Care: Cavities in Baby Teeth

When we refer to cavities, the image that comes to mind is that of a grown child or an adult, who due to poor hygiene suffers from pain and must go to a dentist for a repair on permanent teeth. However, since high sugar consumption and poor hygiene are the main causes of cavities, they can also occur in baby teeth.

Caries is a bacterial infection that causes the demineralization of the hard tissues of the tooth, which are, referred to as the outermost layer, enamel and dentin in the crown and cementum in the root.

"When food remains are not removed properly, they break down, forming acids that cause demineralization. This demineralization can begin as a white spot (known as white cavities) and later become a cavity, if a cavity does not occur. remineralization process," explains the pediatric dentist Brenda Achon.

He points out that when cavities reach the dentin, which is the second layer of the tooth, discomfort is generally experienced when sweet and cold foods are consumed. And if it continues to progress, the deterioration will reach the pulp or nerve of the tooth, which will cause pain when eating food, spontaneous pain or/and night pain.

Tooth remineralization is achieved through changes in diet, which includes eating fewer carbohydrates and sugars, and in hygiene habits, which would include the use of fluoride pastes and fluoride rinses.

"In the case of babies, it is not recommended that the mother blow or taste the child's food, since she can transmit the bacteria from her mouth to the child and thus increase the risk of infection," says the pediatric dentist.

Cavities in baby teeth
According to Achon, cavities in baby teeth are mainly due to the use of the bottle during the night, either at bedtime or when the child wakes up several times during the night to eat, which prevents cleaning of the teeth. teeth after eating.

The above, combined with inadequate hygiene habits, can lead to the syndrome known as Baby Bottle Caries, in which most of the child's teeth have carious lesions.

"Baby Bottle Caries syndrome mainly affects children who fall asleep with a bottle of milk or sugary liquids such as juice or water with honey. It will affect the teeth that have the most contact with liquids, which are generally the upper incisors and molars. lower teeth, although there are times when all the teeth are affected. We have seen patients with 20 baby teeth and 20 cavities," he points out.

Breast milk can also cause cavities if hygiene habits are not adequate.

"Baby bottle cavities occur because milk or sugary juices remain 'stuck' for a long time between the cheeks and tongue; then they decompose forming acids that begin to demineralize the enamel and cavities form. When these acids do not are removed properly and the teeth do not achieve remineralization or hardening, this will result in carious lesions," says the dentist.

Diagnosis and treatment
According to Achon, not all white or dark spots seen on teeth are cavities. To confirm that these are carious lesions, the dentist uses a tool called an explorer, with which he inspects all the grooves and fissures of the teeth to rule out the presence of cavities. Obviously if the cavity is very large, it will be visible to the naked eye.

Preventing the development of cavities is the best treatment; However, once it occurs, the earlier it is identified, the less aggressive its management or treatment is.

"When the cavity is visible to the naked eye, it does not mean that it cannot be corrected. Even if the cavity is very advanced, there are several treatments that can be performed before thinking about a tooth extraction," he indicates.

The pediatric dentist comments that the simplest solution is to remove the decayed material and place a restoration or wedge. In the case of children, she points out that if the injury reaches the nerve, a pulpotomy may be necessary, which consists of removing the coronal portion of the nerve, or a pulpectomy, which refers to removing the entire nerve from the piece.

As preventive measures for cavities in baby teeth, Achon highlights the importance of brushing children's teeth from the moment the first tooth appears in the mouth. "If the baby falls asleep while breastfeeding or after feeding, it is advisable to give him a bottle of water to rinse a little of the milk left in his mouth. If he is more awake, you could also clean the tip of the baby with gauze. of the diaper or a towel the bottom of the cheeks and the teeth, and as soon as he wakes up completely, proceed with better hygiene.

If it is an older child, the pediatric dentist emphasizes that the best hygiene is carried out by brushing the teeth with fluoride toothpaste (as long as they know how to spit) and flossing before going to sleep.

It also emphasizes the importance of visiting the dentist every 6 months, once the first tooth appears, an action that will help in the early detection of cavities and dental problems in general. During these visits, the dentist may also place pit and fissure sealants on the posterior teeth to protect against occlusal decay.

"Baby teeth are equally susceptible to cavities as permanent ones. At approximately 6 years of age, the permanent I molars erupt. When there is baby bottle tooth decay, poor hygiene habits and lack of dental care, it is very common for these permanent teeth to present cavities, since they erupt in a dirty and acidic environment," he points out.