Adults' efforts to limit their children's intake of sweet snacks and drinks are being undermined by earlier and earlier influences in the child's life and by access to money, which allows the child to out-manoeuvre his or her parents. This is compounded by the provision of additional income, mostly from grandparents.

This cluster randomised controlled study assessed the effectiveness of twice-yearly applications of fluoride varnish as a public health measure to reduce dental caries in children living in relatively deprived communities. The test (n = 334) and control (n = 330) children in 2 school years (unit of randomisation) attended 24 state primary schools and were 6–8 years of age at the start. Good baseline balance was found. Duraphat varnish was applied at school on 5 occasions over 26 months, by dental therapists. A combined visual and fibre-optic transillumination examination included all surfaces of primary and first permanent molars at baseline and after 26 months for small and large enamel and dentine lesions. At the final examination the only statistically significant difference was in the caries increment for small enamel lesions in the primary dentition, with the test children having fewer lesions. This study failed to demonstrate that the twice-yearly application of fluoride varnish provided at school reduced dental caries in children living in this community. The low level of response and a lower than expected caries increment had a major impact on the effectiveness of the intervention, since the children who participated were least likely to have benefited from the programme, whereas those who might have benefited did not consent.

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Background

Background There is evidence to suggest that the family is becoming a more democratic unit and that the ability of children to influence adult decision-making processes should not be underestimated. A study was undertaken to investigate whether children can influence adult decision- making in relation to the use of sugary snacks. Method A cross-sectional interview study; children aged 7-8 years from twenty inner-city Manchester primary schools were interviewed about their pocket money and their perceived levels of influence on the consumption of sugary snacks within their household. Twelve of the questions were scored '1' if the child answered 'yes' (denoting that the child usually got his/her own way) or 'zero' for 'no' (denoting that the child believed the adult was in control). This was reported as the child's influence score within a range of 0-12. Results The mean influence score for the group ( n=340) was 4.7 and was independent of the child's gender, ethnicity or number of children in the family. Sixty-eight per cent ( n=232) of the children reported that they usually received sweet items whenever they asked for them. Sixty-three per cent ( n=215) of the children admitted to pestering their parents when greeted with a 'no' response, with nearly two-thirds of the 'pesterers' reporting a successful outcome. Evidence of the children's autonomy was shown by nearly three-quarters of the group stating that they received pocket money. Conclusions In this study, adults' efforts to limit their children's intake of cariogenic food/drink are being undermined by children having an increased degree of freedom either to make or influence decisions particularly about sweet snacks.