5 Smart Ways To Prevent Cavities in Kids

Parents often assume that kids get cavities because they're lax about brushing and flossing. That's true to an extent, but what few people know is that "rotten teeth" or tooth decay is a disease known as "dental caries." It’s caused by specific germs, spreads easily within families, and can last a lifetime.

Dental caries is more common among young children than any other chronic illness, including asthma and diabetes. In fact, about 42% of children aged 2 to 11 have had dental caries affecting primary teeth, according to The National Institute of Dental and Craniofacial Research.

Here’s what you need to know about cavities in babies, toddlers, and children.

What Causes Cavities in Toddlers and Children?

Tooth decay begins with a group of germs called mutans streptococcus. "The bacteria feed on sugar and produce acid that eats away at the structure of teeth by depleting calcium," explains Burton Edelstein, DDS, founding director of the Children's Dental Health Project. The bacteria also create plaque, a yellowish film that builds up on teeth and contains even more enamel-eroding acid. Once an area without calcium becomes big enough, the tooth's surface collapses, and that's a cavity.

Babies are born without any of these harmful bacteria in their mouths, and studies have shown that the parent or caregiver with the most frequent interaction with their baby typically infects their child before age 2. It happens when you transfer your saliva into your child's mouth by repeatedly eating from the same spoon as your baby, for example, or letting your toddler brush their teeth with your toothbrush. And if you've frequently had cavities yourself, you're even more likely to pass the germs along.

Once a child's mouth has become colonized with this bacteria, they'll be prone to cavities in their baby and permanent teeth that can cause pain and difficulty eating. "It's an old wives' tale that 'soft teeth' run in families, but what's really passed along in families are high levels of decay-causing bacteria," says Dr. Edelstein. The key role that bacteria plays in decay may also explain why some kids who eat tons of candy or never floss are lucky enough to avoid dental problems.

If you've had trouble with your teeth, you need to take responsibility for your child's dental health—just like you'd be vigilant if you've had a family history of high cholesterol or skin cancer.

Unfortunately, antibiotics can't eliminate the cavity-causing bacteria in your child's mouth. That's why the American Academy of Pediatrics (AAP) urges pediatricians to ask parents about their own dental history by the time their baby is 6 months old and to recommend taking extra precautions if a child is at high risk for dental caries.

When Should My Child See a Dentist?

Your child should see a dentist by their first birthday, according to recommendations from the American Academy of Pediatric Dentistry Association (AAPD) and the AAP. If you wait until your child is older, decay can be well underway: About 28% of 2- to 5-year-olds have cavities in primary teeth, according to The National Institute of Dental and Craniofacial Research.

However, most parents don't know they should make a dentist appointment for their baby. "Not all pediatricians look out for a toddler's oral health, and some doctors don't even look at the teeth," says Paul Casamassimo, DDS, professor of pediatric dentistry at the Ohio State University College of Medicine and Public Health in Columbus.

But it's important to treat cavities in baby teeth: These first teeth serve as space holders for permanent teeth, so losing one prematurely can cause alignment problems that must be corrected with braces later.

Although you may worry that your little one will never sit still and open their mouth, the first dental visit will be quick. The dentist can easily spot the telltale plaque buildup along the top gum line, which is a sign of cavity-causing bacteria, and they can also do a culture to measure bacteria levels (in you and your child).

How to Prevent Cavities

A crucial way to help limit cavities—regardless of whether they run in your family—is to diligently brush and floss, which physically pushes bacteria, plaque, and sugar off the teeth. Fluoride is an essential part of dental health because it not only restores calcium to decaying teeth but also limits the production of corrosive acid.

Even though some kids are at a much higher risk of developing childhood cavities, all children can get them. So, it's important for everyone to follow this road map for dental health.

Reduce sugar consumption

Limiting sugar—which bacteria need to survive—is the number-one way to prevent cavities. It's actually the frequency, not the total quantity of sugar consumption, that matters most, says Dr. Edelstein.

For example, drinking a cup of juice with morning snack is less harmful to the teeth than sipping that juice all day. That's because repeatedly exposing the teeth to sugar prevents saliva, the body's natural tooth cleanser, from doing its job. Juice and candy aren't the only offenders: Starchy carbohydrates like crackers and cereal and sticky foods such as raisins can also promote decay.

Avoid sugary drinks

Fruit juice (even diluted) and breast milk and formula bathe the teeth in sugar, says Ronald Kosinski, DMD, chief of pediatric dentistry at Schneider Children's Hospital in New Hyde Park, New York.

Dentists used to call early dental caries "baby bottle tooth decay" because it often occurs in children who drink milk or juice during the night, allowing sugar to sit on the teeth for 10 or 12 hours. The American Academy of Pediatrics (AAP) advises weaning your child from the bottle by 12 to 18 months to prevent tooth decay—but you shouldn't let your toddler walk around all day with a sippy cup either (unless it's filled with plain water).

Focus on fluoride

If your community's water is not fluoridated (check with your dentist or municipal water supply board) or your kids only drink non-fluoridated bottled or filtered water, talk to your pediatrician about fluoride supplements. Too much fluoride, however, can lead to fluorosis, which causes white spots on the teeth. That's why kids under 2 or 3 shouldn't use fluoride toothpaste until they can spit it out instead of swallowing it.

Treat teeth earlier

Dentists can now apply a safe and protective fluoride varnish to young children's teeth. A study found that 1-year-olds who got this treatment twice a year were four times less likely to get cavities in their baby teeth. Also, ask your dentist about sealants or plastic coatings that prevent decay. Some insurance plans will cover these treatments.

Take care of your own smile

If you have a history of dental problems, avoid sharing utensils or toothbrushes with your baby or toddler—or even letting them stick their fingers in your mouth. You might also consider taking measures to reduce the levels of cavity-causing bacteria in your mouth. Your dentist can prescribe an antibacterial mouthwash that can reduce transmission to young children.

Research has also found that chewing sugarless gum containing the sweetener xylitol (such as Trident, Wrigley's Orbit, or Carefree Koolerz) four times a day significantly lowers a mother's bacteria levels.

Good nutrition during pregnancy may also strengthen a baby's tooth enamel. Of course, you should brush and floss well and get any problems treated promptly. This will also set a good example for your child and show them that taking care of their teeth is as essential as taking care of other aspects of their health.

Dental Health at Every Age

Here are some age-specific tips for preventing tooth decay.

Babies

• Clean your baby's gums even before their first teeth erupt. Wipe them with a damp washcloth after feedings.
• Start brushing as soon as the first tooth appears. Wet a baby toothbrush and gently rub it back and forth on the tooth's surface and along the gum line. If you use toothpaste, make sure it's fluoride-free.

Toddlers

• Brush your toddler's teeth for at least 30 seconds (ideally a minute) after breakfast and before bed. Lean your baby's head on your lap and place the brush at a 45-degree angle to the teeth.
• Start using a tiny amount of fluoride toothpaste when they're 2 or 3 years old. Begin flossing teeth for them when two of their teeth are touching.

Preschoolers

• Brush your own teeth at the same time your preschooler brushes, and give them lots of positive feedback.
• Studies have found that manual toothbrushes are just as effective as powered ones. But if letting your kid use an electric or battery-operated one makes it easier to get them to brush, go for it.

School-age kids

• Your child can start brushing and flossing on their own at around age 7. If your child can tie their own shoes, chances are they are ready to brush solo. Your child should now brush for two minutes.
• Look for food and plaque around the gum line of their teeth to see whether they are doing a sufficient job. You can also periodically let them chew gum with xylitol.