The Fight Against Cavities: How to Care For Big Kids' Teeth

Tooth decay isn't something to brush off: It's actually the most common childhood disease. Save your kid's smile with these healthy habits.
child bruishing her teeth

Alexandra Grablewski

When Lisa Kiell of New York City took her 5-year- old son, Jake, to the dentist for a checkup, she was shocked. X-rays revealed that he had five cavities, including three in his molars that were so severe they couldn't simply be filled. The kindergartner would need considerable work, including treatments sometimes referred to as "baby root canals."

To avoid this extensive dental work -- requiring three appointments -- Kiell had asked about having the three molars pulled, since they'd be falling out anyway when his permanent teeth came in. But since primary molars last until a child is 12 or older, and losing baby teeth early can cause the permanent teeth to come in crooked, the dentist felt it was better to save all the baby teeth.

Although Jake received laughing gas and a shot of Novocain, the little guy was so freaked out that he cried almost the entire time he was in the dentist's chair. The next appointment was even harder for Jake and the third one, when he needed a restraining jacket, was the worst.

This story may sound like an extreme example, but dentists are seeing more and more children like Jake. The Centers for Disease Control and Prevention reports that cavities in young children have been on the rise, and that one in seven 3- to 5-year-olds have untreated tooth decay. Early tooth decay is now the most common childhood disease -- five times more common than asthma. (It's considered a disease because cavities are caused by bacteria that use sugar in a child's diet to produce acids that destroy the teeth.) Even if a cavity isn't painful, decay in baby teeth greatly increases the risk of cavities in permanent teeth. "When permanent teeth come into an environment where the baby teeth have already decayed, the same bacteria will attack the new teeth," says Parents advisor Burton Edelstein, D.D.S., M.P.H., professor of dentistry and health policy at Columbia University and founding director of the Children's Dental Health Project.

Causes of Cavities
Rates are rising in part because of what, and how often, kids are eating, say experts. They're consuming more processed carbohydrates like pretzels and crackers, as well as more sweets, juice, and soda, than in the past. (Kiell was told that Jake's fondness for gummy candies had contributed to his severe cavities.) The bacteria that feed on sugar erode the structure of teeth by depleting calcium. Once an area without calcium becomes big enough, the surface of the tooth collapses and your child has a cavity.

Many parents are surprised to learn that kids need help brushing their teeth until at least age 6. Young children simply don't have the manual dexterity to do the job well. "They tend to brush the same teeth in the front over and over again, but don't get to the back teeth or the inside surfaces," says Paul Casamassimo, D.D.S., chief of dentistry at Nationwide Children's Hospital, in Columbus, Ohio. That was the case with Jake. He'd insisted on brushing his own teeth at age 4, says his mom, who's now taken over the task.

Another reason for the cavity surge may be a lack of fluoride, as more families rely on non-fluoridated bottled water, and fluoridation of public drinking water has been discontinued in some communities. Fluoride strengthens tooth enamel, making it resistant to the acid produced by bacteria. In the last four years, at least 15 municipalities across the country have halted the practice due to tight budgets and skepticism about its benefits.

With cavities on the rise and healthy baby teeth so important, it's up to you to be proactive about checkups and early oral care. We've gone straight to the experts to get the latest advice and smart strategies for preventing dental problems in your preschooler.

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