Asha S from Kochi, Kerala shares the experience of her daughter, Eshal’s early years. Asha first noticed small white spots on a few of Eshal’s milk teeth when she was three.
“When Eshal turned five and a half, I noticed black dots on her upper and lower last teeth,” says Asha. Moreover, Eshal experienced pain while chewing food due to the cavity. Eshal has been using fluoride-based toothpaste since her initial cavity filling treatment. Although she has been doing better, the delay in the intervention led to the damage of the teeth.
Dr Sowmini P V, pedodontist, Bengaluru, says, “Cavities are nothing but bacterial infection. Initially, it affects the enamel layer. When the cavity is left untreated, it spreads to other layers of the tooth.” She adds that when it reaches the pulp, it causes infection, discomfort, fever, swelling in the face, and pain. She further explains that tooth has three layers, namely enamel, dentin, and pulp. Pulp is the core of the tooth in which nerves and blood vessels are present.
Tiny teeth, huge influence
Dr Sushrutha M, a dentist from Coimbatore, Tamil Nadu, says, “Food habits like eating biscuits, sticky foods, and chocolates are the major reasons for cavities in children.”
A 2018 study published in the Indian Journal of Pediatrics states that cavities are one of the most prevalent conditions (about 50 per cent) in children across the globe. Moreover, the cavities caused due to long-term use of milk bottles during night spread faster.
Liquids such as milk, formula or fruit juice contain sugar which act as source for harmful bacteria present in the mouth.
The bacteria produce acids which result in cavities. This condition is referred to as baby bottle tooth decay. “It commonly affects the upper front teeth. Since the teeth appear discoloured, it affects the smile, facial appearance, and self-esteem of the child,” says Dr Sushrutha.
Read more about early tooth decay in children’s.
Effects on the child
Exfoliation of milk teeth starts around the age of six and continues until the age of 12. “Though milk teeth exfoliate after a period, each tooth has a specific age to shed,” says Dr Sowmini. When each milk tooth falls out, it is replaced by a permanent tooth.
However, if there is a cavity in milk teeth it can damage the developing permanent teeth and the bone surrounding it. “Cavities in the milk teeth affect the alignment of the permanent teeth and may erupt in a crooked position,” says Dr Sushrutha. Pain due to cavities affects the sleep and eating pattern of the child, says Dr Sowmini. Milk teeth are smaller in size, and the layers are thinner than permanent teeth due to which cavities can progress faster in children than in adults. The bacteria causing the cavity damages the enamel and causes demineralisation. Cavities in children can result in teeth loss which can affect speech.
Role of fluoride
A 2021 study published in Bio Med Central Pediatrics states that fluoride increases the bone density and mineralisation of tooth enamel. It also acts against the bacteria causing cavities.
Taking early measures help to avoid the spread of infection. Dr Sowmini and Dr Sushrutha list out some measures:
- Children below three should use non-fluoridated toothpaste. The amount of toothpaste used should be the size of a rice grain.
- Children above three should use fluoride toothpaste. The amount of toothpaste should be pea-sized.
- The dentist may apply fluoride over the tooth in a gel form or varnishes. It is usually recommended at least twice a year.
- Dentists also apply sealants (a protective coating made of resin) over the tooth, which prevents food particles and bacteria from entering the tooth.
Protecting the little smile
Dr Sowmini and Dr Sushrutha recommend a few strategies for parents to maintain their children’s oral health.
- The oral hygiene of the baby should be taken care of right from the time of breastfeeding. The mother should wipe the baby’s gums and lips after feeding. As soon as the baby gets its first tooth, the tooth should be cleaned with wet cotton after feeding.
- Teeth cleaning is mandatory even while feeding the child with bottles. Do not let the child sleep with the bottle or milk in mouth.
- Brushing with finger toothbrush without toothpaste after every meal will remove the food particles stuck in-between the teeth.
- Consider dietary modifications for your child like limiting the intake of white sugar and sticky foods.
- After the age of four, children should start practising brushing twice a day.
- If the parents notice bad breath or any colour difference in the child’s gums or teeth, they should consult the dentist immediately.
- Consult the dentist soon after the eruption of your baby’s first tooth. Thereafter, follow a routine dental examination once in six months.
Read more about the food route to good oral health.
Nurturing the oral health in children
“Cleaning and filling the cavities at an earlier stage is painless and reduces the fear of dentist in your child. Moreover, it takes much less time when treatment is performed at an earlier stage,” says Dr Sushrutha.
“Treatment varies depending on the depth of the cavity and the severity of infection. It includes fillings, root canal treatment, or removal of tooth,” concludes Dr Sowmini.
