What are Cavities in Children?
Cavities are small holes in the teeth that are caused by mouth bacteria building up on the teeth due to poor oral hygiene. They feed on sugars from food and create an acidic environment that will eat away at the tooth enamel and cause cavities.
Are children more susceptible to cavities than adults?
Yes, In Children their teeth are still developing with less mineral and thin enamel. This along with frequent sugary foods consumption and not having good oral hygiene habits, all will make children more susceptible to cavities. The World Health Organization considers dental caries or tooth decay the most common noncommunicable disease worldwide. It means it is a health condition that affects many individuals globally.
According to a 2022 Global Oral Health Status Report, an estimated 2 billion people worldwide suffer from caries of permanent teeth, and 514 million children suffer from caries of primary teeth.
How Do Cavities Happen?
Cavities are caused by bacterial growth that destroys the enamel which is the hard protective surface of the teeth. The bacterium eats the sugars left behind from food or drinks, and the acidic waste they leave behind slowly eats away at the protective enamel. Over time, this causes the tooth to decay, leading to cavities, or holes in the teeth. Very serious cavities will eventually take over the tooth, causing it to die at the root. It will either fall out or need to be removed, If not intervened earlier.
The same bacteria also produces plaque, which is a yellowish chalky substance that sticks to the teeth, and degrades the enamel over time. Even with excellent brushing and flossing, plaque can still stick to the teeth, which is why visits to the dentist are important for kids and adults, so the dental team can remove the plaque from the teeth. If left on the teeth, plaque can lead to gingivitis, periodontitis, and other gum issues and diseases.
Cavities in Infants and toddlers (0-3years):
Cavities (tooth decay) in baby teeth used to be known as Baby Bottle Tooth Decay. In Modern times this condition is referred as Early Childhood Caries.
What is Early Childhood Caries (ECC):
ECC is defined as “the presence of one or more decayed (non-cavitated or cavitated lesions), missing teeth (due to caries), or filled tooth surfaces in any primary tooth in a child of 72 months age or younger.
In children younger than 3 years of age, any sign of smooth-surface caries is indicative of severe early childhood caries (S-ECC).
From ages 3 to 5, one or more cavitated, missing teeth (due to caries), or filled smooth surfaces in primary maxillary anterior teeth, or decayed, missing, or filled score of ≥4 (age 3), ≥5 (age 4), or ≥6 (age 5) surfaces constitutes S-ECC.
Early Childhood Caries usually develops before age 6, often as early as 1 .Teeth most commonly affected is upper front teeth first.
Causes of Early Childhood Caries :
- . Frequent Bottle Feeding or Breast Feeding at Night: Sugars stay on teeth over night, especially with milk or juice.
- . Sugar Intake: Sugary snacks, juices and sweetened drinks throughout the day
- . Poor Oral Hygiene: Not cleaning baby`s teeth or gums, sharing spoons or cleaning pacifiers with mouth thereby causing bacterial transmission
- . Lack of Fluoride: Not using fluoride toothpaste or having non-fluoridated water
Signs and Symptoms of Early Childhood Caries:
- . White Chalky Spots on teeth (early sign)
- . Brown or black spots
- Tooth Sensitivity or pain
- . Difficulty in eating or chewing
- . Bad breath
Causes of Cavities in Children (4-10 years):
- . Sticky Snacks like Gummy candies, chips, packaged snacks and school lunches
- . Poor Brushing Habits
- . Deep Grooves in Molars
- . Skipped Dental Visits.
Potential Consequences of Cavities and Decay in Baby Teeth:
- . Disrupted speech development or speech impediments
- . Pain and soreness when biting and chewing food
- . Chronic pain, soreness, inflammation of the teeth and gums
- . Headaches and jaw aches
- . Sensitivity to hot or cold on the teeth
- . Bad breath
- . Improper development of adult teeth, requiring invasive orthodontic care or surgery
- . spreading to other teeth, or infecting permanent teeth
- . Tooth or gum infections.
Prevention of Cavities by age group :
For Infants (0-12 months ):
- . Clean Gums with a clean, damp cloth after feedings.
- . Avoid putting babies to bed with bottles of milk or juice .
- . Once the first tooth appears , start brushing with a soft baby toothbrush and plain water.
- . Never dip pacifiers in sugar or honey.
For Toddlers ( 1-3 years ):
- . Brush twice daily with a rice grain sized amount of fluoride toothpaste.
- . Encourage drinking water instead of sugary drinks.
- . Avoid frequent snacking, especially sticky foods.
- . Consult pediatric dentist by age of 1 year.
For children (4-12 years):
- . Supervise brushing and flossing daily.
- . Use a pea-sized amount of fluoride toothpaste (2 minutes twice a day ).
- . Teach proper brushing technique
- . Maintain a balanced diet low in sugars.
- . Schedule dental checkups every 6 months.
- . Dental sealants for molars.
Treatment for cavities based on severity:
Mild Decay (White Spot Lesions or Initial Enamel Decay):
Appearance :
- . white chalky spots on surface of teeth .
- . No Pain or Sensitivity
- . Usually seen during routine checkup
Treatment:
- Fluoride Varnish : Re-mineralizes enamel and stops early decay .
- Silver Diamine Fluoride : A liquid applied to arrest decay, especially useful for young or uncooperative child .
- Oral hygiene improvement : Brushing twice a day .
Moderate Decay (Cavity reaches Dentin):
Appearance :
- . Brown or black spots
- . Small to medium holes in teeth
- . Mild sensitivity or discomfort especially with sweets
Treatment:
- . Tooth colored fillings (composite resin): Used to restore shape and function of the tooth
- . Glass ionomer fillings : Releases fluoride and is often used in younger children.
- . Minimal drilling techniques : Used with behavior management techniques to keep child calm
- . Silver Diamine Fluoride: Painless application that stops cavity progression .
Severe Decay (cavity reaches pulp or causes Infection):
Appearance :
- . Large visible cavity
- . Toothache or Sensitivity to hot or cold
- . Swelling, pus or abscess(in advanced cases).
Treatment :
- . Pulpotomy : Removes infected pulp from crown portion of the teeth.
- . Pulpectomy : Removal of all pulp tissue (root and crown) when infection is severe
- . Stainless steel crown : covers and protects the treated tooth..
- . Tooth Extraction : If tooth is severely damaged ,it is removed.
- . Space Maintainers : To keep space for future permanent teeth.
Note: At Solitaire Family Dentistry, we specialize in child friendly dental care for infants, toddlers, and children. Book your child`s first dental visit with us today and help build a lifetime of healthy smiles!