Juice, Milk at Night and Sweet Drinks

By Dr. Mohsen Alozaibi, Tiny Teeth Dental Center, Abu Dhabi

"But it's 100% natural juice!" Many parents are surprised to learn that drinks, not just sweets, are one of the most common causes of cavities in young children. The reason is less about the drink itself and more about how often and when it is sipped.

Why drinks matter so much

Every time a child sips something sugary, mouth bacteria turn that sugar into acid, and the teeth are under attack for a while afterwards. A cup finished with lunch is one acid attack. The same cup sipped slowly over two hours keeps the teeth under attack the whole time.

That's why watering juice down doesn't remove the risk if it is sipped all day. It is still sugar, just spread out over a longer time.

Water and plain milk are best

• Water is the best drink between meals, and the only drink teeth never need protecting from.
• Plain milk is a good drink with meals for children over one year. Your doctor can advise how much suits your child's age.

What about juice?

Following American Academy of Pediatrics guidance:

• Under 1 year: no fruit juice.
• Ages 1 to 3: no more than about 120 ml a day, if any.
• Ages 4 to 6: no more than about 120 to 180 ml a day.
• Older children: no more than about 240 ml a day.

Whole fruit is a better choice than juice. If you do offer juice, serve it in an open cup with a meal, not in a bottle or a sippy cup carried around the house, and never at bedtime.

Bottles and sippy cups

• Aim to move from the bottle to a cup around 12 months, and certainly not long after.
• A sippy cup is a stepping stone, not an all-day companion. Water only in any cup your child carries around.
• No bottle in bed with milk, formula or juice. If a comfort drink is needed, make it water.

Night feeds and the "last thing is brushing" rule

Breastfeeding is recommended and has many benefits for mother and baby, and this advice is not a reason to stop. Once teeth appear, though, any milk (breast milk or formula) that sits on the teeth through the night can contribute to cavities, especially when combined with other sugars during the day.

Some gentle steps that help:

• Brush the teeth before sleep, and try to make brushing the last thing before bed.
• If your baby feeds to sleep or wakes for feeds, wipe the teeth and gums with a clean, damp cloth or gauze afterwards when you can.
• As your child grows, talk to your dentist and paediatrician about night feeds and a plan that suits your family. There is no single "right" answer, and no judgement.

Drinks that are easy to underestimate

• Fizzy drinks and energy drinks: high in sugar and acid. "Diet" versions are still acidic and can wear enamel.
• Sports drinks: designed for long, intense exercise. For normal play and school sports, water is enough.
• Flavoured milks, sweetened laban and yoghurt drinks: often contain a surprising amount of added sugar. Check the label and choose plain versions.
• Sweet tea, including karak with sugar: children often share a cup with adults. Small amounts add up.
• Vimto and other cordials in Ramadan: a family tradition for many. Serve them with the iftar meal rather than sipping through the evening, and follow with water and brushing before bed.

Practical tips

1. Keep a water bottle in the school bag and the car. 2. Sweet drinks with meals only, not between them. 3. Use a straw for occasional fizzy drinks, and don't let children swish them around their mouth. 4. Rinse with water after a sweet or acidic drink, and wait about 30 to 60 minutes before brushing after acidic drinks. 5. Lead by example. Children copy what they see adults drink.