Tooth decay, or cavities, remains a prevalent issue affecting children of all ages. While seemingly small, these dental lesions can lead to significant pain, infection, and even impact a child’s overall health and development.

Navigating the world of paediatric dental care can feel overwhelming. In this article we demystify tooth decay to help parents and caregivers with essential knowledge about understanding, preventing, and effectively treating cavities in children.

What is Tooth Decay

Let’s start from the very basics. Tooth decay is the destruction or breakdown of the harder outside of a tooth, commonly known as enamel. This can lead to the formation of cavities, also called dental caries. These cavities form holes in the teeth and if left untreated can get bigger. If such holes reach deep inside, where the nerve endings are, it can lead to excruciating pain.

Cavities are found in children of any age. But usually, they grow faster in baby teeth than in adult or permanent teeth. They can start to develop as soon as baby teeth come in, usually between 6 months to one year of age.

Why are Baby Teeth Prone to Cavities?

Cavities are generally caused by a type of bacteria living in the mouth and sugar. These particular bacteria present in a child’s mouth change the form of sugar present in food and drinks. This bacterium in the mouth along with saliva and leftover food particles together form a sticky film known as plaque which forms residues in the teeth.

These bacteria can turn breast milk into a kind of acid that eats up the enamel of teeth. The enamel of baby teeth is usually thinner than permanent teeth. Thus this acid forms easily and faster, thus resulting in cavities. In fact, this acid starts to form within 20 minutes of a baby eating or drinking something.

Babies and toddlers are often put to sleep with a bottle containing things other than water, especially drinks containing artificial sugar, which is another major cause of tooth decay. The saliva in the baby’s mouth or spitting helps to wash away the acid to some degree. However, while sleeping the saliva flow slows down, which is when the acid becomes most active.

One of the early signs of tooth decay in babies is white spots on the teeth. These may later turn into brown holes.

Long-Term Effects of Tooth Decay in Children

In the initial stage tooth decay might not reflect any noticeable effects. This itself makes early detection of tooth decay quite challenging. The earlier stages of tooth decay might present themselves as white, brown or black stains.

Also sometimes one may experience tooth sensitivity or mild pain while consuming hot or cold beverages or sweet food products. Tooth decay if not addressed at the right time can lead to several health hazards:

Pain

The first and the most common effect of tooth decay is pain, which can disrupt your child’s sleep, eating and daily activities.

Infection

The small cavities formed in teeth when left untreated can expand until they reach the pulp chamber. The pulp chamber is the inner chamber of a tooth which contains connective tissues, blood vessels and nerves. Usually, the pulp chamber is sealed, but it can be opened up due to tooth decay. This will affect the soft tissues situated inside the pulp chamber. Such a condition will result in infection, which leads to unbearable toothaches. A tooth infection can spread to areas like the brain, which can cause a threat to life.

Weakened Immune System

The bacteria formation in the mouth due to poor oral hygiene can pave its way into the bloodstream, thus travelling to other parts of the body. This overall can result in a weak immune system leading to fatigue, increasing the chances of other illnesses.

Increased Self-consciousness

Tooth decay can ruin the appearance of teeth and make children self-conscious about their appearance. They may feel reluctant to smile or show their teeth. They may fear being judged which is quite justified since in a social context the first thing that people notice about a person is the smile. This can severely affect a child’s self-confidence and lead to body image issues.

Complications Related to Tooth Decay

Several other complications can arise as a result of tooth decay such as:

• Dental plaque contains bacteria which can damage the surrounding gums and the dental bones along with the teeth. This can lead to painful dental abscesses in the gum and teeth.
• Tooth decay can lead to damage and even breakage of the tooth resulting in loosening of the teeth and falling off.
• Gum disease known as gingivitis is another complication, that is not uncommon. It is characterised by pain, redness or swelling of the gums, and bleeding when touched or brushed.
• Periodontitis, a more severe form of gum disease may also eventually develop.
• Dental abscesses, where pus-filled swellings caused due to dental plaque form inside the gums, are another complication of tooth decay. This can result in severe pain, fever and other symptoms of infections.
• If left untreated, tooth decay can lead to dental sepsis, where sinuses associated with an affected tooth may become infected and swollen.

Paediatric Dental Disease

According to dentists and oral health experts childhood tooth decay has become a leading chronic childhood illness all over the world. Over usage of sugary food products is one of the key factors in causing cavities and tooth decay among children.

Paediatric dental disease can affect oral development in children. They can be the root cause of unusual speech functionality, malnutrition and decreased self-esteem. Pediatric dental disease can have serious potential side effects such as crooked adult teeth, poor jaw development or speech impairments, if not attended to at the proper time. Therefore it is essential for parents to teach their children good oral health habits such as daily teeth brushing, good eating habits and washing their mouth properly. Parents also need to take their children for regular dentist check-ups, even if no symptoms are visible.

Treatment of Tooth Decay in Children

Treatment for tooth decay depends on its severity and can range from fluoride treatments for early stages to fillings, root canals, or even extraction in case of advanced stage. Regular checkups help in the very early detection of cavities and other dental issues before they cause more serious problems. Treatment of cavities depends on how serious they are. Some of the treatment options include:

Fluoride Treatments

At the initial stage of cavity formation, a fluoride treatment may help restore the enamel of your child’s tooth and can sometimes even reverse a cavity. Professional fluoride treatments contain more fluoride than the amount found in tap water, toothpaste and mouthwash. Fluoride treatments may be given in a liquid, gel, foam or varnish format that’s brushed onto your teeth or placed in a small tray that fits over your teeth.

Fillings

Also known as restorations, fillings are the main treatment option for tooth decay and cavities. Fillings can be made of various materials, such as tooth-coloured composite resin or porcelain, or dental amalgam which is a mixture of several materials. This mixture is poured to seal off the cavity and prevent it from spreading.

Crowns

In case of a lot of decay or weakened teeth, you may need a crown. A crown is a custom-fitted cover prepared to replace your tooth’s entire natural crown. The crown provides an additional artificial protection that keeps the tooth out of external damage and lowers the risk of fracture. The decayed area is drilled away by the dentist and a custom-made dough is created to ensure a good fit.

Root canals

When decay is deep and reaches the inner material of the tooth known as the pulp chamber, your child may need to go through a root canal. This treatment helps to repair and save an infected or badly damaged tooth instead of removing it. The diseased tooth pulp is removed. Medicine is sometimes used for root canals to clear any infection. Then the pulp is replaced with a certain medicinal filling.

Tooth Extractions

Sometimes teeth become so seriously decayed that they can’t be restored. In such a case it must be removed before the infection affects other teeth. Removal of a tooth can result in loosening of the entire dental structure. If possible, consider getting a bridge, dentures or a dental implant to replace the missing tooth.

How to Avoid Tooth Decay

Though tooth decay is a very common disease that is often overlooked by most parents and can turn into a serious concern, it is also possible to avoid this situation. Maintaining good oral health regularly is the easiest way to stop tooth decay or further spreading of it. Primarily, regular brushing, flossing and cleaning of the mouth are the easiest ways to ensure good and healthy dental hygiene. Also, an appropriate focus should be paid on diet and food habits. A balanced diet not only benefits your child’s teeth and gums but their overall health and well-being. Consumption of excess amount of sugar and fat should be strictly avoided. Yes, we know avoiding sugary food and beverages is easier said than done. Hence ensure your child rinses their mouth with water or baby mouthwash after consuming sugary food to ensure no residues are left in the teeth.

Here are a few pointers to remember:

• Begin brushing your child’s teeth as soon as you notice the first tooth. Use a fluoride toothpaste to brush the teeth, gums and tongue for 2 minutes twice a day. Once your child can brush their teeth on their own, ensure to keep a watch when they brush.
• Children younger than three years of age need only a little bit of toothpaste, usually the size of a grain of rice, to brush their teeth. After the age of three, they can use a pea-sized amount.
• Flossing should commence once your child reaches 2 years.
• It is important to prevent the transfer of bacteria from your to your child’s mouth. Hence, avoid sharing utensils with your child. Ensure to clean your child’s pacifier properly.
• Do not put juices or sugar-laden formula in your child’s bottle, if your child uses one during bedtime.
• Ensure your child eats a well-balanced diet with a limited amount of snacks rich in sugar.
• Take your child for a dental checkup every 6-months.

Sources:

• https://www.hopkinsmedicine.org/health/conditions-and-diseases/tooth-decay-caries-or-cavities-in-children
• https://www.nidcr.nih.gov/research/data-statistics/dental-caries/children
• https://www.mayoclinic.org/diseases-conditions/cavities/symptoms-causes
• https://my.clevelandclinic.org/health/diseases/cavities
• https://www.mayoclinic.org/diseases-conditions/cavities/diagnosis-treatment