Tooth Decay and Cavities In Children

By Gina C. Pham, DDS

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Tooth Decay and Cavities In Children

Moms often ask me, “Is it normal for my child to have tooth decay at such a young age?” Many parents are not aware that a child may have tooth decay as soon as a tooth first appears in the mouth and this could happen to children as young as three months old. My hope is that this article will answer most of the questions parents are asking about tooth decay in young children and help them take better care of their children's teeth.

Tooth decay often starts on the biting surfaces called “occlusal surfaces” or between teeth called “interproximal surfaces.” Tooth decay, or a cavity, is a location on a tooth where so much of the tooth's mineral content such as calcium and phosphorus has been dissolved from the tooth surface that the tooth becomes softer and eventually breaks off to form a cavity on the surface.

When a cavity is large and visible, it may appear to be a brownish, or chalky white, soft spot on the tooth surface. This allows bacteria to enter, causing decay of the tooth.

There are three major structures of the tooth enamel (outer protective layer), dentin (middle layer), and pulpal layer (where the nerve of the tooth is housed).

In baby or primary teeth, the enamel is much thinner and the pulpal area is proportionally larger then in permanent teeth. Due to its smaller surface area and thinner enamel, it takes much shorter time for a cavity to spread on baby teeth than on adult permanent teeth.

Your child may complain of pain as soon as a cavity penetrates through the first layer of enamel and is in contact with the dentin. If untreated the cavity will grow and infect the pulpal area, which may cause a local abscess around the tooth.

Cellutitis is a condition when abscesses spread beyond the area of the tooth and may cause large swelling on the child's face. Untreated abscesses around the baby teeth may cause damage to the developing permanent teeth, systemic infections, and possibly death.

Parents should start brushing their children's teeth as soon as teeth appear in the mouth. We recommend routine checkups by a pediatric dentist every six months to prevent undetected small cavities that may develop. The child's first checkup should be no later than one year old.

Taking these simple steps would go a long way to ensure that your child has healthy teeth and happy smiles.