Tooth Decay in Children

What is tooth decay in children?

Tooth decay is the breakdown, or destruction, of tooth enamel. Enamel is the hard outer surface of a tooth. Tooth decay can lead to cavities (caries). These are holes in the teeth.

What causes tooth decay in a child?

Tooth decay is caused by bacteria and other things. It can happen when foods containing carbohydrates (sugars and starches) are left on the teeth. Such foods include milk, soda, raisins, candy, cake, fruit juices, cereals, and bread. Bacteria that normally live in the mouth change these foods, making acids. The combination of bacteria, food, acid, and saliva form a substance called plaque that sticks to the teeth. Over time, the acids made by the bacteria eat away at the tooth enamel, causing cavities.

Which children are at risk for tooth decay?

All children have bacteria in their mouth. So all children are at risk for tooth decay. But the following may raise your child’s risk for it:

  • High levels of the bacteria that cause cavities
  • A diet high in sugars and starches
  • Water supply that has limited or no fluoride in it
  • Poor oral hygiene
  • Less saliva flow than normal

What are the symptoms of tooth decay in a child?

The following is the common way that teeth develop decay and cavities. But decay may be a bit different for each child.

  • White spots begin to form on the teeth in areas affected. These spots mean that the enamel is starting to break down. They may lead to early sensitivity in the teeth.
  • An early cavity appears on the tooth. It has a light brown color.
  • The cavity becomes deeper. It turns a darker shade of brown to black.

The symptoms of tooth decay and cavities vary from child to child. Cavities don’t always cause symptoms. Sometimes children don’t know they have one until their dentist finds it. But your child may feel:

  • Pain in the area around the tooth
  • Sensitivity to certain foods, such as sweets and hot or cold drinks

How is tooth decay diagnosed in a child?

Your child’s dentist can usually diagnose tooth decay based on:

  • A complete history of your child
  • An exam of your child’s mouth
  • Dental X-rays

How is tooth decay treated in a child?

Treatment will depend on your child’s symptoms, age, and general health. It will also depend on how severe the condition is.

In most cases, treatment requires removing the decayed part of the tooth and replacing it with a filling. Fillings are materials placed in teeth to repair damage caused by tooth decay. They are also called restorations. There are different types of fillings:

  • Direct restorations. These need a single visit to place a filling directly into a prepared hole. These fillings may be made out of silver, fine glass powders, acrylic acids, or resin. They are often tooth-colored.
  • Indirect restorations. These require 2 or more visits. They include inlays, onlays, veneers, crowns, and bridges. These are constructed with gold, base metal alloys, ceramics, or composites. Many of these materials can look like natural tooth enamel.

How can I help prevent tooth decay in my child?

You can help prevent tooth decay in your child with these simple steps:

  • Start brushing your child’s teeth as soon as the first one appears. Brush the teeth, tongue, and gums twice a day with a fluoride toothpaste. Or watch as your child brushes his or her teeth.
  • For children younger than 3 years old, use only a small amount of toothpaste, about the size of a grain of rice. Starting at 3 years old, your child can use a pea-sized amount of toothpaste.
  • Floss your child’s teeth daily after age 2.
  • Make sure your child eats a well-balanced diet. Limit snacks that are sticky and high in sugars, such as chips, candy, cookies, and cake.
  • Prevent the transfer of bacteria from your mouth to your child's by not sharing eating utensils. Don’t clean your infant’s pacifier with your saliva.
  • If your child uses a bottle at bedtime, only put water in it. Juice or formula contain sugars that can lead to tooth decay.
  • Talk with your child’s healthcare provider or dentist about using a fluoride supplement if you live in an area without fluoridated water. Also ask about dental sealants and fluoride varnish. Both are put on the teeth.
  • Schedule routine dental cleanings and exams for your child every 6 months.

Key points about tooth decay in children

  • Tooth decay is the breakdown of tooth enamel. It can lead to holes in the teeth called cavities.
  • Tooth decay is caused by bacteria in the mouth. These bacteria make a sticky substance called plaque that can eat away at a tooth’s enamel.
  • Poor oral hygiene can raise your child’s risk for tooth decay.
  • A dentist can diagnose tooth decay with an exam and X-rays.
  • Treatment requires removing the decayed part of the tooth and replacing it with a filling.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

  • Know the reason for the visit and what you want to happen.
  • Before your visit, write down questions you want answered.
  • At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.
  • Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.
  • Ask if your child’s condition can be treated in other ways.
  • Know why a test or procedure is recommended and what the results could mean.
  • Know what to expect if your child does not take the medicine or have the test or procedure.
  • If your child has a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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