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Say Goodbye to Tooth Decay in Children


Tooth decay is a major oral health problem in children. It is caused by several factors, including feeding habits, food intake, cleaning methods and tooth structure. However it is caused, tooth decay leads to ongoing problems. This article provides you with all the information you need to know about tooth decay so that you can promote dental health for your children of any age.

Baby: 1st year

How to prevent tooth decay

Breast milk or infant formula is a baby’s main source of nutrition. Milk does not cause tooth decay (except sweetened milk), but tooth decay at this age is caused from:

  • Putting a baby to sleep with a bottle, feeding a baby at night, feeding a baby when he/she cries at night because you assume that your baby is hungry (always feed your baby when he/she cries), and filling your baby’s bottle with syrup.
  • Poor oral cleaning.
  • Destruction of the outer surface of the teeth – the surface of a baby’s new teeth is not strong, and minerals are required to build strong teeth.

The above factors can cause tooth decay over a period of time (in accordance with the order of tooth growth). Tooth decay affects a baby’s overall health. It can cause pain, swelling and infection. This causes the baby to lose his/her appetite which results in nutritional deficiencies that hinder physical and cognitive development. More importantly, the baby may be scared of going to the dentist at a very young age.


  • When feeding the baby with the bottle, the bottle nipple sits on baby’s tongue and will leave the milk behind the upper front teeth. This is difficult for baby’s saliva to wash away all the milk left on the teeth. During the night, the saliva flow is reduced even further, resulting in an accumulation of plaque on the surface of the baby’s teeth and ultimately causing decay.
  • By the age of 6 months, the baby can sleep through the night (when the first tooth comes) because his/her stomach has expanded, so he/she does not need to be fed during the night.

Information from Dentists

White spots on the teeth (that cannot be removed) may be an early sign of tooth decay. These white spots are caused by bacterial plaque that forms on the teeth. If left untreated without proper cleaning, the white spots will become pitted and turn brown, black or yellow. However, brushing the teeth with fluoride toothpaste will make the enamel harder and more resistant to decay.

Caring for your baby’s teeth

You should take your baby to the dentist for the first time when the first tooth comes or during the first year of age so as to seek appropriate advice about dental and oral care. It’s never too late for the dentist to fix tooth decay. However, you should aim to prevent decay from developing in the first place by caring for your baby’s teeth as follows:

Brushing teeth

Children between 1-3 years generally refuse to have their teeth brushed. However, you can teach your child to clean his/her teeth with the following techniques:

  • Slow, easy steps will be more successful than fast ones, such as starting by having your child sit on your lap when brushing his/her teeth, or wrapping your child in a sheet to stop him/her from squirming and moving (if you alone).
  • Teach your child to clean his/her teeth similar to have a shower, and wash his/her hair as part of a routine.
  • Before the teeth start to grow through, you should gently wipe your baby’s gums, roof of the mouth, tongue and inside of the cheeks with a soft wet wash cloth. When the first tooth comes, you should then start to brush your baby’s teeth with a small amount of fluoride toothpaste.


  • Feed your baby only at designated meal times.
  • Just because your baby wakes up at night, it does not mean that he/she is hungry. He/she may have had a bad dream or feel unwell. Young children always cry when something upsets them and it’s a natural reaction. Gently pat your baby’s bottom to calm him/her down and help him/her go back to sleep.


Choose foods for healthy teeth, including foods high in protein, vitamins, and fiber such as carrots or sandwiches.

Restrict the intake of sugars and starches in each meal because they cause tooth decay. For example, a child may be allowed to have ice-cream within 20 minutes after a main meal, but then after that, should drink some water to rinse the mouth.

Toddler: 1-3 years

How to prevent tooth decay

Toddlers should be given 3 main meals a day, like adults. They can now eat a variety of foods and will begin to decide which foods look inviting. Sometimes, he/she may continue to drink from a bottle and have a bottle at bedtime, which is a cause of tooth decay among children in this age group. Tooth decay can lead to premature loss of baby teeth and cause the following problems:

  • Chewing problems result in nutritional deficiencies.
  • Decay in the upper front teeth can result in speech problems.
  • Decay in baby teeth also affects adult teeth, such as being twisted or overlapping the wrong way because the baby teeth determine the space in which the future permanent teeth will grow.
  • An attractive smile reflects a healthy and confident personality for children.

It is important for children to stop drinking from a bottle and having a bottle at bedtime as soon as possible. You should try to break your baby’s bottle habit during the first year of age.


The longer you keep giving your baby a bedtime bottle, the harder it seems to break the bottle habit. You can do it gradually, or you can make your baby go cold turkey. However, breaking the bottle habit should be done on non-working days because the crying may last for hours. To save you and your toddler from tears, remember that a baby who is ready to sit up is ready to drink from a cup.

Information from Dentists

Falling and hitting a baby’s tooth can make the tooth become loose, causing chewing problems. If a tooth is badly broken, it must be removed and may affect the development of adult teeth. This is because injuries to baby teeth can cause damage to the adult teeth that are forming in the jaws. The possible damage includes discolored teeth (white or brown), rough teeth, and misshapen teeth such as curved front teeth. However, the level of damage depends on the severity of the initial injury.

Sucking a thumb or fingers can affect development of occlusion by putting pressure against the front teeth and causing them to protrude. This is common during the first year of age and children generally quit sucking their thumbs at about 2-4 years. If they quit sucking before the age of 4 years, the buck teeth will only be temporary. However, if the sucking continues after the age of 4 years, the buck teeth will be permanent. Therefore, you should take your child to seek appropriate advice from a doctor if your child’s sucking habit continues after 4 years of age.

Caring for your toddler’s teeth

  • You should break your child’s bottle habit during the first year of age.
  • You should be involved in brushing your child’s teeth until he/she is 7 years of age.
  • 3-year old children can use a pea-sized amount of toothpaste and dental floss should be used to clean between their teeth.
  • If your child wants to brush his/her teeth by himself/herself, you should first check whether he/she has developed the fine motor skills needed to control small muscles. For example, can your child tie his/her shoelaces and color inside the lines?

Pre- School
Children older than 3 years of age

How to prevent tooth decay

You can start to see the development of your child’s dental structure at this age. Children have 20 primary teeth and molar teeth will be moving closer together. At about the age of 6 years, the first permanent teeth erupt. Usually, the lower front incisors (as with the primary teeth) or the molar teeth will erupt first. The lower front permanent incisors develop below and towards the tongue side of the primary teeth (coming in overlapping while the primary teeth are still there). The tongue will then push the permanent tooth forward into position. In cases where the permanent tooth erupts half way or fully but the primary tooth does not fall out as expected, or if a child loses his/her appetite and cannot brush his/her teeth due to pain, the dentist can help to remove the tooth.

Information from Dentists

At about the age of 6 years, the first molar tooth erupts by pushing through the gum. Some parents mistakenly believe that these are primary teeth and will later be replaced by permanent teeth as with other primary teeth, but there is only set of permanent teeth for the molars. Approximately 80% of cavities occur there where brushing is difficult. For children in this age group, the parents should be involved in brushing and flossing between their teeth. The children should get sealants on their permanent molars as soon as these teeth come in.

Caring for your child’s teeth

  • Once the first molar erupts, you should regularly open your child’s mouth and check the teeth for cavities.
  • Do not worry about gums bleeding during brushing or flossing. Bleeding gums are usually a sign of gum disease and the symptoms will go away after proper cleaning.

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Wichuda Booranalertphaisan, D.D.S. Summary: Pediatric Dentistry Pediatric Dentistry