. Source: 64 Amazon reviews who expressed a taste preference.

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