Why Does My Child Keep Getting Cavities?

All children can be at risk for tooth decay and many factors can contribute to the incidence of tooth decay. According to the CDC, tooth decay (aka Dental Caries) remains one of the most common childhood diseases. It is important to seek regular dental care (6 month check-ups/examinations) so that a dentist can evaluate your child for preventive care, evaluation of caries risk, and examination of teeth and othe oral structures. In this segment, we will discuss some of the sources,causes of dental decay and some preventive measures you can employ to help prevent dental decay.


We want to reiterate the importance of seeking regular dental care (6 month check-ups/examinations) so that your child’s dentist can evaluate your child’s teeth and other oral structures in the mouth. If the dentist finds that your child does have cavities/dental caries, your dentist will discuss with you treatment options in effort to address your childs oral health. It is important to note that cavities that aren’t properly treated or managed have the potential to lead to more serious infections and pain which could impact the quality of life for your child including – speech development, learning, eating, pain, infection and general well being and overall health. Untreted decay can lead to more serious and debliltating illness and pain. We want to help ensure that every child experiences a childhood free of dental disease and illness through high quality preventive and restorative dental care!

If your child has dental decay, or has repeat incidence of dental decay, here are some things to know and consider:

Cavities are caused by bacteria

Unfortunately, tooth decay is rather common in children – it is preventable with excellent oral hygeiene and diet practices, however, dental caries still remains one of the most common diseases that affects children of all ages. By the age of 4, more than 1 in every 4 children has at least one cavity. Some children do get cavities much earlier, so it’s very important to schedule your child’s first dental visit by their first birthday – to disucss prevention practices, dietary practices and other recommendations to help ensure your child has protective measures in place to help prevent tooth decay from developing. According to the National Institute of Dental and Craniofacial Research, 42% of children who are ages 2 to 11 develop a cavity in their baby (primary) teeth.

The group of germs (bacteria) that play a major role in development of tooth decay are called mutans streptococcus. These bacteria feed on sugar and produce acid that in time, will dissolve minerals on the outermost layer of the tooth, known as enamel. As decay progress, the inner layer of the tooth will also become affected – this layer is known as the dentin. When caries progresses even further, the nerve and blood vessels of the tooth can become affected. It is important to have best preventive practices in place at an early age.  It is also important to have regular dental examination for a dentist to examine for any signs of decay that might be present and to address accordingly. Regarding tooth decay, the first sign that minerals are being lost, a process known as ‘deminerlization’ is the development of white/chalky spots on the teeth. In time, as these areas break down, a cavity may form. These same bacteria are also responsible for contributing dental plaque—a soft, sticky, yellowish film that builds up on teeth and can further cause tooth decay and /or lead to gum disease (gingivitis, periodontitis, and other infections, health concerns) if not removed regualarly.

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How does a dentist know there is a cavity?

At each dental visit, the dentist will examine your childs teeth, tounge, gums, and other soft tissues and oral structures. As the dentist examines the teeth, he or she will be evaluating each tooth for potential signs or presence of dental decay. To facilitate a thorough examination, your dentist may recommend certain dental radiographs be taken (also known as x-rays). Dental radiographs provide a view of your child’s teeth and surrounding bone that a dentist would not otherwise be able to see by visual examination only. With dental radiographs in addition to clinical examination, your dentist may be able to detect early signs of dental disease and offer preventive recommendations or treatment recommendations based on their findings.

How can I help prevent dental decay/cavities in my child’s teeth?

There are certain measures you can take to help prevent or reduce the incidence or development of dental caries.

  1. Regular brushing and flossing: Brushing in the morning and before bed actually removes plaque – which can serve as the resorovoir for bacteria, sugar. Flossing does the same and gets in between teeth – areas where tooth brush bristles are not able to reach.
  • Begin oral/tooth cleanings when teeth erupt.
  • Non-Fluoride tooth paste available for children under 2 years of age
  • For High caries risk patients: by 2 years of age. (Parent supervision of age appropriate amount of paste –rice size/smear).
  • Recommend parent/caregiver brush teeth until child is approximately 6 years of age and is able to demonstrate thorough brushing.
  • Recommend brushing twice per day
  • Bed time most critical time to brush
  1. Fluoride: fluoride toothpaste helps to restore minerals that were lost due to acid producing bacteria. Fluoride on tooth can also limit the activity acid that’s created. Fluoride that is ingested (foods/beverages) — most commonly from fluoride-treated water that we get from our water faucet in our homes, and sometimes via foods that were processed with fluoridated water. This also helps to strengthen teeth (potentitally helping to strengthen permanent teeth that may be still developing under the baby teeth).
  1. Fluoridated Tooth Paste: The American Academy of Pediatric Denistry has the following recommendations regarding the use of Fluoride tooth paste.

Fluoridated toothpaste (generally 0.1% F; 1,000 ppm F) should be used twice daily as a primary preventive procedure. Brushing twice daily has greater benefits than brushing once per day. It is important that a parent or other responsible adult, dispense the appropriate volume of toothpaste, based on child’s age, onto a soft, age-appropriate sized toothbrush. The parent should also supervise the frequency of brushing, and assisit/participate in performing brushing teeth for young children.

  • For children less than 2 years of age, use only a ‘smear’ of fluoridated toothpaste is recommended (see FigA below). 
  • For children aged 2 through 5 years. A ‘pea-size’ amount (see Figure 1) of toothpaste is appropriate. To maximize the beneficial effect of fluoride in the toothpaste, rinsing after brushing should be kept to a minimum or eliminated altogether.

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Your dentist may recommend additional at-home topical fluoride regimens utilizing increased concentrations of fluoride if your child has an increased or high risk for dental caries. These may include over-the-counter (0.02% F; 200 ppm F) or prescription strength (0.09% F; 900 ppm F) formulations.

Additionally when your child presents for their 6 month dental check-up, your dentist may recommend an professionally applied fluoride product known as fluoride varnish to further help strengthen and protect your child’s teeth from dental caries!

There are many options for recommended exposure for fluoride including mouthwashes, supplements and treatments at the dental office. Please speak to your dentist to find out what’s the best option for your children.

  1. Less exposure to sugary or starchy foods: The more frequently sugary, starchy foods are consumed throughout the day and in between meals, the more bacteria can build up. Remember, the bacteria build up, digest the sugar and proeduce acid as a waste product. The bacteria feeds on sugar – the acid by-product can lead to loss of the minerals in the tooth surface – leading to dental caries ‘Cavities’.  Try to limit the sugary and starchy (chips, breads, cookies, etc.) snacks your child eats. Starch turns into sugar once eaten. It is especially important to avoid starches and sugars before bedtime!

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  1. Visit the dentist regularly: Children should have their first dental visit by their first birthday, and then every six months for a cleaning and check-up/examination. The early preventive measures are very important to help prevent decay from forming. If decay is already present – early detection is best to address before the dental caries progresses further potentially requiring more extensive treatment.
  1. Dental Sealants: Dental sealants can be an excellent preventive measure. Depending on your child’s age, caries susceptatility and caries risk assessment, your child’s dentist may recommend sealants to the chewing surface of molars. In many cases, dental sealants are recommended for your child’s permanent molars. A dental sealant is a flowable plastic type material that bonds to the tooth. It is applied on the chewing surface of molars – it helps to ‘seal’ the deep grooves on the tooth surface which helps to ensure that the tooth has a smooth surface that a tooth brush can more easily clean.

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We always encourage you to speak with your child’s dentist to help ensure your child has the preventive measures in place to help reduce the chances of dental caries developing in your child’s teeth. Please feel free to ask any questions you may have!