Cavities in Toddlers: Causes, Signs and Prevention

Can toddlers get cavities?

Yes. HealthyChildren.org, from the American Academy of Pediatrics, says cavities can develop as soon as your baby has teeth. The American Dental Association (ADA) says tooth decay in infants and toddlers is often called baby bottle tooth decay.

The National Institute of Dental and Craniofacial Research (NIDCR) calls severe decay in young children “early childhood caries.” It says this severe decay starts in the baby’s front teeth and extends to the back teeth. Knowing it can happen helps you act early. A cavity in a baby tooth is a real problem, even though that tooth will fall out later.

What causes cavities in toddlers?

Sugar, germs and time on the teeth cause decay. Bacteria in the mouth make acid when they meet sugars and starches, and that acid attacks tooth enamel. The main toddler causes are:

• Bottles in bed. HealthyChildren.org says putting a child to sleep with a bottle lets the sugars in formula and breast milk linger on teeth.
• Sweet drinks. It says fruit juice, soda and sweetened drinks are not good for little teeth.
• Sticky snacks. It lists raisins and other dried fruits, gummy candies, taffy, fruit roll-ups and snack bars with honey or molasses.
• Shared germs. It says decay-causing bacteria can easily move from mouth to mouth.
• Dipped pacifiers. The ADA says pacifiers dipped in sugar, honey, juice or sweetened drinks can lead to tooth decay.

Even the natural sugars in breast milk and formula can start the process, according to HealthyChildren.org. That is why timing and cleaning matter, not blame.

What do toddler cavities look like?

Early decay is easy to miss. The NIDCR says that in early tooth decay there are usually no symptoms, and that decay signs include white, brown or black staining on the tooth. Pain often comes later. The ADA warns that in some cases decay in infants and toddlers is so severe that the teeth cannot be saved and need to be removed.

If your child has a swollen face with a fever, or trouble breathing or swallowing, this is an emergency. Read swollen face and tooth abscess for what to do.

How can I prevent cavities in my toddler?

Small daily habits do most of the work. These are based on ADA and AAP advice:

1. Brush twice a day. For children younger than 3, use fluoride toothpaste in an amount no more than a smear, about the size of a grain of rice. From age 3 to 6, use a pea-sized amount.
2. Clean between teeth. The ADA says to start daily cleaning between teeth once your child has two teeth that touch.
3. Switch to a cup. HealthyChildren.org suggests moving from the breast or bottle to a lidded cup around 12 months.
4. Skip bottles in bed. HealthyChildren.org says milk, breast milk and formula can be given at mealtimes, but fill your child’s cup with plain water in between.
5. Limit sticky and sweet foods. HealthyChildren.org suggests having kids brush or rinse with plain water after sticky foods.
6. See the dentist. HealthyChildren.org says a pediatrician or dentist may apply fluoride varnish a few times a year.

The AAP suggests brushing about twice a day for 2 minutes around the first birthday. A fluoride varnish is a coating a dentist or pediatrician can apply. For more, see the glossary entry on tooth decay and our guide to kids’ cavities and fluoride.

Does the water my toddler drinks matter?

It can. HealthyChildren.org says to make water the family drink of choice. It says drinking plenty of water cleanses the mouth and helps maintain saliva flow, which washes away decay-causing bacteria. The NIDCR lists drinking tap water that has fluoride as one way to get fluoride, along with fluoride toothpaste.

Water supplies differ from place to place. If you live near Wildwood, read does Wildwood tap water have fluoride for the reported number and the source. Ask your dentist or pediatrician whether your child needs anything more.

What should I tell the dentist at the visit?

Bring a short list. Note what your child drinks and when, whether there is a bottle at bedtime, how often they snack, how you brush, and which toothpaste you use. Mention any white or brown spots you have seen. Honest answers help the dentist give advice that fits your home, and no one will judge a busy family.

When should my toddler see the dentist?

By the first birthday at the latest. Our post on when a baby should see the dentist covers the first visit. The NIDCR says tooth decay can be found during a regular dental check-up, and a dentist can look at each tooth, which you may not see at home.

How are toddler cavities treated?

It depends on the cavity. The NIDCR says dentists commonly treat cavities by filling them. Town Center Dental lists dental fillings among its services. Your dentist will explain what your child needs and what to expect. If a tooth is badly decayed, the ADA says it may not be savable.

How can I make brushing easier at home?

Make it part of the day and make it friendly. HealthyChildren.org suggests setting a positive example by letting little ones watch while you brush and floss, and adding fun to your child’s routine. Toddlers often like brushing to music or tracking progress on a chart.

Keep the steps short and the same each time. Let your child hold a second brush while you do the real brushing. Praise effort rather than results. If a day goes badly, try again the next day without a fight. Over weeks, the habit sticks, and the habit protects the teeth.

Next step

If you see spots on your toddler’s teeth, or it has been a year since the first tooth, book a visit. Read about dentistry for kids at Town Center Dental, then call (636) 273-5866 or request an appointment.