Patient education: Tooth decay in children (The Basics)

What is tooth decay? — 

This is when the enamel that covers a tooth is damaged (figure 1). Then, a soft spot, hole, or "cavity" forms.

Tooth decay can happen on the tooth surface or deeper in the tooth. It will worsen if it is not repaired. Repair involves putting in a "filling."

How common is tooth decay in children? — 

Tooth decay is one of the most common problems of childhood. "Baby teeth" are important and help children eat and speak. They also help guide the permanent, or "adult," teeth into the proper position. This is why it is important to take care of your child's teeth.

What causes tooth decay? — 

After eating or drinking, bits of food and sugar are left on the teeth. Germs in the mouth combine with food and sugar to make plaque, which is a soft, sticky, film-like coating. If you or your child doesn't brush their teeth, the plaque builds up. The bacteria in plaque combine with food and sugar to make acid. The acid can weaken the protective enamel on the tooth and cause decay.

If the soft plaque stays on the teeth, it can also harden and form something called "tartar." Dental plaque ca also cause inflammation of the gums ("gingivitis").

What can raise the risk of tooth decay in children? — 

Several things raise the risk. For example:

●The enamel on a child's teeth is softer and thinner than in an adult. This puts them at a higher risk for tooth decay.

●Putting a baby to bed with a bottle of milk, formula, or other sweetened drink allows the liquid to pool in their mouth. This feeds the germs as the baby sleeps. Letting your child continually drink from a sippy cup can also cause similar problems.

What are the symptoms of tooth decay? — 

Since it takes time for acid to break down enamel, there are often no symptoms of early tooth decay. It might only be seen with X-rays.

When there is more breakdown in the enamel, your child can have symptoms. These might include:

●Tooth sensitivity to hot or cold

●Bad breath, or a bad taste in their mouth

●Gray, black, or brown spots on a tooth

●Bleeding, red, or swollen gums

●Swelling of the jaw, face, or neck

Will my child need tests? — 

Your child's regular doctor will check your child's teeth as they grow in. Most children should see a dentist by the time they are about 1 year old.

Most teeth problems are treated by a dentist. They will check your child's teeth, gums, and mouth. They will gently touch and tap on the teeth to check them. The dentist might ask about pain or problems with heat or cold.

Sometimes, the dentist might do other tests, like an X-ray, to check their teeth.

How is tooth decay treated? — 

Treatment is based on how serious the tooth decay is. Possible treatments include:

●Removing decay, and placing a filling or crown on the tooth

●Doing a root canal if the nerve of the tooth is infected or inflamed

●Pulling a tooth if it cannot be fixed

How can I help prevent my child from getting tooth decay? — 

Here are some tips:

●Brush your child's teeth at least 2 times a day. Use a smear of toothpaste with fluoride for infants and toddlers under 3 years old (picture 1). Use a pea-sized amount of toothpaste for older children (picture 2).

●Use dental floss to clean between your child's teeth every day.

●Do not put your child to sleep with a bottle. If they need a bottle to soothe themselves, water is the only liquid that is safe for the teeth. Check with your child's doctor to see if this is a good choice for your child.

●Older children who can safely chew gum can chew sugar-free gum if they cannot brush their teeth after eating.

●Take your child to see a dentist for regular cleanings and check-ups. The dentist might put fluoride or a sealant on their teeth to treat early tooth decay and prevent it from getting worse.

●Give your child a healthy diet. Try to avoid or limit foods and drinks that are high in acid, sugar, and starch. These include things like chocolate, sweets, and fizzy or sugary drinks. Limit how much juice your child drinks each day.

When should I call the doctor or dentist? — 

Call for advice if your child has:

●Signs of infection, such as:

•A fever of 100.4°F (38°C) or higher

•Swelling of the gums, neck, or face

•Discharge or pus around a tooth

●A toothache that doesn't go away in a few days, or pain that is getting worse or keeps them from sleeping

●Trouble chewing or opening their mouth all of the way

●A lot of bleeding from their gums

More on this topic

Patient education: Fluoride (The Basics)
Patient education: Toothache (The Basics)
Patient education: Dental abscess (The Basics)
Patient education: Tooth decay in adults (The Basics)