Cavities, Caries, Tooth Decay in Children

Cavities, caries, tooth decay in children may be prevented by teaching proper brushing and flossing, starting at an early age. Tooth decay can occur as early as the toddler stage when bacteria within the mouth begin to eat away at the protective outer covering (enamel) on the primary teeth. Because bacteria are naturally present in the mouth, children can get cavities as soon as they start getting teeth. Cavities are caused by plaque, a sticky, clear film of bacteria that forms on teeth and weakens the enamel. The good news is that cavities in children can be easily avoided by practicing good dental hygiene habits starting at an early age. Dr. Lalani states that research shows that cavities are caused by:

1 Sugar
2 Bacteria
3 Susceptible tooth
4 Time

How Cavities, Caries, Tooth Decay in Children Form

Cavities form when bacteria combines with saliva and food to create plaque on the teeth. Natural bacteria present in the mouth thrive on the sugar that remains on our teeth after we consume food and drinks that contain these certain sugars and starches. Plaque that is allowed to remain on teeth will harden and form tartar, which is more difficult to remove.

Acid in the plaque attacks the minerals in the tooth enamel in a process called demineralization. Once the enamel is worn away, the acid can damage the soft layer beneath which is called the dentin. Untreated tooth decay can progress into the pulp (the inner tooth) where nerves and blood vessels are located.

Risk Factors for Cavities in Children

While anyone can get a cavity, children tend to be more susceptible to dental caries because they are not experienced with dental hygiene and do not always understand the repercussions of not taking care of their teeth.

Areas of the teeth which are particularly susceptible to decay are:

Between the teeth: This area is hard to reach with a toothbrush. Dental floss should be used to avoid plaque build-up between the teeth.
Biting surfaces of the teeth: The grooves of the molars can be easily missed when brushing the teeth, so be sure to take extra care to brush thoroughly.
Root surfaces of teeth: Patients with gum disease are more likely to develop cavities at the root.

Being aware of factors which increase the risk for cavities can help with their prevention.

Risk factors for tooth decay include:

Diet high in sugar, carbohydrates, and sweets: Food or drinks that are more difficult for saliva to wash away are more apt to cling to teeth and cause cavities. Some foods that can stick to teeth include:
Milk
Sugary food and drinks
Sticky foods like dried fruit
Chips or dry cereal that may get stuck in grooves
Frequent snacking: Eating or drinking continuously throughout the day without brushing the teeth allows bacteria to keep producing damaging acid that covers the teeth all day.
Tooth size, shape, and location: The molars and premolars in the back of the mouth have more grooves in which bacteria can collect. Smaller teeth can have multiple deep grooves that are difficult to brush thoroughly.
Feeding infants at bedtime: Giving anything other than water at bedtime is not recommended. Liquids such as milk, juice, or formula contain sugar which can remain on the teeth all night creating a breeding ground for cavity-causing bacteria. Cavities that result from this practice are often called “baby bottle tooth decay”. This can occur in toddlers who drink from a sippy cup all day also.
Insufficient fluoride: Fluoride is a mineral which helps prevent tooth decay and even has the ability to reverse early tooth damage. Be sure to use fluoride-containing toothpaste (an appropriate amount recommended by your dentist) and give your child fluoridated water. Many bottled waters do not contain fluoride while most tap water does.
Poor oral hygiene: Have your child brush his/her teeth after consuming any food or drink (except water), if possible. Teach your child proper brushing techniques and help with the brushing until he/she can brush thoroughly.

Symptoms of Cavities in Children

When a cavity first presents, it may have no symptoms at all. This is one reason why regular dental visits are important. Your pediatric dentist can detect cavities early, and if small enough, they can be reversed. Once a cavity grows, your child may begin to experience symptoms.

Symptoms of cavities include:

Tooth sensitivity (usually to hot, cold, or sweets)
Toothache
Pain when biting down
White, brown, or black spots on the tooth (white spots usually appear first)
Visible pit or hole in the tooth

Untreated cavities can result in:

Chewing difficulty
Pain
Infection of teeth and gums
Tooth abscess (pus around tooth caused by an infection)
Tooth loss

A common misconception about childhood cavities is that they do not matter since the primary teeth fall out anyway. Baby teeth, however, are extremely important to keep healthy.

Functions of the primary teeth include:

Enable proper chewing
Help with word formation and speech
Create and hold the space for the permanent teeth

When primary teeth are damaged or fall out too early, the result can be misalignment of the permanent teeth when they erupt. In addition, decay in a baby tooth can spread to an incoming adult tooth, causing even more damage.

Stages of Dental Decay:

Diagnosing Cavities in Children

Cavities are typically easy to identify during a routine dental check-up. Visiting your pediatric dentist before any symptoms arise will aid in early detection.

Your dentist can diagnose cavities by:

Examining your child’s teeth and mouth
Probing the teeth with special dental instruments
Viewing your child’s dental x-rays

The key to an easy, stress-free cavity treatment is discovering the cavity early.

Treating Cavities in Children

Cavity treatment will depend on the severity of the cavity. If your child’s cavity is identified soon enough, it may be possible to reverse it through a process called remineralization. Remineralization involves using fluoride treatments to restore the tooth’s enamel making it more resistant to cavities.

If the tooth needs to be restored, several options can be used depending on the extent of tooth damage.

Filling: Most common tooth restoration in which decay is removed, or drilled out, and the hole is filled with either silver alloy, porcelain, gold, or composite resin
Crown: Restoration (used for weakened tooth or extensive decay) in which the decayed portion of the tooth is removed and replaced with a covering (typically made of porcelain, gold, or resin) that fits over the remainder of the tooth
Root canal: Treatment for an infected or badly damaged tooth (when the pulp is decayed) in which the diseased portion is removed and the pulp is replaced with a filling
Tooth extraction: Typically utilized only when a tooth is too decayed to be restored

Baby Root Canal Treatment and Crown Placement:

Preventing Cavities in Children

The best treatment for a cavity is preventing it. Teaching your child good oral hygiene habits is the best way to ensure long-lasting dental health. Parents should assist children with teeth brushing until they become proficient at cleaning teeth thoroughly. Making it a fun time together will encourage your child to brush often.

Tips to Prevent Cavities in Children

Brush teeth at least twice a day
Use fluoride-containing toothpaste: Your dentist will instruct you on safe amounts for younger children.
Use floss teeth daily to remove plaque in between teeth: Fun character flossers are available for children.
Drink tap water: Most water supplies contain fluoride which strengthens teeth.
Limit sugary foods and drinks
Avoid all-day sipping and frequent snacking
Eat a healthy diet: Fruits and vegetables actually increase saliva flow which helps wash away bacteria.
Visit your dentist regularly: Dental check-ups are recommended twice a year, starting at the first birthday or upon tooth eruption.
Get dental sealants: Having your dentist apply these protective coverings can protect your child’s teeth for up to 10 years, reducing the risk of cavities. At Discovery Kids, Dr. Lalani uses only BPA-free dental sealants to ensure that your child is not exposed to any potentially harmful substances.

At Discovery Kids Pediatric Dentistry, our priority is providing the highest quality dental care in a kid-friendly environment that results in a lifetime of good dental health. If you are concerned that your child may have a cavity, contact our office for a thorough dental examination.

Dr. Zarmin Lalani is a board certified pediatric dentist in Frisco dedicated to helping her patients develop and maintain good oral health habits that last a lifetime. If you are looking for a pediatric dental office to call your dental home, please contact Dr. Zarmin Lalani and her team at Discovery Kids Pediatric Dentistry Frisco, Texas, by completing an online appointment request or phone 469-365-5437.