London - 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 nine-year-old 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."
Tiwari, 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 Tiwari. "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 her 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.
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."