Early signs of tooth decay or dental caries
In a child less than 5 years of age, cavities first begin as whitish opaque spots or chalky white lines on the necks of teeth near the gumline. These white spots are due to the loss of minerals from the tooth enamel. At this stage, the tooth can be treated (without drilling and filling) using remineralisation pastes or fluoride varnishes. If not treated at this stage, the enamel can break down leading to brownish discoloration and exposure of the underlying layer called dentine. Once the caries reach dentine, the child starts feeling to have sensitivity to hot and cold foods or drinks. At this stage, the tooth can be restored using simple fillings. If still not treated at this stage, it can progress to breakdown of the tooth structure resulting in pain or infection of the tooth. Treatment at this stage involves either root canal treatment and crowns or extraction of the concerned tooth depending on the severity of tooth destruction.
Hence, the longer you wait, the more your child suffers and the more time, money and effort you spend for treatment.
RISK FACTORS FOR TOOTH DECAY
According to the American Academy of Pediatric Dentistry (Caries-risk assessment and management for infants, children, and adolescents), the risk factors for dental caries are:
- Improper cleaning of teeth
- Mother/primary caregiver has active dental caries
- Parent/caregiver has low health literacy
- Child has frequent exposure of (>3 times/day) between-meal sugar-containing snacks or beverages per day
- Child uses bottle or non-spill cup containing natural or added sugar frequently, between meals and/or at bedtime
- Child has special health care needs
PROTECTIVE FACTORS AGAINST TOOTH DECAY
- Child receives optimally-fluoridated drinking water or fluoride supplements
- Child has teeth brushed daily with fluoridated toothpaste
- Child receives topical fluoride from health professional
- Child has dental home/regular dental care