1. What causes cavities in baby teeth? Are they solely the result of poor oral hygiene?
Cavities in baby teeth are caused by bacteria consuming carbohydrates and turning them into acid, which demineralizes the tooth. Carbohydrates sitting on the teeth cause cavities. Poor oral hygiene results in bacteria and carbohydrates sitting on the surface of the teeth for longer periods, increasing the risk of substantial acidic damage. Minor demineralization is reversible, but if enough demineralization occurs to collapse the inner tooth layer (dentin), cavitation results. This step is irreversible.
2. Why are cavities in baby teeth so common?
Cavities are common in baby teeth due to the dietary choices of kids and their inferior oral hygiene compared to adults. There can also be genetic anatomical differences, such as deep narrow grooves that make it difficult to remove bacteria and carbohydrates, which can break down teeth and form cavities.
3. How are cavities in baby teeth treated?
Cavities in baby teeth are usually treated the same way as adult teeth—drill and fill. Mild cavities or cavities that a child cannot tolerate to have fixed are sometimes treated with a temporary resin. This makes the filling more likely to last in situations where it is difficult to get a child to cooperate fully during the dental appointment. Children that can't tolerate a standard filling can also receive various forms of sedation to ease the process. There are also pediatric crowns for larger cavities or even mini-root canals called pulpotomies. Occasionally, a baby tooth can be extracted, and a space maintainer may be placed to hold room for the permanent tooth. Rarely, if a tooth is loose and will fall out soon naturally, the filling may not be performed.
If the tooth appears affected by acidic degradation but has not yet turned into a cavity, demineralization with fluoride can help. Some dentists use silver diamine fluoride to help arrest cavity progression in some kids as a short-term, less invasive solution to help stabilize the tooth.
4. What can you do to prevent cavities?
Avoiding fermentable carbohydrates and sugars is the most important step, with proper oral hygiene as a close second. The use of fluoride on the surface of the teeth is also effective in remineralizing and strengthening the hardness of the teeth, making them less susceptible to acid.