How serious is tooth decay in baby teeth? Do I really need to force my child (and myself) to brush twice a day, or can I take a more relaxed approach?
These are questions almost every parent faces at some point, especially on days when brushing turns into a battle. The short and simple answer is: that cavities in baby teeth are a serious problem. They can affect dental health for a lifetime, which is why prevention is crucial.
That said, simply knowing this isn’t enough to help parents in their day-to-day routine. Many practical questions arise, like how to ensure proper dental care that not only promotes good oral health but also makes the brushing routine stress-free and fear-free for everyone involved.
In this blog, she answers the most important questions about baby teeth, tooth decay, and prevention.
- How does tooth decay develop?
- How common is tooth decay in baby teeth?
- How should baby teeth be properly cared for?
- Should dental floss be used for baby teeth?
- How should fluoride be dosed for children’s teeth?
- What impact do food and drinks have on baby teeth?
- How can brushing be made fun for children?
- When should young children visit the dentist for the first time?
- When should tooth decay in baby teeth be treated?
- What happens if tooth decay in baby teeth is left untreated?
- How can fear of the dentist be avoided in children?
- How can parents prepare their children for a dentist visit?
Table of Contents
How does tooth decay develop?
“Tooth decay is caused by a combination of several unfavorable factors,” explains a pediatric dentist. For example, when infants or young children frequently consume sugary foods and lack proper oral hygiene, cavity-causing bacteria thrive and spread. These bacteria convert sugars and food debris into acid, which attacks and destroys the tooth enamel. Initially, the damage is superficial, and the child doesn’t feel any discomfort. However, if left untreated, deep cavities can form, which may harm the tooth nerve. If the nerve gets inflamed, it can lead to swelling and pain.
First teeth are particularly prone to decay
Most cavity-causing bacteria produce lactic acid, including the common bacterium Streptococcus mutans. These bacteria naturally occur in almost every mouth. The problem arises when they multiply excessively due to plaque buildup or tartar, which provides a perfect breeding ground on the tooth surface. The acid attack weakens the tooth enamel by dissolving minerals from its outer layer. Although saliva helps replenish these minerals, excessive acid exposure can cause more damage than the saliva can repair. This allows the decay to penetrate the enamel and reach the underlying dentin, and eventually the nerve.
First teeth are especially prone to decay because their enamel is thinner. Additionally, the enamel is not fully matured when the teeth first come through.
How common is tooth decay in baby teeth?
“It’s hard to give an exact figure,” says, a pediatric dentist. Many studies on baby teeth cavities don’t include X-rays, making it difficult to detect early-stage decay. As a result, tooth decay in children is likely more common than estimated, even though oral health in babies and toddlers has improved over the past decade. One of the biggest challenges is that when small children have cavities, it often affects multiple teeth due to inadequate care and preventive measures. Early and proper advice could have prevented these problems in most cases. Studies clearly show that if parents take care of their children’s dental health from the first baby tooth, cavities can almost always be avoided. Preventive care is effective and worthwhile.
How to properly care for baby teeth?
“A clean tooth doesn’t get sick.” This simple rule should guide parents, and advise a pediatric dentist. Daily oral hygiene, both morning and night, is the foundation of good dental health.
Dental care can begin even before the first tooth appears. Many babies find it soothing when parents massage their gums with a clean washcloth or a finger brush. This also helps babies get used to the sensation of brushing. Once the first tooth comes in, it should be cleaned with a fingerbrush, but parents should quickly switch to a toothbrush for more effective cleaning.
Here’s what parents should know about brushing small children’s teeth:
- Most babies get their first tooth around six months old. Even if they are still breastfeeding, it’s important to start brushing immediately because breast milk contains a lot of sugar, and the first teeth are particularly prone to decay.
- The duration of brushing is not as important as thoroughly cleaning every surface of the teeth during each session. This time varies for each child.
- Establishing a brushing routine helps ensure no area is missed and makes brushing a daily habit. A good approach is to start with the spaces between the teeth, followed by the chewing surfaces, inside surfaces, and finally the outer surfaces. Use circular motions and light pressure for the teeth and gums. For chewing surfaces, brush back and forth.
- Encourage children to hold a toothbrush early on, even if they just play with it or chew on it. Eventually, they will want to brush by themselves. However, parents should continue supervising and helping until children have the motor skills to brush effectively, usually around age eight for girls and age nine for boys.
- For easier brushing, lay your child down so you can see their mouth clearly. This can also prevent tantrums as you have better control in this position.
- After each use, rinse the toothbrush or fingerbrush with hot water and let it air dry.
Should floss be used for baby teeth?
As soon as the gaps between teeth close, parents should start using dental floss on their children’s teeth. Interdental cavities are the most common type of decay in baby teeth, highlighting that flossing is often overlooked in young children’s dental care.
Floss holders can make the process easier. It’s important to gently guide the floss between the teeth without hurting the gums. Avoid using interdental brushes for young children due to the specific anatomy of baby teeth.
How to properly dose fluoride for children’s teeth?
Fluoride is a mineral that strengthens teeth and protects them from decay. The benefits of fluoride are well-established. Here’s what a pediatric dentist recommends for fluoride use:
- Fluoride tablets should be avoided, even though pediatricians still prescribe them. Fluoride needs to be applied directly to the teeth to be effective, which can only be done through brushing. Excessive fluoride can cause a condition called fluorosis, which affects the enamel.
- For children under two, use fluoride toothpaste only once a day, preferably at night.
- From the age of two, brush with fluoride toothpaste twice a day.
- From age six, switch to junior toothpaste with a higher fluoride content.
- After the first permanent teeth appear, children should strengthen their enamel with fluoride gel once a week.
- In addition, fluoride treatments are recommended twice a year during dental checkups.
How do food and drinks affect baby teeth?
We all know that sugar is bad for teeth. The bacteria that cause cavities turn sugar into acid, which erodes the enamel. But it’s not just about keeping kids away from chocolate, biscuits, and sweets, says a pediatric dentist. Sugar hides in unexpected places, so here are some additional tips for tooth-friendly eating and drinking for children:
- Extended breastfeeding is not recommended once children have teeth, as breast milk contains a lot of sugar.
- Sugary drinks, including fruit juices, can be harmful to baby teeth. It’s important to introduce children to water early on as their main drink. The problem with sugary drinks isn’t occasional consumption but frequent sipping throughout the day, which continuously exposes teeth to sugar and acid. This prevents the enamel from remineralizing and recovering. However, juice with lunch isn’t harmful if teeth are otherwise well-cared for.
- The same principle applies to snacks like fruit or starchy foods like bread. It’s the frequency of snacking that matters. Encourage children to eat, then take a break, allowing the enamel time to recover.
- Bottle feeding is another potential issue for baby teeth, especially for the front teeth. Early introduction to cups can help prevent cavities. Prolonged use of bottles, pacifiers, or thumb-sucking can lead to tooth and jaw misalignment, which may require braces later on. Ideally, children should stop using bottles by age three.
How to make brushing fun for children?
“All parents go through phases where their kids refuse to brush.”. But giving in is not an option, as it harms their teeth. Even when kids resist, consistency is key, just like buckling them into a car seat for safety. The same attitude applies to brushing for dental health.
Here are some tips to make brushing more fun:
- Turn brushing into a playful ritual with set times, locations, and routines. For example, use a toothbrushing song or let your child play with their toothbrush.
- Brush in a position where you can clearly see your child’s teeth. Laying them down can make this easier.
- Allow enough time for brushing to avoid stress. If it takes less time than expected, even better!
- Brush gently with little pressure, avoiding sensitive areas like the gums and frenulum (the tissue that connects the lips to the gums).
- Encourage your child to explore brushing on their own. The goal isn’t for them to master it right away, but to help them feel comfortable with the process.
- Use the many available tools, like electric toothbrushes (which parents can use for more effective cleaning) or apps that reward kids for brushing long enough. However, children should only use electric toothbrushes themselves once they reach school age.
When should young children first visit the dentist?
“We recommend the first dentist visit when the first tooth appears,” says a pediatric dentist. This initial visit is covered by most insurance plans and focuses on parent education. It’s a good idea to choose a pediatric dentist, as they are trained to cater to children’s needs. The latest by 2.5 years, once all baby teeth have come in, children should begin regular checkups every six months.
When should tooth decay in baby teeth be treated?
“If only the enamel is affected, professional cleaning and fluoride treatments are often enough,” explains a pediatric dentist. Fluoride helps rebuild the enamel and protects against further decay. However, if cavities extend to the dentin, the decay needs to be removed, and a filling will be applied. In severe cases, baby teeth may need crowns or even extraction. If a tooth is lost, spacers are often used to keep the space open for the permanent teeth.
What happens if tooth decay in baby teeth is left untreated?
Some may think that because baby teeth fall out eventually, treating cavities isn’t necessary. However, untreated decay significantly increases the risk of cavities in permanent teeth. Infected baby teeth can also damage the developing permanent teeth underneath and lead to premature tooth loss, which may cause alignment issues or even affect jaw development. This can lead to problems with eating, speaking, or future orthodontic treatment.
How to Prevent Fear of the Dentist in Children?
“It’s important for children to visit the dentist as early as possible and then regularly, to become familiar with the environment,” says a pediatric dentist. “Ideally, this should happen while their teeth are still healthy, allowing them to have positive experiences.”
If dental treatment is needed, a professional dental cleaning can be a helpful preparation. This allows children to get used to the feeling of a dental procedure, practice sitting still and keeping their mouth open for a longer time, and become familiar with the tools and sounds. In pediatric dental practices, dentists and assistants engage with children on their level. If they have questions, they receive child-friendly explanations. The language used is often positive, incorporating behavior management techniques to keep children calm.
How Can Parents Prepare Their Children for a Dental Visit?
Here are a few ways to make the experience easier:
- Introduce the upcoming dental visit as part of your daily toothbrushing routine a few weeks in advance. For example, play a game like “count the teeth” and prepare your child for opening their mouth, explaining that it’s as normal as smiling, talking, or whistling.
- Create excitement by explaining that the visit is a positive experience.
- Take your child’s questions seriously, like “Will it hurt?” Avoid negative phrasing such as “Don’t worry, it won’t hurt,” which might not help. Instead, offer more concrete answers like, “It might tickle a little when they check your teeth.” Also, avoid words like “drill” or “injection.” The dentist and their team will use kid-friendly explanations without causing unnecessary anxiety.
- Let the dental professionals handle the communication during the visit.
- Avoid promising rewards, as this can create pressure for the child, making the visit more stressful.
- Try not to transfer your own anxiety or fear of the dentist to your child. The more relaxed you are, the more confident your child will feel.
This blog post on baby teeth and tooth decay was created in collaboration with a pediatric dentist from Hamburg. It includes a link to her dental practice. The photos were kindly provided by a pediatric dentist.
The content is based on an interview with a pediatric dentist and thorough journalistic research. The information aligns with the recommendations of the German Association of Pediatric Dentists. Additionally, a pediatric dentist shared practical, parent-tested tips that I found very helpful and wanted to share here.
