Childhood caries: how to detect and prevent it
Oral health care should start in childhood. Children’s teeth can be seriously affected by caries, an easily preventable oral health problem that still affects many children today. It is therefore important to know what this pathology consists of and, especially, what causes it in order to prevent it from appearing in the first place.
What you should know about childhood caries in order to prevent it:
- What is tooth decay and how does it affect the very young?
- What are the main causes of childhood caries?
- How can you recognise tooth decay in your child?
- How is childhood tooth decay treated?
- How should tooth decay in children be prevented?
What is tooth decay and how does it affect children?
Tooth decay is the most common chronic childhood disease. As in adults, caries involves the destruction of the hard tissues of the tooth. This is due to demineralisation of the enamel caused by acids from bacteria found in dental plaque. Unfortunately, when it comes to the teeth of the youngest children, i.e. baby teeth, the destruction process can be even more severe.
These bacteria that live naturally in the mouth feed on food debris that accumulates on the surface of the teeth. Their own digestion process involves the release of corrosive acids that destroy the first layer of tooth tissue and, over time, can lead to deeper and deeper cavities.
If this happens, the caries can reach the innermost layers of the tooth, affecting what is popularly known as the nerve, causing necrosis of the nerve. If this happens, episodes of pain begin to manifest themselves, but also other important functions of the teeth begin to be affected, especially if they are lost due to caries.
It is important to bear in mind that milk teeth are essential for the oral health of the youngest children. Primary teeth are not only important in the chewing process, but also play a crucial role in speech, favour the development and strengthening of the maxillary bones and serve as a guide for the permanent teeth.
Therefore, in order to guarantee the oral and dental health of the youngest children for their correct development, it is essential to know the causes and habits that can lead to the appearance of caries in children, bearing in mind that in milk teeth this condition is usually more severe because their pulp cavities (where the nerve lives) are larger.
2. What habits can cause childhood caries?
This condition can develop from the eruption of the first milk teeth. In this case it is known as baby bottle tooth decay or infant caries and is closely related to the bad habit of sleeping with a bottle in the mouth.
In older children, caries can have a multifactorial cause. In addition to an increased susceptibility of tooth enamel to the problem, the consumption of carbohydrate-rich foods such as sweets or sugary drinks, together with poor oral hygiene can lead to the spread of caries-causing bacteria.
3. How can you recognise tooth decay in your child?
Childhood caries can be difficult to detect. However, one of the first symptoms is a change in the colour of the tooth, which becomes duller and whiter. If the disease progresses, the decayed area may turn yellow, brown or even black. In more advanced cases, the caries will begin to break down the tooth enamel.
On the other hand, although it does not occur in all cases, children may experience pain when chewing and increased tooth sensitivity. There are also cases where the gums become swollen and may bleed when brushing the teeth, an indication of both caries and periodontal disease.
But the most effective way to recognise caries is through regular check-ups. Especially if the aim is to prevent its appearance, or at least to detect incipient caries in time, it is essential to visit paediatric dentistry specialists. With the right equipment, caries can be detected and treated as early as possible to prevent it from progressing.
4. How is childhood dental caries treated?
For the treatment of childhood caries, the specialist must initially identify the type of tooth that has been affected.
- Children from 2 to 5 years of age will have a dentition made up of milk teeth.
- Children from 6 years of age will have a mixed dentition with permanent teeth.
Therefore, depending on the tooth affected (temporary or permanent) and the severity of the pathology present, the treatment to be carried out may be different.
In both temporary and permanent teeth, if the caries has not affected the nerve tissue, the specialist would carry out a filling using a paste (the filling) to treat the tooth.
If the lesion has reached the nerve, a pulpotomy or nerve treatmentwould be carried out on the primary tooth. This is a different intervention to endodontics or root canal treatment, which would be carried out if the tooth is permanent.
In the event that caries has caused a large hole in the baby tooth, a metal crown would be applied. Although they are not aesthetic, they are very effective as, in addition to allowing the child to chew well, their purpose is also to act as a space maintainer, allowing the eruption of the permanent tooth that comes out later to do so without problems. In fact, the majority of orthodontic treatments currently carried out are generated by space loss in the primary dentition.
In permanent teeth with severe destruction due to caries, the application of crowns on teeth or another series of dental reconstructions could also be carried out with the aim of avoiding the loss of the permanent tooth.
On the other hand, the tooth would only be extracted when there is no other alternative, i.e. when the infection is so severe that its extraction is necessary because the roots of the tooth have been destroyed and it is unviable. In these cases, if the extracted tooth is a temporary tooth, a space maintainer should always be installed to avoid losing the space necessary for the correct location of the permanent tooth.
If the extracted tooth is the permanent tooth, the only alternative to tooth loss would be a dental prosthesis. It is therefore crucial to avoid the loss of permanent teeth, hence the importance of knowing how caries can be prevented in children:
5. How should caries in children be prevented?
Although childhood caries is an easily preventable disease, according to a National Oral Health Survey its prevalence in baby teeth is 36%. In addition, children who have tooth decay at such an early age may develop other oral health problems. It is therefore essential to be aware of the most effective methods to prevent childhood caries:
5.1. Perform proper oral hygiene.
According to the WHO, oral hygiene can reduce the incidence of caries by up to 50%. This hygiene should be carried out even in babies who do not yet have teeth and as they erupt, it will be possible to incorporate special brushes and, later on, small toothpastes.
It is important to establish good oral hygiene habits from early childhood and to educate children in the care of their oral health. To learn more about how to perform proper oral hygiene in children, we recommend visiting our article on children’s oral hygiene.
5.2. Control the type of food.
A diet rich in sugars can lead to a greater likelihood of tooth decay. Processed biscuits and cereals, milk drinks, pastries, sweetened yoghurts, juices, sweets and sweets have a large amount of sugars that are harmful to oral health, especially if proper oral hygiene is not carried out immediately after consumption. On the other hand, the advantages of eating a balanced diet free of processed or industrial foods are multiple, both for oral health and general health.
5.3. Go for check-ups and cleanings.
Parents and children, especially at very young ages, tend to interact more with other health professionals than with dentists. Going for check-ups from the first appearance of milk teeth can be a good oral health habit, avoiding the development of phobias and normalising dental treatment.
Check-ups by paediatric dentists, who are qualified to deal with children, can determine if there is any alteration in the state of oral health of the little ones and prescribe treatment with a preventive objective. In the case of caries, this could be the application of fluoride if necessary, but also professional dental cleanings.
Professional dental cleanings are essential for any patient and at any age, as they allow for a more thorough removal of the bacterial plaque that causes caries, but also other oral health problems such as gingivitis or periodontitis that can affect children.
