Kusp Pediatric Dentistry

What is dental decay or caries?

What causes a cavity in teeth?

Dental decay is known scientifically as caries. Believe it or not it is one of the most infectious human diseases (hard to believe in the era of COVID). What do caries look like? Caries can be completely invisible to the naked eye – a carious tooth may look completely intact but when we take a radiograph (x-ray) we can identify that the tooth may actually be carious. Dental caries can also look like white chalky spots in the early stages and in the later stage, a brown or black hole in the tooth. Caries is actually a very complex disease with many factors and we are still learning exactly how or why children (and adults) get cavities while others never do.

Are the sugar bugs real?

In our present knowledge, we know that caries are bacterial in nature (the sugar bugs are real)! Some of the commonly found oral bacteria involved in dental decay includes acid producing bacteria such as Streptococcus mutans, lactobacilli, and Streptococcus sobrinus, to name a few. The bacterial component of decay is why it is important for parents with dental decay to maintain oral health and hygiene to prevent the transmission of these bacteria to their children – we call this vertical transmission. When a parent and a child swap saliva when kissing, sharing utensils, and sharing food they risk transmitting this bacteria to their child.

How does diet cause cavities?

We also know caries are dependent on diet. Refined sugars are an easy fermentable food source for bacteria and also can affect the thickness and tenacity of the plaque on the teeth. This is why we encourage a diet that limits the amount of refined sugar a child receives. Even more so, caries is also driven by how often during the day the mouth is exposed to carbohydrates. Every time we eat or drink something, our mouth becomes acidic in pH. The saliva can help buffer the acidity, however the less plaque and available sugar in the mouth and on the teeth, the less drastic the drop in pH becomes when we eat. This is why diet becomes an important component of dental health as well as the frequency of snacking and what we are snacking and drinking.

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Are dental cavities genetic? Can my child have weak enamel?

Lastly, the other contributing factors are dependent on the child’s own genetics. The quality of the enamel, the quality and quantity of the saliva, the protective and immune factors of the saliva are all a variety of factors which make a child more or less susceptible to caries. When all of these factors negatively overlap, this is when we see a cavity. This is also why we often tell parents that dental caries is not always in their control. Even if hygiene and diet are perfect, there are still other factors that a parent has no control over and a child may still end up with a cavity.

A child's mouth with cavities in the molars

How about saliva?

For all of these reasons, when we see your child for a regular dental exams, we try to advise families on how to ideally address the things we can control like cleaning the teeth properly, controlling diet, reduce frequent snacking and sugary drinks like juice, even if its diluted and of course ensuring that the family is all caring for their oral health. Beyond that, we can assess salivary flow and quality. This may be affected by certain medications commonly taken by children such as asthma medication and ADHD medication. This can also be caused by dehydration, stress, or salivary gland dysfunction. When we notice a dry mouth or sticky saliva in a child, we may recommend certain types of rinses, toothpastes, or chewing gum to help stimulate the flow of saliva to better protect the teeth and buffer the mouth. 

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Ultimately, our goal as dentists is to assess all of a child’s risk factors for cavities and help guide both parents and child for a lifetime of a healthy mouth!