Tooth decay is one of the most common chronic conditions in childhood. The enamel of baby teeth is thinner than that of permanent teeth, so decay can progress faster in baby teeth. The good news is that decay is largely preventable and, when caught early, can be stopped with simple measures.
How does decay develop?
Bacteria in the mouth use leftovers from sugary and starchy foods to produce acid. This acid causes the enamel to lose minerals. Saliva and fluoride can repair this loss to some extent, but if acid attacks happen too often, the enamel weakens and a cavity forms over time.
Three factors work together in the development of decay:
- Bacterial plaque: The sticky layer that builds up on tooth surfaces that are not brushed
- Sugar frequency: How often sugar is eaten matters more than how much
- Time: How long the acid stays on the tooth surface
What are the first signs?
- Chalky white, dull spots near the gumline (early enamel loss)
- Brown or black discoloration
- Sensitivity to hot, cold or sweet things
- Avoiding chewing or not using one side when eating
- Bad breath
- In advanced cases, pain, swollen gums or an abscess
Decay caught at the white-spot stage can often be stopped with fluoride and better care habits.
Why do cavities in baby teeth matter?
Decay in baby teeth is sometimes ignored with the thought that "they will fall out anyway". Yet baby teeth are needed for chewing and speaking and hold space for the permanent teeth. Baby teeth lost early can let neighbouring teeth drift into the gap and lead to orthodontic problems later, such as crowding. Advanced decay can also affect a child's eating and sleep through pain and infection.
Risk factors
- Drinking milk or fruit juice from a bottle at night
- Snacking all day, sugary drinks
- Irregular brushing or using toothpaste without fluoride
- Dry mouth, mouth breathing
- A family history of frequent decay
When should you see a dentist?
The first dental visit is recommended after the first tooth appears, and no later than around the first birthday. After that, a check-up every six months is usually enough. If you notice spots, sensitivity, pain or swelling, it is wise to book an appointment without waiting for the next check-up.
For prevention tips, see our article on ways to prevent tooth decay in children.
