What? My child has a cavity! – Is often heard shocking reaction that most parents come up with – a mix of surprise and fear!

Unfortunately, a dental cavity diagnosed by the Pedodontist is the time when the tooth really needs treatment, as the damage has already happened, even though the child may never have complained of pain. What kind of treatment would depend on the age of the child and history of pain, as it determines the extent to which the decay may have spread?

A regular 6 month checkup is ideal as it gives your pediatric dentist a chance to do a thorough examination, identify any hidden (or potential) cavity, treat any lesion, identify the child at high risk and suggest good preventive measures to keep cavity away!

What is a cavity?

Cavity or tooth decay is caused by bacteria that feed on sugars, which produce acid that eats away at the structure of teeth, and hence the surface of the teeth collapses or breaks down.

Why do cavities occur?

The prime reason that cavities occur is improper brushing; regular intake of refined food and proneness to tooth decay. Children have much more sugar in their diets at an early age. The trend these days is to consume more of refined carbohydrates, sugary and sticky foods. Eg:  biscuits, chips, cookies, chocolates, hard-boiled candies etc, different condiments that have high amount of sugar etc.

When there is an imbalance in good oral hygiene and increased intake of cavity forming foods, the enamel of the tooth – the outer most layer and hardest substance does not remain strong and gets more prone to decay.

What is nursing decay?

Parents often complain that my child’s teeth have been bad since the time they have first appeared. Babies are born without any of the harmful bacteria in their mouths. Typically mothers/ caregivers transfer the bacteria that causes tooth decay through various medium like kissing, sharing the same utensils, feeding from a used (contaminated) spoon and letting toddler brush his teeth with their toothbrush etc.

But the most important factor that produces tooth decay in infants is incorrect way of nursing. Once the tooth erupts, the child should not be put to sleep with the milk in his mouth – be it breast milk or bottle milk. Since last mouthful of milk still remains, which doesn’t get swallowed and the teeth remain soaked in milk all the while the child is asleep and this gives rise to nursing decay.

Why do we need to treat milk teeth? They will fall!!!!

This is the most common objection/ question when treatment is suggested and least bothered area wherein awareness is yet to set in amongst general population. The first milk tooth to fall is the lower front one at the age of 6-7 years, followed by upper front by 7-8 years and so on. Gradually and eventually all the milk teeth WILL fall and the permanent teeth will take their place. The last teeth to fall will be second milk molars at 11-13 years. The milk teeth are required for chewing, speech, aesthetics, growth of jaws and maintaining the space for the yet to come permanent teeth. Once the decay sets, it will progress until treated. An infected tooth will cause pain, difficulty in chewing and therefore poor nutrition. Hence a tooth that can be saved with a simple filling may require a root canal or maybe even extraction later if the infection is severe. And we are only complicating by leaving it untreated, as it is the child who suffers with pain and swelling in the infected tooth.

Whenever we consume diet containing sugar, starch or refined carbohydrates, there is an immediate acid attack on the tooth. However, good brushing within half an hour would take care of the attack and prevent the tooth from further damage as the fluoride in the toothpastes and few components in the saliva have anti-cavity properties. Doing a good job of brushing morning and evening is a must, but if the wrong foods are consumed throughout the day, the teeth are bound to decay as the bacteria producing acids get charged up and attack the enamel. This constant consumption would further deplete the tooth of the important minerals required for strength and instead would weaken the structure of the tooth.

What kind of treatment is done for the cavities? (Dealing With Cavities)

Depending on the extent of the cavities the teeth can be treated with simple fillings. The doctor might take few X-rays of the teeth, which will give relevant information whether the cavity has reached the nerve if the child complains of pain. In situations if the cavity has already reached the nerve, root canals or extractions, space maintainers could be the ideal choice for treating the infected tooth.

How can I prevent cavities?

• Ideal way to prevention begins from pregnancy with self-oral care.
• Wiping gums and teeth for the infant, introducing baby brush by one year of age.
• Use of fluoridated toothpastes- 500 ppm by two years and once the child learns to spit and gargle switch to a 1000ppm of fluoride.
• Fluoride applications.
• Pit and Fissure Sealants.
• Dietary modification.
• 6 monthly visit for regular check ups.

About Dr Mitali:

Dr Mitali Kochar, M.D.S (Pediatric and Preventive Dentistry) has received her Master’s degree from the Bharati Vidyapeeth University- Pune in 2011 after obtaining her BDS in 2007.

She has various publications on clinical pediatric dentistry and has participated at various conferences.

For past two years she is working at an exclusive pediatric dental clinic, dedicated to rationally managing dental needs of children. Her main focus is preventive dentistry.

Mitali has just been blessed with a baby girl and we are sure she is going to practice what she is advising others about.