How to Prevent Childhood Cavities

Sadly, children get cavities and worse - and the main cause may surprise you. As a pediatric dentist, I want to share ways to prevent decay in your children’s teeth.

Acidic beverages are  among the top causes of  tooth erosion and decay in children.  Soda is the worst offender.  Drinks thought to be healthy, like fruit juices, and sports drinks, also are among the leading causes of cavities.

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Even surprisingly small quantities of soda can damage a child’s teeth. As little as one glass per day has been linked to tooth damage, according to the National Institutes of Health (NIH).

How Soda and Fruit Juice Damage Children’s Teeth

Dental enamel - the tooth’s hard outer surface - is the hardest substance in the human body. Acidic drinks are strong enough to break down enamel, especially in baby teeth. That’s because the enamel in baby teeth is still relatively soft and weak, creating opportunities for damage. And tooth decay begins with damage to the enamel.  

Soda and fruit juices wear away enamel. That makes teeth more susceptible to tooth decay (cavities), erosion, sensitivity and pain. Enamel erosion is a problem because enamel that is destroyed can't grow back. Once enamel is damaged, your child will need the help of a pediatric dentist.

Although citrus fruit juices contain healthy vitamins and minerals, they're not healthy for your child’s teeth. They’re packed with Vitamin C, but they're full of tooth-damaging acids as a result. Believe it or not, both lemon and lime juice are comparable to the acidity of battery acid!

What’s pH?

The acronym pH stands for potential hydrogen. It describes the chemical acidity or alkalinity level of a substance. The most alkaline pH level is 14, and the pH level of 0 is the most acidic. The normal pH level in the mouth is 7.0. Tooth decay can begin at a pH of 5 or below.

To put that in perspective, the lower the pH number, the more acidic the substance. The pH of battery acid (sulfuric acid) is 1.0, while the pH of orange juice is 3.3. The pH of soda is about 2.5. 

How does pH cause childhood tooth decay?

The pH level in the mouth affects the health of our teeth and gums. Consuming acidic foods and drinks, can cause the pH in the mouth to quickly fall below 5.0. That can lead to enamel erosion, cavities and root damage.

Interestingly, many beverages generally considered to be nutritious for children have the highest acidity. For example, Welch’s Ruby Red Grapefruit Juice, pH 2.97, Minute Maid Lemonade, pH 2.57; and Arizona Iced Tea, pH 2.85. 

Acidic Drinks That Can Cause Childhood Cavities

Many beverages contain at least one of these acids: carbonic acid, phosphoric acid, malic acid, and citric acid. For example, Gatorade contains citric acid, Coca-Cola contains phosphoric and carbonic acid, and Sprite contains carbonic and citric acid. These acids  weaken the mineral composition of the enamel and dentin, leading to mineral loss and tooth softening.  

This table lists a few of the beverages categorized as “extremely erosive” by a recent study in the Journal of the American Dental Association.  These low pH drinks can cause childhood cavities.

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Rethink Sugary Drinks for Infants

The primary teeth of babies and toddlers are highly susceptible to erosion.  Acidic beverages should not be placed in a baby bottle, especially before bed-time, when the mouth is relatively dry.

Giving children milk or yogurt rather than an acidic beverage has been shown to lower the prevalence of tooth erosion. The protective effect of milk is most likely due to its high amounts of calcium, phosphate, and casein (a protein). Calcium and phosphate protect the dental surface against demineralization and work as a protective barrier against acids. Yogurt also protects against acid-induced tooth erosion.

However, too much milk, particularly at night, may cause a different type of enamel  deterioration leading to “baby bottle cavities.”

Steps to take to prevent tooth decay in children

Besides drinking less acidic beverages, you can help avoid childhood cavities by:

  • restricting the consumption of acidic beverages to the main meals

  • teaching your child to swallow acidic drinks instead of swirling them in the mouth

  • adding calcium effervescent tablets to acidic beverages (e.g., to orange juice)

  • replacing with calcium-enriched sports drink

  • reducing intake of drinks with pH level of 3 or less

  • rehydrating with water (pH7), rather than with sports drinks (pH 2.8 to 3.2)

Concerned that the enamel on your child’s teeth could be damaged by soda, juice or other acidic drink? Make an appointment at our Upper East Side pediatric dentistry office.