Cavities (Tooth Decay)

Healthy teeth do not have cavities (holes in teeth). When children eat or drink anything with sugar or starch, bacteria in the mouth turn the sugars and starches into acids. The acids result in demineralization, when minerals such as calcium disappear from the teeth.

Frequent eating and drinking of sugary or starchy foods and drinks cause this demineralization and finally lead to cavities. This can result in pain and infection (swelling).

Almost 25 percent of children younger than 5 and 50 percent of 5- and 6-year-olds have cavities.

Each child may experience symptoms differently. Symptoms may include white spots on the teeth that appear first. Then, an early cavity appears that has a light brown color on the tooth. The tooth color progressively becomes darker.

Some children may inherit from their parents "good teeth" and never develop cavities. But more importantly, what your child eats will determine the chance of developing cavities.

Risk factors that put a person at a higher risk for tooth decay include:

• Diets high in sweets, carbohydrates, and sugars. We recommend limiting juice consumption to no more than four ounces daily.
• Water supplies with limited or no fluoridation. We encourage parents to use fluoridated water for cooking and drinking, as most bottled water does not have adequate fluoride.
• Age: children and senior citizens are at an increased risk for tooth decay)

Smart snacking

When you are deciding on a snack, the National Institute of Dental and Craniofacial Research, part of the National Institutes of Health (NIH), reminds you to think about the following:

• The number of times a day you eat sugary snacks
• How long the sugary food stays in your mouth
• The texture of the sugary food: chewy or sticky

According to the NIDCR, damaging acids form in your mouth every time you eat a sugary snack. Consider an alternative, such as raw vegetables, fresh fruits, or whole-grain crackers next time the urge to snack strikes.

Preventing tooth decay and cavities involves five simple steps:

• Brush your child's teeth, tongue, and gums twice a day with a fluoridated toothpaste, or supervise them brushing their teeth.
• Floss your child's teeth daily after the age of 2.
• Make sure your child eats a well-balanced diet and limit or eliminate sugary snacks.
• Consult your child's physician or dentist regarding the supplemental use of fluoride and/or dental sealants to protect your child's teeth against plaque.
• Schedule routine (every six months) dental cleanings and examinations for your child.

Dental cavities are usually diagnosed based on a complete history and physical examination of your child. A diagnosis may be performed by your child's physician or your child's dentist.

Treatment, in most cases, requires removing the cavities and replacing the lost substance of the tooth with a filling.

What are fillings?

Teeth that have been affected by tooth decay require a filling. There are many different types of fillings, including:

• Dental amalgams: Dental amalgams, also known as silver fillings, are comprised of a mixture of mercury (45 to 50 percent), and an alloy of silver, tin, and copper (50 to 55 percent). When combined with other materials in a dental amalgam, mercury's chemical nature changes.
• Composite resins: Also known as white fillings, a composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide) that is used primarily for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

Other alternatives to restoring damaged or decayed teeth

• Porcelain veneers: A ceramic material is bonded to the front of teeth to change the tooth's color, size, and/or shape
• Crown: A cap that covers a cracked or broken tooth, unfixed by a filling, to approximate its normal size and shape
• Cast gold restorations: This type of restoration is often more costly and may require more than one dental fitting