Early Childhood Cavities

Dental caries, commonly termed “cavities” or tooth decay, is the breakdown of teeth as a result of bacterial biochemical reactions that generate acids. Dental caries is caused by bacteria and is considered to be the most common chronic infectious disease in childhood.

Specifically, it is caused by the metabolic activities of bacteria, on sugary foods, thereby generating acids that adversely affect the tooth enamel. Although enamel is the hardest substance in the human body, the acidic end products of the bacterial decomposition of sugars cause de-mineralization of the enamel, leading to dental caries.

Read more on how to prevent childhood cavities.

Newly erupted teeth with immature enamel are highly susceptible to developing caries. A baby is not born with the oral bacteria that cause cavities, but may acquire the bacteria from its mother or caregiver through salivary contact (e.g., by sharing utensils) or from other children in daycare (e.g., by sharing things that have made oral contact with others).

Infants or toddlers with caries have a much greater probability of subsequent caries in both the primary teeth and the permanent teeth.

The ramifications of untreated cavities are many and are varied. If the child’s condition remains untreated, dental health deteriorates and is more difficult and costly to treat.

Severe cavities may lead to:

• extreme pain
• discomfort
• acute and chronic infections
• altered eating
• sleeping habits

Because of the associated pain with cavities and lack of desire to eat, young children may be underweight. A young child with rampant early childhood cavities may weigh less than 80% of their ideal weight and grow at a slower rate than dental caries-free infants.

Cavities leading to tooth loss have psychological, social, and physical effects including:

• impaired speech development
• absence from school
• lowered self-esteem

As compared to permanent teeth, newly erupted baby teeth are particularly susceptible to cavities. The enamel and underlying dentin of baby teeth are thinner than permanent teeth and the progression of a cavity to the inner pulp occurs more rapidly in baby teeth.

Cavities, missing teeth, and tooth restorations on toddlers and preschool age children are a particularly challenging situation.

Early childhood caries is defined as one or more cavities or missing teeth, due to cavities in a child under age six.

ECC is a multifactorial disease with a multitude of causes.

Diet is an important factor, principally, the consumption of fermentable carbohydrates and the length of time of exposure of teeth to sugar. Bottle feeding and sleeping with a bottle of sweetened drink has been correlated with ECC.

Although breast milk is considered the perfect nutrient for an infant, prolonged and nocturnal breastfeeding has also been associated with ECC.

Parents may need to refine their feeding behaviors, such as shunning ad libitum (on demand) breastfeeding after the eruption of the first primary tooth, avoid putting a child to sleep with a bottle containing fermentable carbohydrates, (i.e., milk or juice), weaning the child from the bottle at 12 to 14 months of age, encouraging the child to drink from a training (sippy) cup, and avoiding between meal snacks. Plain water before bedtime or naps is the most ideal drink.

Fluoride, either in a tooth paste or in water, has a positive effect on reversing the process of ECC, as it promotes re-mineralization of the tooth surface, as opposed to bacterial acids which promote de-mineralization of the tooth surface.

For more information about the early childhood cavities or its treatment, please visit pediatric dentist Dr. Sara Babich or call our office. Dr. Sara provides individual, personalized and excellent pediatric dentistry on the Upper East Side.

Pediatric Dentistry: Dr. Sara B. Babich, DDS
116 E 84th St
New York, NY 10028
(84th St. btw Park Ave / Lex Ave)
☎ 212-988-4070

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New York City pediatric dentistry practice 212.988.4070