One of the most common questions I hear from parents during a dental visit is, “How do my kids have cavities?” or “How do cavities even form?” I would not have truly known the answers to these questions until I actually went through dental school and learned about dental decay.
Early childhood caries (ECC), which was previously known as “baby bottle tooth decay” or “nursing bottle caries,” continues to be a prevalent chronic disease of childhood. ECC is defined as having one or more decayed, missing (due to caries), or filled teeth in the mouth in children under six years of age.
In addition, children as young as one and two years of age can come into the office showing areas of teeth with decay, and this is known as severe early childhood caries.
Cavities can form from many different factors. Several factors that are often unknown to patients and their parents are that some teeth are more susceptible to decay due to defects in the enamel, the level of cavity-causing bacteria in the mouth, and the metabolism of sugar by these bacteria. Most people know that a diet high in sugary food and beverages like candy and juice increases the chances of cavities. This is because the bacteria in the mouth feed off the sugar on the teeth and produce an acid, which over time, breaks down the tooth structure, leading to cavities.
I often educate my patients that the best time to detect and treat decay is during the early stages, often before a child starts to experience pain from the cavity. An additional fact that I provide is that the majority of children don't lose their baby molars and canine teeth until the age of eleven or twelve.
I also encourage my parents to help children brush and floss their teeth until the child is about seven or eight. At night, after brushing, have children avoid eating additional snacks or drinking anything other than water. I recommend parents avoid having their young children go to bed with a bottle that contains milk or juice. I inform parents to limit the frequency of snacking on sugary foods and beverages. Even food like pretzels, chips, and crackers can increase the risk of cavities because these foods break down to sugar as well.
Finally, we encourage that children have their first dental visit by the age of one or within six months of getting their first tooth. We like to see our patients every six months to help ensure that they maintain a healthy mouth!
American Academy of Pediatric Dentistry. (2021). Policy on Early Childhood Caries (ECC): Consequences and Preventative Strategies, The Reference Manual of Pediatric Dentistry, 81-82.
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