Cavities in Toddlers: Prevention and Treatment

93% of young children in Indonesia have cavities. That is Riskesdas 2018, and WHO puts 90% of children aged 3 to 5 in the same position.

Which means if your toddler has one, you have not failed. It also means the odds are not on your side, and the habits below are what move them.

How a hole actually forms

Bacteria in her mouth meet sugar and make acid. The acid pulls calcium out of the tooth and wears the enamel down. Do that often enough, for long enough, and the surface gives way.

The word doing the work there is often.

One sweet thing leaves her mouth acidic for about 20 minutes. Five small snacks across an afternoon is five acid attacks, which does more damage than one bigger portion. Frequency beats quantity, and almost nobody is told this.

What to look for

• White or dark spots on a tooth, the very first sign the enamel is going
• Crying, or telling you a tooth hurts
• Wincing at hot or cold

Genetics are in this too. Softer enamel runs in families, so if you have had a lot of fillings, she starts at higher risk than her friends.

Four things that prevent it

Watch how often, not just how much. Sweets are the obvious one. Less obvious: biscuits, cereal, fruit juice and milk all feed the same process.

Juice or milk in a bottle at bedtime is the worst version of it. The sugar sits against her teeth for hours while she sleeps and her saliva slows down.

Do not share spoons. The toothbrush one is obvious. The one nobody notices is tasting her food from her spoon and then feeding her with it, which moves bacteria from your mouth into hers.

Brush twice a day from the first tooth. Water at first, then a smear of paste. And keep her off the bottle at bedtime.

Take her to a dentist before her first birthday, or as soon as teeth appear, then every 6 months.

If there is already a cavity, they will fill it to stop it growing. Filling a milk tooth keeps it in place until it is due to come out, which matters more than most people assume.

Getting a toddler to let you brush

Expect a fight. She cannot coordinate the movement yet, and plenty of children simply hate the taste.

What helps: same times every day, letting her hold the brush first before you take over and do it properly, brushing yours next to her, and a flavour she does not object to.

Mama's Choice Baby & Kids Toothpaste is made for this age, with a mild flavour.

A cavity will not close on its own

This is the most common misunderstanding, so plainly: a hole in a child's tooth cannot be healed or closed by brushing, or by switching toothpaste.

Fluoride toothpaste in the right amount helps slow and prevent new damage, and at the very earliest stage, when there is a white spot and no hole yet, remineralisation genuinely can happen. Once there is a hole, it needs a dentist.

How much paste:

• Under 3: a smear the size of a grain of rice
• 3 to 6: pea-sized

Supervise so she is not swallowing it, and teach her to spit as soon as she can manage it.

They are only milk teeth, and it still matters

A decayed milk tooth causes pain and infection, and it can disturb the permanent tooth forming underneath.

Losing one early also changes how the permanent teeth come through, because the milk tooth was holding the space open.

Go the same day if

• Pain wakes her at night
• Her face is swollen, or the gum has pus in it
• A tooth has turned grey or dark after a knock
• She will not eat because her mouth hurts