Child Caries Prevention

What is Caries?

Caries is also called Tooth decay dental caries. It’s a disease that causes damage to tooth structure.

If bits of food are left on the teeth after a drink or meal, the germs in your mouth (called plaque) can turn those tiny bits of food into acid. Over time, this acid eats away at the surface of the tooth, creating holes or cavities.

Tooth decay can cause pain, infection and even affect children’s growth. Severe decay in baby teeth can have serious consequences for your child’s speech and jaw development.

The longer tooth decay is left untreated, the more your child will experience:

● pain and discomfort

● a higher risk of new decay in other baby and adult teeth

● more complicated and expensive treatment

● anxiety when he does visit a dentist, because he might start to associate dentists with pain

● loss of time at school.

Early signs of tooth decay
Early tooth decay can be hard to spot, especially if you don’t have special training.

The first sign of tooth decay is when the upper incisors develop a dull, white band along the gum line (the area at the base of the tooth, near the gums). You might see brown spots on the teeth, and the gums might be red and swollen. In more advanced stages of tooth decay, blackened areas show up on the teeth, with the gums still looking red and swollen.

Preventing tooth decay with good dental care

Regular dental checks and visits to the dentist, brushing and flossing are essential steps towards preventing tooth decay. You can read more about dental care for your child in the following articles:

Preventing tooth decay with healthy eating and drinking

Teeth cleaning alone isn’t a guarantee against tooth decay. The types of food and drink you give your child can affect the development of tooth decay.

Babies under 4-6 months
Newborns and young babies only need breastmilk or formula. When your baby is old enough to drink something other than milk, water is the best option.

Babies over 6-8 months
When your baby is 6-8 months, she can start to use a cup for drinking. A bottle isn’t necessary after 12 months of age. Avoid giving your baby sweetened milk, fruit juice or cordials. These will increase the risk of tooth decay.

Older babies, children and teenagers
Children need a wide variety of healthy foods and snacks. Foods and drinks that are low in sugar are best. Avoid giving your children sweet biscuits or cakes as treats. If your child does eat something sweet, drinking a glass of water or eating a ‘tooth-friendly food’ afterwards can reduce the amount of acid on his teeth.

Tooth-friendly foods’ are foods that are low in sugar, promote chewing and get your child’s saliva going. Some good examples of tooth-friendly foods include cheese and chopped vegetables such as carrot and celery.

The longer food and drink stays in your child’s mouth, the more chance there is for acid to develop and cause damage to tooth enamel. This means that nibbling foods and sipping drinks over longer periods of time is more likely to cause tooth decay.

You can discourage your child from long periods of eating or drinking by:

● Establishing regular snack and meal times, rather than all-day grazing

● making sure your child eats and drinks in one place only – for example, at the table

● putting food away when snack time or mealtime is over

● encouraging your child to drink tap water if she’s thirsty (if you don’t have juice, cordial or soft drink in the fridge or cupboard, you won’t have to watch what your child drinks as carefully)

● giving your child sweet foods as part of a meal rather than as a snack.

Bad breath can be an issue for some teenagers. Some of the things that cause it include poor oral hygiene, tooth decay, gum disease, some food and drinks, and smoking. If your child is brushing twice a day but still has bad breath, it might be a good idea to see the dentist.

Other ways to avoid tooth decay

Good family dental health

The germs that cause tooth decay can be transmitted between people. This means it’s important for the whole family to keep their teeth healthy and clean.

If all the family members’ toothbrushes are kept in the same place, make sure the brushes don’t touch – this reduces the risk that decay-causing germs will travel between brushes and into mouths. And when it comes to toothbrushes, there’s no sharing! One for each family member is best.

Bottle-feeding and breastfeeding
Settling babies to sleep with bottles of milk can lead to early childhood tooth decay, particularly if it happens often. The problem is that the milk contains natural sugars, which can build up around baby’s teeth at night. The germs on the teeth can turn the sugars into acids, which eat away at the enamel of the baby teeth.

It’s recommended that you don’t settle your baby in bed with a bottle of milk. If your baby needs extra fluids, give him a quick drink of cooled boiled water before you put him into bed.

In general, if you’re bottle-feeding, take the bottle away when your baby’s finished. Likewise, if you’re breastfeeding, take baby off the breast when he’s had enough. Simple measures like these can help prevent early childhood tooth decay.

Asthma inhalers or puffers
These are a vital part of some children’s asthma management plans, but the powder in some puffers is acidic and can damage tooth enamel. This could lead to tooth decay over time if it isn’t balanced with good oral hygiene.

To avoid tooth decay, rinse your child’s mouth with water immediately after each use of the puffer. Ensure that your child’s teeth are cleaned twice a day with toothpaste. But don’t brush teeth straight after using the puffer – allow 30–60 minutes before brushing.

Other medications
Some medicines can affect your child’s oral health because of their sugar content. Check the label of any medication for any hidden sugars, particularly if your child’s going to be taking the medication for a long period of time.

Saliva helps clean and protect your child’s teeth - without saliva, tooth decay and other oral health problems can become more common. But some medications can reduce saliva production, leaving your child with a dry mouth. Talk to your doctor or pharmacist about the effects of the medication on saliva and teeth. Older children and teenagers could try chewing sugar-free gum. It stimulates saliva flow and helps to protect teeth from decay.

You can also encourage your child to rinse her mouth with water immediately after taking medication, and to brush with fluoride toothpaste one hour after.

Sports drinks
Sports drinks can erode your child’s teeth, particularly if your child drinks them regularly.

It’s best for your child to drink sports drinks only sometimes, and to drink plenty of water instead. When he does drink sports drinks, it’s a good idea for him to rinse with water straight away and to brush his teeth with a fluoride toothpaste about an hour after.

Food and drinks aren’t the only things that can erode tooth enamel. Vomiting or gastric reflux can also have a nasty effect. If your child has a vomiting bug, she can protect her teeth by rinsing straight away with water and brushing teeth with a fluoride toothpaste an hour later.
Root Canal Treatment

Because primary teeth are so important, the pediatric dentists at Children’s Dental Fun Zone of Eagle Rock, as well as in our other practices, will recommend that these teeth be kept intact instead of being prematurely extracted. It is for this reason that root canal therapy for kids is a potential option for saving a baby tooth that is affected by extensive decay.

When does a child need root canal therapy?
This treatment is often indicated if your child feels pain in a tooth, is sensitive to different temperatures, or if the tooth is chipped or cracked with the pulp already exposed. When this happens, the pulp becomes damaged beyond simple medication or surface repair. As a result, the infected pulp is removed and a crown is placed on the tooth, allowing it to be strong enough so the tooth can remain in the child’s mouth until the permanent tooth erupts.

How is root canal therapy on baby teeth different than that done on adult teeth?
For children, a pulpotomy is done, where only the infected pulp chamber is removed. For the most part, the dentist does not need to use special instruments to remove the pulp from roots of the tooth since only the surface nerve structure in the chamber is removed. This makes the procedure much faster and a lot more painless for children. Also, after the treatment is completed, a baby crown is placed on the tooth right away to protect the weakened tooth.

What will happen when the permanent tooth wants to come in if the baby tooth has a root canal and crown?
Since the material we use in Children’s Dental Fun Zone of Los Angeles for the baby root canal is completely biocompatible, it will not negatively affect the incoming permanent tooth. Rather, the tooth will get loose in its own time and will fall out like all other baby teeth.

Will my child have pain after a baby root canal is performed?
Since the affected nerves of the tooth are removed, your child should have very minimal pain after the treatment. During the treatment itself, the tooth is completely numbed using local anesthesia. However, it is common to have sensitivity to the crown or to any dental procedure for the first two weeks. During this time, it is important to continue brushing, particularly around the gums of the tooth, to keep them from becoming inflamed. If excessive pain or irritation is experienced, have the child brought to the dental office for a re-evaluation.


What is a Filling?

A filling is a way to restore a tooth damaged by decay back to its normal function and shape. When a dentist gives you a filling, he or she first removes the decayed tooth material, cleans the affected area, and then fills the cleaned out cavity with a filling material.

By closing off spaces where bacteria can enter, a filling also helps prevent further decay. Materials used for fillings include gold, porcelain, a composite resin (tooth-colored fillings), and an amalgam (an alloy of mercury, silver, copper, tin and sometimes zinc).

Which Type of Filling is Best? No one type of filling is best for everyone. What's right for you will be determined by the extent of the repair, whether you have allergies to certain materials, where in your mouth the filling is needed, and the cost. Considerations for different materials include:

● Gold fillings are made to order in a laboratory and then cemented into place. Gold inlays are well tolerated by gum tissues, and may last more than 20 years. For these reasons, many authorities consider gold the best filling material. However, it is often the most expensive choice and requires multiple visits.

●Amalgam (silver) fillings are resistant to wear and relatively inexpensive. However, due to their dark color, they are more noticeable than porcelain or composite restorations and are not usually used in very visible areas, such as front teeth.

● Composite (plastic) resins are matched to be the same color as your teeth and therefore used where a natural appearance is desired. The ingredients are mixed and placed directly into the cavity, where they harden. Composites may not be the ideal material for large fillings as they may chip or wear over time. They can also become stained from coffee, tea or tobacco, and do not last as long as other types of fillings generally from three to 10 years.

● Porcelain fillings are called inlays or onlays and are produced to order in a lab and then bonded to the tooth. They can be matched to the color of the tooth and resist staining. A porcelain restoration generally covers most of the tooth. Their cost is similar to gold.