Cavities in Children: What to Do

Medically Reviewed by Renee A. Alli, MD on April 14, 2023
4 min read

Cavities, also known as caries or tooth decay, are common among children. Left untreated your child can experience pain and infection. This can lead to problems with speaking, eating, and learning. 

Good dental hygiene can help your child prevent cavities. You can help your child establish healthy dental habits even before their first tooth appears. Knowing what causes cavities in children and how to treat them if they develop can help you and your child prevent them in the future. 

Cavities can be caused by bacteria, foods, acids, and saliva. Foods with sugars and starches in them, like candy, soda, cake, juices, milk, and cereals, become acidic from the bacteria in your child’s mouth. The acids break down tooth enamel and cause cavities. If left untreated, cavities can be dangerous for children. 

All children are at risk for cavities, but some factors may increase that risk: 

  • Higher than average levels of bacteria in your child's mouth
  • Too many carbohydrates, sugars, and starches in your child's diet
  • Drinking water with little to no fluoride
  • Little to no oral hygiene
  • Low saliva production

Signs and symptoms of cavities may be different for every child, but common signs include: 

  • White spots on the tooth 
  • Formation of a light brown color on the tooth
  • Darkening of the tooth
  • A hole in the tooth
  • Reactions to sweets or cold foods

If your child has noticeable signs of a cavity, they’ll need to see a dentist. Your dentist will treat their cavities with a filling, also known as a restoration. There are two types of restorations: direct and indirect. Direct restorations require one visit to fill the cavity holes. Indirect restorations need two visits and involve repairs to the tooth with a customized material.   

If your child experiences the following symptoms, you should seek immediate medical attention: 

  • Increased pain or swelling
  • Fever and other signs of infection
  • Trouble eating or chewing
  • Pus draining from the tooth

Untreated cavities and tooth decay can cause life-threatening infections that have long-term effects. 

According to the Centers for Disease Control and Prevention, about 20% of children between the ages of 5 and 11 have at least one untreated decayed tooth. Cavities are a common disease in children, and some children may be predisposed to them, but there are ways to prevent them. Speak with your pediatrician about topical fluoride applications and age-appropriate dental hygiene at your wellness visits

Schedule regular visits to the dentist. Take your child to the dentist 6 months after their first tooth appears or before they're 12 months old. It’s recommended you take your child to the dentist at least twice a year. 

Regular dental check-ups will let you know if your child has any problems with their teeth. Frequent visits can also help your child learn good dental habits like brushing and flossing. 

Teach your child good brushing and flossing habits. Forming the right habits early will help your child stick to the routine when they’re older. All children with teeth should have their teeth brushed twice daily for two minutes with small amounts of fluoride-containing toothpaste. Children aged 3 to 6 years old should use a "pea-sized" amount of toothpaste, and all children under 8 years old should be helped when brushing their teeth.

While your child brushes their teeth, make sure they are brushing in circles.  They should also lightly brush their gums to prevent buildup. It's important to watch them so you can ensure their teeth are clean. 

Flossing once a day is a good way to remove plaque buildup from your child’s teeth. You can do this for them until they’re old enough to do it themselves. Flossing removes left-behind food that can cause cavities. 

Give your child tooth-healthy foods. Avoiding certain foods such as sugary treats can prevent cavities, but there are also foods your child can eat that lower their risk. Calcium-rich foods, foods high in vitamin C and protein, and bacteria-fighting foods can all be helpful in preventing cavities. Some examples are carrots, celery, apples, strawberries, oranges, hard-boiled eggs, yogurt, and cheese. 

Use fluoride. A toothpaste with fluoride will prevent tooth decay. Your child should also drink tap water. Most tap water is fluoridated, which is good for preventing cavities. Your dentist can test your water to find its natural fluoride content. If there’s not enough, they might prescribe your child a fluoride supplement. 

These strategies can reduce the number of cavities your child may get.  Even if your child is predisposed to dental health problems, they should be taught the consequences of not brushing.