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As dentists, we often hear stories from patients of friends who “never brush their teeth, drink sodas all day long, and still never get cavities.” It’s not fair. We know. Some people are simply more prone to cavities than others. In dentistry, we call this assessment of someone’s tendency to get cavities their “caries risk.”
Caries is the scientific term for tooth decay or cavities. It is an unfortunate fact that some people have a naturally higher caries risk than others. It is important to understand your child’s caries risk so you can take preventive steps to reduce and avoid cavities whenever possible.
Cavities in their earliest stages are not detectable with the naked eye. Often, cavities develop between the teeth, in areas we cannot see. If you can see your child’s cavity, that means it is a large cavity and requires dental treatment as soon as possible.
Cavities in their early stages typically do not cause any pain or sensitivity. Catching them before they cause noticeable symptoms usually means your child’s dental treatment will be less invasive and less expensive.
If your child has any of the following signs or symptoms, please call to schedule a visit with your pediatric dentist right away. These are indications of a large cavity that requires treatment.
Many unique factors influence a child’s predisposition for cavities. We can explain these best by breaking them into a few broad categories. Children with a high risk for developing new cavities typically have several risk factors combined.
Enamel Strength
Healthy tooth enamel is the hardest substance in the human body. It is stronger than bones and very difficult to penetrate. However, not everyone has strong enamel. For some, enamel is naturally weak and thin due to genetics. Enamel can also weaken over time from damage, or natural erosion from everyday chewing.
It is also important to understand that baby teeth have much thinner enamel than permanent teeth, so your children can develop cavities more easily and more often than adults.
Saliva Quality and Quantity
Saliva is the body’s best natural defense against cavities. When we have naturally strong enamel and healthy saliva, our tendency to develop cavities is fairly low. This is important because enamel cannot grow back once damaged, but it can be made strong again. Saliva contains minerals to help re-harden the teeth, and it is alkaline in pH, which counteracts the acid attacks from cavity-causing bacteria.
When a child lacks healthy saliva and suffers from dry mouth, their cavity risk is automatically classified as high. That’s how important our saliva is!
Oral pH
An acidic pH inside the mouth increases the risk for cavities. This is because acid softens and weakens enamel, making it easier for bacteria to penetrate your child’s teeth. A dry mouth results in an acidic mouth because it lacks the neutralizing effect of saliva. Health conditions like frequent nausea and vomiting also create an acidic environment inside the mouth.
Understanding the pH of the beverages you give your child is important, too. Sipping sodas, chocolate milk, or fruit juices throughout the day can lower the pH inside your child’s mouth and increase their risk for cavities.
Oral Hygiene
Cavity-causing bacteria is what makes up dental plaque. The longer plaque stays on the teeth, the greater your child’s likelihood for developing a dental disease. The purpose of dental hygiene is to remove plaque from the teeth so the bacteria within the mouth cannot cause cavities or gum disease.
When a child has poor brushing technique or inconsistent oral hygiene, they end up leaving dental plaque on the teeth and trapped under the gums for days, weeks, or months at a time. This greatly increases the risk for cavities and gum disease.
Diet
Cavity-causing bacteria need carbohydrates to thrive. A diet high in sugar and other simple carbs feed these bacteria by producing acid that breaks down the tooth enamel surface, increasing the risk for cavities.
On the other hand, we can lower a child’s cavity risk by “starving” these bacteria by reducing sugars and other simple carbs from their diets. Giving children snacks that are mostly fats or proteins, like nuts and cheese, can help them fight cavities!
Prior Dental Work
The existence in a child’s mouth of a lot of dental work increases the risk for new cavities. Even wonderfully performed dental treatments carry a risk for future cavities. This is because the enamel is no longer intact. When there is an edge where the restoration (filling or dental crown) meets the tooth, dental plaque is attracted to that edge and will collect there if not properly cleaned.
Pediatric dentists often use a tool called the CAMBRA, or Caries Management By Risk Assessment, to weigh the chance of caries development for a patient on a scale from disease to health. This helps explain a child’s risk for cavities and how you can help them take steps to tip the scales to better their health. While no one can have zero risk, those with a Low Risk simply need a maintenance routine to stay in the low risk range. This will include continuing good oral hygiene at home, seeing their pediatric dentist on a consistent basis, watching their diet and managing any dry mouth issues that arise.
Children with a Moderate Risk for cavities need to take more action to lean more toward the healthy end of the scales. This should involve an improvement in both home care and the consistency of dental visits. We also recommend adding fluoride treatments and reducing sugar in a child’s diet.
Those who have a High Risk for developing new cavities need to make changes that we call aggressively preventive. This means, to prevent developing further cavities, your child should see their dentist more frequently than someone with a low risk, follow the dentist’s recommendations for preventive treatments, like professional fluoride applications, and reevaluate habits that can affect the pH of the mouth. In order to lower a high cavity risk, your child must greatly reduce their sugar intake, closely guard the pH of their mouth, and perform consistent and effective plaque removal every single day!
No one should feel resigned to getting cavities all the time. Take action to stop it! You can positively influence your child’s risk factors listed above through helping them make a few diligent behavior changes.
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