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Leading Causes of Cavities in Children

February is National Children’s Dental Health Month

Close to half of all children aged two to 11 years old develop at least one cavity in their lifetime. Early childhood cavities – identified as those that occur between birth and age six years old – can cause pain and distress, while damaging the primary (baby) teeth. Among children aged six to eight years, more than half (52%) have had a cavity in their primary teeth.

Also known as tooth decay, cavities are regarded as one of the greatest unmet health needs. Cavities remain the most common childhood chronic disease in the United States. Untreated cavities can cause pain and infections under the gums, which can spread to other parts of the body. In some cases, this could lead to serious harm.

According to the U.S. Centers for Disease Control and Prevention, this can lead to difficulties with eating, speaking, playing, and learning. Also, children with poor oral health tend to be absent from school more and receive lower grades than children who have optimal oral care. Limiting certain foods and teaching dental hygiene habits at a young age can lead to a lifetime of healthy behaviors while preventing cavities in the process.

5 risk factors for cavities in children

The following five factors may elevate a child’s risk for tooth decay:

  1. A diet high in sugary, starchy, and acidic foods: Sugars and refined starches in foods promote tooth decay because they begin breaking down in the mouth, feeding the bacteria that live there. Also, acidic foods and beverages can cause cavities by speeding up enamel dissolution. These are some of the foods that are known to cause cavities:
  2. Crackers
  3. Potato chips
  4. Cakes and pastries
  5. Cookies
  6. Hard, sticky, and chewy candy
  7. Breakfast cereal
  8. Fruit snacks
  9. Dried fruit
  10. Soda, energy drinks and sports drinks
  11. Sugary vitamins (gummy vitamins in particular)

Certain foods can help kids negate cavity risk. Calcium-rich foods, foods high in vitamin C and protein, as well as bacteria-fighting foods, are at the top of the list. Examples include celery, carrots, apples, oranges, strawberries, hard-boiled eggs, yogurt and cheese. Also, some products like toothpaste, mints and gum can contain Xylitol, a natural sweetener that helps prevent cavities.  

  • High levels of bacteria: Humans have more than 500 different species of bacteria living in their mouths – and not all of them are bad. Some of them defend the teeth and promote good digestion. But when a bacteria called Streptococcus mutans (S. mutans) multiplies in the mouth, cavities can occur. This happens when S. Mutans interacts with food particles in the saliva to create acids and form plaque.   
  • Inadequate oral hygiene: Children must develop consistent brushing and flossing habits at a young age. Parents should start caring for their baby’s teeth as soon as they come in by brushing twice a day with a soft, small‑bristled toothbrush and plain water. By about age 3 years old, they should learn how to brush their teeth themselves. The CDC recommends watching all children under the age of 6 years old brush to make sure they use a pea-sized amount of toothpaste and spit it out instead of swallowing. Children’s teeth should be flossed as soon as they touch each other. Consistent oral health habits should be stressed to the entire family. Adults and children alike should brush twice a day and floss at least once a day.
  • Water supply with limited or no fluoride: Drinking fluoridated water strengthens developing teeth and reduces cavities. If children are drinking bottled water, consider talking to their dentist to make sure they are getting enough fluoride. Fluoride toothpastes are also available, and dentists may offer a topical fluoride treatment.
  • Medications: While not a leading cause of tooth decay, some medications can damage primary teeth. The use of inhalers to treat asthma can cause dry mouth and disrupt salivary pH balance. Saliva plays a large role in protecting teeth, so a decrease in saliva can cause decay. Also, in the case of a severe childhood illness, children on high-dose antibiotics may be exposed to developmental defects in the primary and permanent teeth.

What to do when children develop cavities

Cavities are common and can occur even when families do their best to safeguard against risk factors. Here are important steps parents and caregivers should take when their dentist diagnoses a cavity:

  • It is important to have a cavity addressed once a dentist identifies it. The most common form of treatment is for the affected part of the tooth to be removed and filled. Fillings come in a variety of options and are completely safe, according to the U.S. Food and Drug Administration. In some instances, an additional option may include the placement of Sodium Diamine Fluoride (SDF). It is administered to a decayed tooth to prevent the cavity from growing, but it may turn the tooth a dark color. Take the time to discuss the treatment options with your child’s dentist.
  • Don’t put off addressing the cavity because it is a baby tooth that will fall out or there is no current pain. Decay will continue to grow and could affect other teeth in the mouth if no dental treatment is performed. Some parents are under the belief that treating cavities requires tooth removal, but that is untrue. Tooth extraction is only performed as a last resort if the cavity has progressed and is untreatable with a filling or SDF.
  • Maintain regular visits. Regular dental checkups are crucial, as they allow the diagnosis of new cavities or identify previous treatment that has broken down before they become bigger issues and cause further problems.

How often should children see the dentist?

Children should visit the dentist after their first tooth appears or before their first birthday. The dentist will then determine how often visits should occur. Regular dental check-ups will let parents know if their child has any problems with their teeth as well as educate them on diet and proper home care. Frequent visits can also help children adopt good brushing and flossing habits. Also, it is important to establish consistency and a good rapport with the entire dental team early.

Kristi Thomas, D.D.S., MPH, FICD, is an associate dental consultant at Blue Cross Blue Shield of Michigan. For more health tips and information, visit

A Healthier Michigan
Author: A Healthier Michigan

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