FAQs on Pediatric Tooth Decay

What causes baby bottle tooth decay?

Baby bottle tooth decay is caused by the frequent and long–term exposure of a child’s teeth to liquids containing sugars. Among these liquids are milk, formula, fruit juice, sodas, and other sweetened drinks.

The sugars in these liquids pool around the infant’s teeth and gums, feeding the bacteria that cause plaque. Every time your child consumes a sugary liquid, acid attacks his/her teeth. After numerous attacks, tooth decay can occur, resulting in baby bottle tooth decay.

Parents and care givers should be especially concerned with giving an infant a sugary drink at nap or night time. During sleep, the flow of saliva decreases, allowing the sugary liquids to pool around the child’s teeth for an extended period of time.

How to prevent baby bottle tooth decay?

Parents sometimes do not realize that baby’s teeth are susceptible to decay as soon as they appear in the infant’s mouth. By the time the decay is noticed, it may be too late to save the child’s teeth. You can prevent this from happening to your child’s teeth by knowing how to protect them.

After each feeding, wipe the child’s teeth and gums with a damp washcloth or small soft toothbrush to remove plaque. Begin brushing your child’s teeth as soon as the first tooth erupts.

Flossing should begin when all primary teeth have erupted, usually by age 2 or 2 1/2. Never allow your child to fall asleep with a bottle containing a sweetened liquid. If your child refuses to fall asleep without a bottle, simply fill it with water and nothing else.

If your local water supply does not contain enough decay–fighting fluoride, check with your dentist to see if your child should receive fluoride supplements. Start dental visits between six and twelve months of age.

How serious is baby bottle tooth decay?

Baby bottle tooth decay can cause painful toothaches which can hinder eating. Severely decayed teeth can become infected and need to be extracted. If your child’s teeth are infected or lost too early due to baby bottle tooth decay, your child may have some of these problems:

• Poor eating habits
• Speech problems
• Crooked teeth
• Damaged adult (permanent) teeth
• Yellow or brown adult (permanent) teeth

Keep your child happy and smiling by preventing baby bottle tooth decay.

Sealants: Sealing out decay

What causes tooth decay?
Your teeth are covered with a sticky film called plaque. Bacteria in plaque break down the sugars and carbohydrates in the food we eat, creating acids that can de–mineralize the enamel of the teeth. Repeated attacks may cause the enamel to break down resulting in cavities.

Brushing helps remove the sticky plaque and decreases the acid in contact with the enamel. But the toothbrush can not reach everywhere. The pits and fissures (grooves) on the chewing surface of the back teeth are narrower than toothbrush bristles preventing thorough cleaning of these areas that are prone to decay. The normal flow of saliva that helps clean food particles from other areas of the mouth, cannot wash out the pits and fissures.

Most cavities occur in these pits and fissures (about 60%) and the molars tend to have deeper pits and fissures than the premolars.

What is a sealant?
A sealant is a plastic resin coating that fills the pits and fissures, preventing plaque and food from getting into these hard to brush spots.

How long do sealants last?
Sealants hold up well under the forces of chewing and will last for several years before a reapplication may be necessary. As the visible portion of the sealant wears the pits and fissures still retain the resin and will continue to prevent decay.

How is a sealant applied?
No needles or drilling is required to place a sealant. The tooth is cleaned to remove any adherent plaque and then the pits and fissures are etched to roughen them so that the sealant adheres to the tooth better. The tooth is rinsed and dried, then the sealant resin is painted on and cured with a light.

Who can benefit from sealants?
The likelihood of developing pit and fissure decay begins as the teeth begin to erupt. Sealants are recommended for the permanent molars in children. The first molars erupt between age 5 and 7, followed by the second molars between ages 11 and 13.

Adults can also benefit from sealants in teeth that have not had a filling placed but have deep pits and fissures. Patients with dry mouth (Xerostomia) or on non–fluoridated water are more prone to decay and sealants can decrease the incidence of decay.