Ask Dr. B :: Cavities

This post is sponsored and written by Dr. Michael Blen. We are huge fans of Dr. B’s and love that we get to share his knowledge with all of our readers!

This is what I hear parents say: “My child has a cavity? How did this happen? I must be the worst parent in the world!” This is a common topic in my office (and no, you aren’t the worst parent in the world!).

Being a children’s dental specialist, I see a number of children with cavities either from my own practice’s new or existing patients or those being referred by general dentists and pediatricians. So, for this post, let me discuss in a generalized manner about cavities.

Q: What is a cavity?

A: In the simplest terms, a cavity is a hole in the tooth with decay. Plaque and sugars/starches mix with bacteria in our mouths to create acid which causes decay and holes in the tooth. Once started, this decay will continue to grow until it is removed and restored. This hole in the tooth starts in the outer layer (the enamel) and can progress to the inner layer (dentin) until it reaches the nerve of the tooth. Once the bacteria gets to the nerve of the tooth, infection can start. This infection can be very dangerous and can cause significant pain, swelling and would require very extensive and expensive dental treatment in order to treat. This is true for children as well as adults. You may be surprised by how many abscessed teeth I have had to extract on very young children due to decay and infection.

Q: When can my child start getting cavities?

A: Your child is susceptible to cavities as soon as they get teeth. It is important to care for your child’s teeth and mouth even prior to the eruption of the first tooth and certainly not put your child to bed with a bottle. Also remember from a previous blog: You should establish a dental home for your child by one (1) year of age.

Q: Why do we and our children get cavities?

A: There are a number of factors working together that are involved with getting cavities.
The Tooth: Some people have teeth that are more susceptible to decay. This can be due to, among other things, their molars being groovier than most, enamel not as well formed, or just not very strong teeth.
Cavity Causing Bacteria: There is one main bacteria (Streptococcus mutans) that is the primary culprit of dental decay. Some people have more of this bacteria in their oral cavity. This bacteria can be transmitted from adults to their children through sharing of utensils (even testing the temperature of their food with their spoon), blowing on their food, or even kissing them on the mouth.
Diet: Of course, diet plays a significant role in dental decay. I preach that children should drink water and white milk. They should stay away from juices, sodas, sweet tea, lemonade, Gatorade, etc. I also preach that children should eat (not drink) their fruits, vegetables and proteins. Sugary drinks, candy, sticky foods (even snacks like raisins), processed carbohydrates (cookies, chips, crackers, etc) that stay in the grooves of the teeth are what I consider “special treats”. It is not the quantity of these sugary substances as much as the frequency of them that does the most harm. I do not recommend these things, but am aware that they will get them and we need them to understand that this is not the normal diet and everyone deserves special treats every now and then.
Oral Hygiene: I recommend brushing at least 2 times a day for 2 minutes each time with a fluoride toothpaste. Please see the previous blog about toothpastes and hygiene. Flossing teeth that have side by side contacts is important to help prevent decay between our teeth. This is true for our children and us adults.
Time: All of these factors play hand in hand and over time allow us to either keep our teeth healthy or start decay.
• Other factors included could be special needs children, dry mouth, medications, illness, inadequate fluoride intake, eating habits (food hoarding) and eating disorders.

Q: Are cavities common in children?

According to the American Academy of Pediatric Dentistry: tooth decay is the single most common chronic childhood disease. It is 5 times more common than asthma, 4 times more common than early-childhood obesity, and 20 times more common than diabetes.

Once a child gets a cavity, the tooth needs to be fixed. In next month’s blog I will briefly discuss why and discuss the different treatment options.

On a personal note, I want you to realize that your child having a small cavity is not the worst thing ever. A child having a cavity does not have to be considered a parental failure. There are a number of times that we as conscientious parents do our very best with our children’s diet, oral hygiene, etc. and our children still get cavities. We just fix it, and try to get into a good routine to reduce the chance of getting any more. It is important to get our children in good routines and teach them the proper diet and oral hygiene techniques in order to help prevent future dental decay.

Please contact me should you have any questions that you would like me to address in upcoming blog posts. Please visit my Facebook (Pediatric Dentistry with Dr. B) or my website ( to find out more about my practice.