Cavities in Baby Teeth: Causes, Treatment, and Prevention

Cavities are decayed areas on teeth that develop tiny holes. They can form on the smooth sides of teeth, in the grooves of teeth, or on the surfaces of tooth roots.

Let’s discuss cavities on baby teeth, their causes, and what you can do to prevent and treat them.

What is a Cavity on a Baby Tooth?

Cavities on baby teeth, or early childhood caries (ECC), are the most common oral disease that affects children from infancy through adolescence.

According to the 2012 National Health and Nutrition Examination Survey (NHANES), 56 percent of children between 6 and 8 years of age had cavities in their primary teeth.

About 20 percent of children have untreated tooth decay in their baby teeth. Additionally, 21 percent of children between 6 and 11 years of age have cavities in their adult teeth.

What Causes Cavities on Baby Teeth?

Tooth decay begins when bacteria that typically live in the mouth combine with carbohydrates from foods and produce acid.

This combination of acid, food, and bacteria forms a sticky plaque. Over time, the acid eats away the tooth enamel, causing cavities.

Baby tooth enamel is more fragile than permanent teeth, making them prone to “caries attacks”. The pits and fissures on primary teeth are also very thin, making it the ideal environment for: 

• Plaque retention
• Bacteria proliferation
• Demineralization

Risk Factors for Cavities in Baby Teeth

Certain factors increase your child’s risk of a baby tooth cavity, including:

• Plaque buildup — High levels of plaque building up on teeth can result in cavities. Pediatric dentists can remove plaque from baby teeth during cleanings.
• Starchy and sugary foods — Refined carbohydrates and sugary foods can cause cavities in baby teeth. Drinking juice from a sippy cup can also be bad for their teeth.
• Improper oral hygiene — Brushing, flossing, and using fluoride toothpaste regularly reduce the chance of childhood cavities. You should also routinely clean their gums.
• Dry mouth — Saliva helps maintain healthy tooth enamel. Reduced salivary flow, or dry mouth, can increase the likelihood of cavities or decay.
• Mother’s oral health — A mother can transfer cavity-causing bacteria to her baby. If she has untreated cavities, sharing utensils can cause cavities in her child’s teeth.
• Childhood habits — Excessive bottle feeding, pacifier use, and thumb sucking can increase the risk of tooth decay.

Potential Complications of Cavities

Untreated cavities in baby teeth can lead to other oral health conditions, such as gum disease or tooth loss. It can even affect the development of permanent teeth.

Tooth decay in baby teeth can affect the development of permanent teeth in two ways. The first is a dental abscess. This bacterial infection can only affect the underlying permanent tooth if it’s still being formed.

The second way is through misaligned teeth. This happens when a primary tooth is extracted or lost due to decay, permanent teeth can move into the open space. This results in crowded or crooked teeth.

Preventing Cavities in Baby Teeth

You can prevent tooth decay naturally with lifestyle changes or through preventive dental techniques, such as tooth sealants and fluoride therapy.

According to the American Dental Association (ADA) and the American Academy of Pediatric Dentistry (AAPD), a child’s first dental visit should occur after the first tooth appears or no later than the first birthday.

Cavity prevention tips include:

• Brushing — Brush your child’s teeth, gums, and tongue twice a day. For children under three, the amount of toothpaste you use should be the size of a grain of rice. 
• Flossing — Start flossing your child’s teeth daily around age 2. This helps to establish good oral hygiene habits.
• Nutrition — Ensure your child eats a well-balanced diet of whole grains, fruits, vegetables, and lean protein. Avoid processed foods and sugary snacks.
• Prevent transferring bacteria — Avoid activities allowing bacteria from your mouth to enter your child’s. Don’t share utensils or use your saliva to clean your child’s pacifier.
• Visit the dentist — Schedule regular dental exams and cleanings. They can provide fluoride treatments, dental sealants, and fluoride supplements to prevent cavities.

Additionally, if your child takes a bottle at bedtime, put only water in it. Formula and juice contain sugars that can lead to cavities.

When Should You See a Dentist?

You should consider visiting the dentist if you notice any of the following:

• White spots on the teeth could be a sign of demineralization.
• Sensitivity to hot, cold, or sweet foods can indicate a cavity.
• Black or brown spots and visible holes in the teeth can be signs of advanced decay.
• Persistent tooth pain or bad breath can also indicate a cavity.

How is a Cavity on a Baby Tooth Treated?

Multiple cavities in baby teeth can lead to severe pain, hospitalizations, or emergency room visits. Treating multiple cavities is more invasive and may require general anesthesia or sedation. It’s also expensive.

Your dentist will determine the best treatment based on your child’s age, symptoms, and overall health. In most cases, cavity treatment involves removing tooth decay and replacing it with a dental filling.

There are two main categories of fillings:

Direct Restorations

These direct restorations are completed in a single visit. They involve placing a dental filling into a prepared hole in the tooth. Common filling materials include:

• Composite resin
• Amalgam
• Glass ionomer 

Indirect Restorations

These restorations are made out of the mouth. They include:

• Dental inlays and onlays — These restorations may be necessary if the cavity is too large for a standard filling.
• Crowns — These restorations fit over the entire tooth.

Treatment Costs and Insurance

The cost of a cavity restoration depends on the type and the dentist’s location. However, dental restorations are medically necessary.

A good insurance policy covers part or most of the procedures. The prices below reflect procedure costs without insurance: