Updated on February 1, 2024
6 min read

Cavities in Baby Teeth: Causes, Treatment, and Prevention

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  • Baby teeth are important and should be cared for like permanent teeth.
  • An untreated cavity on a baby tooth can negatively affect your child’s oral health and cause problems when the adult teeth grow.
  • Untreated cavities in baby teeth can lead to problems in developing permanent teeth.
  • To prevent cavities in baby teeth, practice good oral hygiene with your child and ensure they eat healthy foods. Also, talk to your pediatric dentist about treatments like fluoride or sealants.

What is a Cavity on a Baby Tooth?

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.

Cavities on baby teeth, known as 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.1

About 20 percent of children have untreated tooth decay in their baby teeth, and 21 percent of children between 6 and 11 years of age have cavities in their adult teeth.1

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. This makes them prone to “caries attacks.” The pits and fissures (deep grooves) on primary teeth are very thin, which creates an 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 bacteria and plaque on teeth result in cavities. Scheduling professional teeth cleanings at least twice a year prevents plaque buildup. 

Pediatric dentists remove plaque you cannot reach with a regular toothbrush during cleanings.

Starchy and Sugary Foods

Refined carbohydrates and sugary foods can cause cavities in baby teeth. Drinking fruit juice from a sippy cup or bottle is also bad for your child’s dental health. This is known as baby bottle tooth decay or bottle rot.

Improper Oral Hygiene

Brushing, flossing, and using fluoride toothpaste regularly reduce the chance of childhood cavities. Before teeth grow in, parents should routinely clean their baby’s gums to prevent the spread of cavity-causing bacteria.

Dry Mouth

Saliva helps maintain healthy tooth enamel. Reduced salivary flow, or dry mouth, can increase the likelihood of cavities or decay.

Family Oral Health History

A mother can transfer cavity-causing bacteria to her baby. You should pay close attention to oral hygiene during pregnancy because it is a critical factor in preventing:

  • Cavities
  • Gum disease
  • Tooth loss

If a mother has untreated cavities, sharing utensils or kissing her baby on the lips can cause cavities in her child’s teeth.

Childhood Habits

Some everyday childhood habits can increase the risk of tooth decay, such as:

  • Excessive bottle feeding
  • Excessive pacifier use
  • Frequent thumb sucking
  • Using pacifiers dipped in honey, juice, or milk

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

Tooth decay in baby teeth can affect the development of permanent teeth in two ways:

  1. Dental abscess This bacterial infection can only affect the underlying permanent tooth if it is still in the process of being formed. 
  2. Misaligned teeth — If 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.

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 also more expensive and invasive and may warrant general anesthesia or sedation.

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 onlaysThese restorations may be necessary if the cavity is too large for a standard filling.
  • CrownsThese restorations fit over the entire tooth.

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:


Begin brushing your child’s teeth as soon as the first grows in. You should brush their teeth, gums, and tongue twice a day. Supervise them as they begin to brush their teeth.

For children under three years old, the amount of toothpaste you use should be about the size of a grain of rice. Around age 3, you can increase that to a pea-sized drop of toothpaste.


Start flossing your child’s teeth daily around age 2. This helps to establish good oral hygiene habits.


Ensure your child eats a well-balanced diet of whole grains, fruits, vegetables, and lean protein. Avoid processed foods and sugary snacks that can increase plaque formation.

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

Prevent the Transfer of 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 pediatric dental exams and teeth cleanings. Talk to your dentist about how to prevent cavities in baby teeth. They may recommend:

Treatment Costs and Insurance

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

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

Amalgam (Silver) Filling$50-$200 (per tooth)
Composite Filling$90-$300 (per tooth)
Stainless Steel Crowns$300-$500 (per baby tooth)
Sealants$30-$75 (per tooth)

Last updated on February 1, 2024
6 Sources Cited
Last updated on February 1, 2024
All NewMouth content is medically reviewed and fact-checked by a licensed dentist or orthodontist to ensure the information is factual, current, and relevant.

We have strict sourcing guidelines and only cite from current scientific research, such as scholarly articles, dentistry textbooks, government agencies, and medical journals. This also includes information provided by the American Dental Association (ADA), the American Association of Orthodontics (AAO), and the American Academy of Pediatrics (AAP).
  1. Dental Caries (Tooth Decay) in Children Age 2 to 11.” National Institute of Dental and Craniofacial Research, 2022.
  2. Fluoride and Healthy Teeth.” Paediatrics & Child Health, 2002.
  3. Johansson, A, et al.Pediatric Dentistry: a Clinical Approach.” John Wiley & Sons Inc., 2017.
  4. Nowak, AJ.Pediatric Dentistry: Infancy through Adolescence.” Elsevier, 2019.
  5. Berkowitz, RJ. “Causes, Treatment, and Prevention of Early Childhood Caries: A Microbiologic Perspective.” Journal-Canadian Dental Association, 2003.
  6. Mathur, VP, and Dhillon, JK. “Dental Caries: A Disease Which Needs Attention.” The Indian Journal of Pediatrics, 2018.
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