Caries in children – why does it appear and how to treat?

Dental problems are not uncommon in children, and maintaining good oral care and regular visits to the dentist are crucial for their overall health. In this article, we will explore what caries is in children, how it develops and manifests, what to do with milk teeth, and how to prevent it.

Why does tooth caries appear in children?

There are several main reasons:

1. Improper hygiene: Children often resist brushing their teeth, and parents may struggle to persuade them. Some parents may also overlook evening teeth cleaning.
2. Prolonged use of pacifiers: If a child continues to use a bottle or pacifier beyond 1-1.5 years of age, or sleeps with a bottle or pacifier, there is a high risk of developing caries on the upper front teeth.
3. Infections: Close contact with infected individuals or unhygienic practices, such as a mother licking the nipple instead of washing it, can transfer bacteria to the child.
4. Congenital factors: Problems can arise if the mother experienced illness, vitamin deficiency, or had poor habits during pregnancy.
5. Excessive consumption of sweets: Candy, soda, and juices contribute to enamel damage and bacterial growth, posing significant harm to children’s teeth.
6. Fluoride imbalance: An excess or deficiency of fluoride can provoke dental issues.
7. Dysfunction of salivary glands: Insufficient saliva production can hinder the effective washing out of bacteria from the oral cavity.

While poor teeth brushing is not the sole cause of dental caries, proper hygiene remains a fundamental factor.

Next, we will delve into how tooth caries develops in children, the classification of caries in milk teeth, when to visit the dentist for caries in children, the importance of treating milk caries, treatment methods, and prevention strategies.

How tooth caries develop in children

The onset of tooth caries in children can be identified when they start experiencing pain while eating. Other signs may include a reluctance to eat, stains on the enamel, and bad breath. However, caries does not develop immediately, so it is crucial to pay attention to these symptoms as early as possible.

There are different stages of caries in children, each with distinct features:

1. Initial stage: At this stage, white matte or rough spots of various shapes and sizes appear on the enamel. There is usually no pain, but if left untreated, the stains may darken.
2. Superficial stage: Sensitivity increases, and pain may occur after consuming cold or sweet foods. However, this stage still primarily affects the outer layers of the tooth and has not reached the deeper layers.
3. Moderate stage: Carious cavities form on the tooth surface and within the tissues. The tooth becomes painful when the child chews and also reacts to cold and hot temperatures.
4. Deep stage: The pathological cavity grows significantly, leading to the destruction of the tooth. Constant pain persists, irrespective of meals. In severe cases, the tooth nerve may be affected.

Without proper treatment for dental caries, children are at risk of nerve and tooth root damage, as well as the formation of a cyst. The choice of treatment for caries in children depends on the type and location of the pathology on the tooth.

Classification of milk teeth caries

In the field of medical dentistry, tooth damage is classified based on specific criteria. The following forms of caries in children are distinguished according to their location:

1. Fissure caries: Occurs when the recesses on the chewing teeth are damaged, leading to the accumulation of food remnants in the grooves, which promotes bacterial growth.
2. Interdental caries: Develops when teeth are tightly positioned together, making it difficult to remove food residues, resulting in plaque formation and subsequent caries.
3. Smooth surface caries: Affects the enamel near the gums, leading to the development of a carious cavity in that area.
4. Root caries: Often found when milk teeth are affected in children, and it impacts the area below the gums.

Based on the severity of the pathological process, the following types of dental caries in children are distinguished:

1. Slow (compensated) caries: Progresses gradually over several months, allowing for the potential restoration of minerals in the enamel and reversal of the tooth destruction process.
2. Decompensated (rapidly progressing) caries: Characterized by a high intensity of the process, with caries occurring on multiple teeth simultaneously. It can rapidly progress from initial stains to root damage within 1-3 months. The tooth becomes highly sensitive, and the enamel structure is significantly affected.

This classification applies to both milk caries in children and caries in permanent teeth. To prevent complications, it is crucial to initiate timely treatment.

When to go to the dentist for caries in children?

Having caries in milk teeth does not mean that treatment can be delayed until the affected teeth are replaced by permanent ones. Regular visits to the dentist are necessary to prevent caries in children. The first signs of problems can be detected as early as 2-3 years old. Even if the child doesn’t complain about anything, it is recommended to visit the dentist every 6 months.

Some parents may think it’s easier to have a diseased milk tooth removed, but this is a misconception. It is important to preserve teeth to ensure proper formation of the facial skeleton and maintain enough space for permanent teeth. Premature removal of teeth can worsen food chewing and affect speech. There is also a high risk of neighboring teeth shifting into the empty space left by the extracted tooth, causing the permanent molars to have insufficient space to grow. This may require corrective measures to align the molars growing unevenly in front or behind the gums, or to correct the bite.

A dental specialist can accurately assess whether specific treatment is required for caries in children and determine the appropriateness of extraction. For example, if a preschool child’s milk teeth are about to be replaced by permanent ones, the dentist may recommend a wait-and-see approach or extraction if necessary.

Why is it important to treat caries in milk teeth in children?

If left untreated, caries in milk teeth can affect the development of permanent teeth. The infection can spread to the underlying structures, leading to malformation. Furthermore, untreated caries in children can weaken the immune system and contribute to ENT issues and allergies. Pain experienced by children aged 2-3 years and older can hinder proper biting and chewing of food, potentially leading to digestive problems. Untreated caries can also cause aesthetic concerns if it affects the front teeth, resulting in possible self-consciousness.

Treatment methods

The treatment approach depends on the extent of tooth damage and the child’s age. In some cases, the dentist may offer non-invasive treatment options as an alternative to fillings. This can include applying special enamel protection through fluoridation. When the child’s permanent teeth begin to emerge, the dentist may seal the grooves in the teeth to prevent destructive bacterial plaque. Additionally, there are drilling-free treatment methods available today, suitable for children aged 4-5 years.

If the caries progresses, filling the affected tooth becomes necessary. The dentist will apply a numbing gel before administering anesthesia. Superficial lesions can sometimes be treated without anesthesia. Deep caries in children is typically treated in multiple stages. Modern dentistry prioritizes children’s comfort, minimising the use of drills and employing more manual techniques to avoid scaring the child.

In advanced cases or when necessary, treatment under anesthesia may be conducted. Parents should not worry about it being painful or frightening, as the dentist will choose a suitable treatment option and ensure a comfortable experience for the child.

Preventing Tooth Decay in Children

Dental diseases are highly prevalent, but it is crucial to take preventive measures to avoid them. The following tips can help:

1. Monitor your child’s diet: Limit or eliminate the consumption of sweets as they are not beneficial for the child’s oral health. Ensure an adequate intake of calcium by including dairy products, legumes, and nuts in their regular diet.
2. Emphasize good hygiene practices: Begin using a toothbrush as soon as the first teeth appear. Encourage your child to take care of their teeth. Around the age of 2, introduce a special toothpaste and a fun toothbrush. Consider visiting a hygienist or showing videos that demonstrate proper brushing techniques.
3. Introduce dental floss: Starting around the age of 3, you can begin using dental floss to clean the spaces between your child’s teeth.
4. Regular dental visits: Children require more frequent preventive check-ups compared to adults. Regular visits to the dentist will help identify any problems early on and provide necessary guidance on oral care. Additionally, it helps familiarize your child with dental professionals, reducing any fear or anxiety.
5. Prioritize oral health: Remember that maintaining good oral health is a foundation for a lifetime. It is much easier and more cost-effective to establish healthy dental habits during childhood than to treat oral issues in adulthood.

By implementing these preventive measures, you can significantly reduce the risk of tooth decay and promote your child’s overall oral health.