What is cavities (tooth decay)?

Tooth decay in children: Overview

Tooth decay is damage to a tooth caused by plaque. Plaque is a thin film of bacteria that sticks to the teeth above and below the gum line. If plaque isn't removed from the teeth, it can build up and harden into tartar. The bacteria in plaque and tartar use sugars in food to make acids. These acids can cause tooth decay and gum disease.

Any part of your child's tooth can decay, from the roots below the gum line to the chewing surface. Decay can affect the outer layer (enamel) and inner layer (dentin) of your child's teeth. The deeper the decay, the worse the damage.

Untreated tooth decay will get worse and may lead to tooth loss. If your child has a small hole (cavity), your child's dentist can repair it by removing the decay and filling the hole. If the tooth has deeper decay, your child may need more treatment. A very badly damaged tooth may have to be removed.

Tooth decay

Tooth decay is damage that occurs when bacteria in the mouth make acids that eat away at the enamel of a tooth. This can cause a hole in the tooth called a cavity. If it isn't treated, tooth decay can cause infection, pain, and loss of the tooth.

What are the symptoms of tooth decay?

You may not have symptoms until you have a cavity or tooth infection. When this happens, it's common to have a toothache. Your gums may swell near the sore tooth. You might have bad breath or a bad taste in your mouth. You could have white, gray, brown, or black spots on your teeth.

How is tooth decay treated?

Treatment for tooth decay depends on how bad it is. If tooth decay is caught early, before a cavity forms, you may be able to stop it by brushing with fluoride toothpaste or getting fluoride treatments.

If the decay has eaten through the enamel, you may need one or more treatments. These may include:

  • A filling if a cavity has formed. Your dentist will remove the decay and fill the hole with material. This will restore the tooth to its original shape.
  • A crown if the decay is bad and your tooth is damaged. A crown, or cap, replaces part of your tooth.
  • A root canal if the pulp of your tooth is infected. The diseased pulp of a tooth is removed.
  • Removal (extraction) if the root of the tooth is badly damaged. The dentist may replace the tooth with a bridge or an implant.

How can you help prevent tooth decay?

  • Brush your teeth when you wake up and right before you go to sleep. Use fluoride toothpaste. Floss once a day.
  • See your dentist for checkups once or twice a year so problems can be found early.
  • Eat healthy foods. These include fruits, vegetables, lean proteins, whole grains, and low-fat dairy products.
  • Avoid foods with added sugar, especially certain cereals, desserts, candy, and raisins.
  • If you smoke, quit or cut back as much as you can.
  • Ask your dentist about fluoride treatments or sealants.

How is tooth decay diagnosed?

Your dentist will ask about your past dental and medical problems and care. Your dentist will check your teeth using a pointed tool and a small mirror. You may also get X-rays of your teeth and mouth to find tooth decay that can't be seen with the eyes alone.

How can you care for your child who has tooth decay?

  • Give your child acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) for pain. Be safe with medicines. Read and follow all instructions on the label.
    • Do not give your child two or more pain medicines at the same time unless the doctor told you to. Many pain medicines have acetaminophen, which is Tylenol. Too much acetaminophen (Tylenol) can be harmful.
  • Put ice or a cold pack on the cheek over the tooth for 10 to 15 minutes at a time. Put a thin cloth between the ice and your child's skin.

What causes tooth decay?

Bacteria and food can cause tooth decay. A clear, sticky substance called plaque is always forming on your teeth and gums. Plaque contains bacteria that feed on the sugars in the food you eat.

As the bacteria feed, they make acids. The acids attack the teeth for 20 minutes or more after you eat. Over time, these acids destroy tooth enamel and cause tooth decay.

You may be more likely to have tooth decay if you:

  • Don't brush and floss your teeth regularly.
  • Don't see a dentist for checkups and cleanings.
  • Eat foods that are high in sugar and other carbohydrates.
  • Don't get enough fluoride. Fluoride helps prevent tooth decay by making teeth more resistant to acids produced by plaque. Fluoride is added to many public water supplies.
  • Don't have enough saliva. Saliva washes away food and harmful sugars, so it helps protect your teeth from decay. A dry mouth may be caused by certain medical conditions, by taking certain medicines, or by breathing through your mouth. If you're older, you're more likely to have a dry mouth.
  • Have diabetes.
  • Smoke, use spit tobacco, or are around smoke.

Children, whose teeth are still growing, are more likely to have tooth decay than adults. This is because the minerals in new teeth are not very strong and are easier for acids to eat away.

Tooth decay

Healthy tooth showing layers of enamel, dentin, and root, and unhealthy tooth with plaque showing cavity affecting layers of tooth.

Tooth decay is damage to the enamel of your teeth. It can lead to a hole in the tooth, called a cavity. Cavities can affect the deeper layers of the tooth.

Tooth decay: When to call

Call 911 anytime you think you may need emergency care. For example, call if:

  • You have trouble breathing.

Call your dentist now or seek immediate medical care if:

  • You have new or worse symptoms of infection, such as:
    • Increased pain, swelling, warmth, or redness.
    • Red streaks leading from the area.
    • Pus draining from the area.
    • A fever.

Watch closely for changes in your health, and be sure to contact your doctor if:

  • You do not get better as expected.

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The content above contains general health information provided by Healthwise, Incorporated, and reviewed by its medical experts. This content should not replace the advice of your healthcare provider. Not all treatments or services described are offered as services by us. For recommended treatments, please consult your healthcare provider.