Children's dentistry

Tooth decay in children

Tooth decay is a bacterial disease of the teeth and can occur as long as there are teeth present in the mouth, regardless of age.

Early childhood caries (ECC) is a common term used by dentists to describe tooth decay in children under the age of 6 years old. A child is considered to have a severe form of ECC if he or she is less than 3 years of age and has any sign of decay.

Early childhood caries is a chronic disease that usually takes months to develop; a common early sign of the disease is the appearance of a white opaque, chalky line on the tooth at the junction when the tooth meets the gums. If this is not addressed, this white line will eventually progress, break down and form a hole in the affected tooth.

What causes tooth decay in children?

Tooth decay is primarily a bacterial disease but is also affected by other factors such as poor oral hygiene and poor dietary habits. Some of these factors include lack of or ineffective tooth brushing, feeding milk/juice/any sweet substance multiple times throughout the night and letting the child fall asleep with a bottle filled with milk/juice/any sweet substance.

Why do we have to treat tooth decay in children?

Primary teeth or “baby” teeth are important for eating, speech development and appearance. They also help to maintain the space for the permanent teeth to erupt into the mouth. Children only begin to lose their front baby teeth at the age of 6 years old and their back baby teeth when they are about 9 to10 years of age. Therefore, if tooth decay is not treated, the cavities will progressively get bigger and may cause pain before the baby teeth are due to fall out. Though rare, some children may develop a facial swelling from the infected tooth which will require immediate medical/ dental attention (e.g., hospitalisation requiring administration of antibiotics through the veins and dental surgery to remove the bad tooth and pus).

How do we prevent tooth decay in children?

Tooth decay in children can be avoided. It is prevented by maintaining good oral health care habits. These include good dietary habits (e.g. avoiding high sugar drinks and frequent snacking), effective tooth brushing and having your child see a dentist early. The Society for Paediatric Dentistry, Singapore recommends that all children should see the dentist no later than 12 months of age. At this visit, the dentist will assess your child and often will formulate a customised oral health home care programme based on his or her risk of developing tooth decay.

Article contributed by the Society for Paediatric Dentistry, Singapore.