What to Do When Your Child Has a Cavity

Cavities, also called dental caries or tooth decay, are extremely common in children. They can develop in baby teeth or permanent teeth when bacteria in the mouth combines with the sugar from food, starting a process that eats away at the tooth’s outer layer. Cavities are often preventable with proper oral hygiene, a balanced diet, and regular visits to the dentist.

This article discusses the causes of cavities in kids, treatment options, and tips for cavity prevention.

Causes and Risk Factors

A cavity is a small hole in your tooth that occurs when the hard outer layer of the tooth, called the enamel, is damaged. Cavities form when bacteria and sugar in the mouth create an acid that eats away at the enamel. Because bacteria are naturally present in the mouth, anyone can get a cavity.

Cavities in Babies and Toddlers

Cavities aren’t only an adult problem. They can also develop in babies and toddlers as soon as baby teeth start to appear. In this age group, there are a few situations that create a prime environment for a cavity to form:

• Exposure to bacteria: Parents and caregivers often unknowingly pass additional cavity-causing bacteria onto babies' mouths. For example, saliva can be shared when a parent tests a food or drink before feeding a baby with the same utensil or cup. It can also happen while cleaning off a pacifier with your mouth before passing it back to your baby.
• Exposure to sugar: Whenever a baby's teeth or gums are exposed to liquid or food other than water, tooth decay can develop. This commonly happens when a baby is put to bed with a bottle of formula, milk, juice, soft drink, or sugar water. It can also happen when toddlers drink anything other than water out of a sippy cup or bottle frequently throughout the day.
• Dental hygiene: Babies and toddlers don't have a mouth full of teeth yet, but they still need an oral hygiene routine. Parents and caregivers can start thinking about professional dental checkups starting as early as 6 months old. In addition, after every baby feeding session, a clean washcloth should be used to gently wipe the inside of the mouth and gums. Experts also recommend gently brushing toddler teeth with a child-sized toothbrush and a drop of fluoride toothpaste.

Cavities in Children

Even though they may not be drinking out of a bottle or sippy cup anymore, older children are also susceptible to getting cavities. Some common risk factors include:

• Eating a diet high in sugars and starches: When mixed with bacteria in the mouth, sugar and carbohydrate-rich foods like juices, candy, cookies, chips, and crackers are easily broken down into acids that can damage the tooth's outer layer and turn into a cavity. Frequent snacking exposes your child's teeth to this damage even more.
  
• Insufficient fluoride use: Experts have found that fluoride, a natural mineral, helps prevent bacterial overgrowth and mineralizes the teeth. If your child does not have access to fluoride through toothpaste or tap water, they may be losing an added layer of protection for fighting cavities.
  
• Limited dental hygiene routine: In addition to professional dental cleanings twice a year, the American Dental Association recommends that children brush their teeth twice a day for two-minute intervals each time (ideally after breakfast and before bed). If not supervised, it's easy for children to be lax about brushing, or skip it altogether.
• Tooth structure and susceptibility: Despite having good oral hygiene habits, some children appear to be more prone to getting cavities. Experts suspect this could be due to genetic predisposition involving the structure of the tooth's enamel, or bacteria naturally present in the mouth.

Signs and Symptoms

Cavities can be tricky to catch, since there aren't always noticeable symptoms that show up during the early stages of tooth decay. As the cavity continues to form, watch out for the following signs in your child:

• Pain
• White spots on teeth
• Dark spots on teeth
  
• Crying or fussiness
• Sensitivity to cold foods or drinks
• Avoiding foods
• Mouth swelling
• Lethargy

Treatment

The goal of cavity treatment is to make sure any damage to the baby teeth or permanent teeth doesn't get any worse. Treatment will depend on your child's symptoms, age, general health, and the extent of the tooth decay.

Treatment options include:

• Fluoride varnish: If the cavity has just started to form, your dentist may be able to help prevent any further damage by using professional fluoride treatments. A solution with a high concentration of fluoride will be applied to the child's teeth to help repair the enamel and reduce any decay that has already begun.
• Dental filling: To treat a typical cavity, the tooth decay is removed with a small drill and filled with a composite or resin material to protect the tooth.
• Dental crown: In cases of more severe tooth decay, the decayed portion of the tooth is removed and replaced with a crown, which is a covering that fits on top.
• Root canal: When a cavity is closer to the nerve, a root canal may be recommended. This involves removing the infection deep inside the tooth, cleaning it out, and then placing a filling or a crown for protection.
• Tooth extraction: When there's a severe infection under the tooth, or the cavity is too big for a filling or crown, the dentist may recommend pulling (extracting) the tooth. A dental bridge or dental implant will be recommended to fill the space that the tooth has left, so that your other teeth don’t move into the space. 
  

Many people of all ages have anxiety or fear about going to the dentist. Rest assured, dentists use local anesthesia to numb the area before performing common cavity treatments, and general anesthesia for procedures like tooth extraction, so your child should not feel any pain.

If you think your child may need additional support to ease their mind or pain level while undergoing cavity treatment options, check with your dentist's office about options to help them relax. Pediatric dentists are used to working in a completely kid-focused and friendly environment, and they may be able to help deal with dental anxiety.

Cavity Prevention

While cavities in children are common, they're also preventable. It's important to take steps to prevent and treat tooth decay to avoid pain, loss of affected teeth, and a negative impact on your child's growth, speech, and overall well-being and self-esteem.

To help prevent cavities in children, experts recommend implementing the following tips.

Daily Habits

• Wipe your baby's gums with a clean, damp washcloth after feedings.
• Gently brush with a soft baby toothbrush and tiny amount of toothpaste at the first sign of baby teeth.
• Brush twice a day and flossing once a day for toddlers and older children.
• Use fluoride toothpaste and fluoridated tap water to brush, as recommended by your dentist.

Diet

• Reduce the number of sweets and snacks that your child eats.
• Avoid putting your child to bed with food or a bottle that contains anything other than water.
• Encourage your child to drink from a regular cup as soon as practicable to reduce the amount of liquid collecting around the teeth.

Dental Care

• See a dentist for regular checkups and professional cleanings before the baby turns 1, and as early as 6 months of age.
  
• Consider dental sealants, a thin plastic layer that protects teeth from food particles and plaque development.
  

Summary

Childhood cavities are common, both in baby teeth and permanent teeth. Factors like poor oral hygiene and a diet high in sugary foods can raise your child's risk for cavities. Treatment involves removing the decayed part of the tooth and protecting it from further damage with a filling, crown, root canal, or, in rare cases, tooth extraction.

Creating good brushing and flossing habits, encouraging a healthy diet, and scheduling regular dental checkups are important for preventing cavities in kids.

A Word From Verywell

Oral health is important for your child's overall health and well-being. That said, dentists don't expect children to be perfect. Cavities are extremely common, and most of us will get at least one in our lifetime. The American Academy of Pediatrics recommends "everything in moderation," so you should feel free to give your child occasional candy or special treats, just as long as they're brushing, flossing, using fluoride, getting routine dental care, and eating a healthy diet.