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  4. Tooth Decay 101: What really causes cavities?
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  • Tooth Decay 101: What really causes cavities?

    By Janna Fischer, 3M Storyteller

    Image of a smiling baby eating food

    • Impress your kids’ dentist by coming to your first appointment armed with a solid understanding of tooth decay.

      Did you know that tooth decay is the single most common infectious disease of children in the United States? Caries is the name of the disease process that causes cavities. Yes, it’s a disease. Caries is five times more common than asthma, four times more common than early childhood obesity, and 20 times more common than diabetes, according to the American Academy of Pediatric Dentistry. The good news? A little knowledge and some good oral care habits go a long way: cavities often can be prevented.

      Cavities are caused primarily by bacteria called Mutans Streptococci, or strep mutans. There’s no escaping it – strep mutans are naturally present in human mouths, so it’s likely we all have it. But depending on what we eat and drink and how we take care of our teeth, some of us can have a breakdown of the bacterial balance that is linked to health.

      In order for these microbes to get to work making cavities, they need an acidic environment and a substrate – or food debris and plaque. And, they need sugar, says Dr. Teresa Fong, pediatric dentist and American Academy of Pediatric Dentistry fellow.

      “When the foods we eat break down into sugars, the strep mutans have a feeding frenzy and start to break down the hard surface of the enamel,” explains Dr. Fong. “Under the enamel is dentin, which is much softer. Once it breaks through to the dentin layer, the cavity process can start progressing more rapidly.”

      Early acquisition of strep mutans has been shown in many studies to be a major risk factor for early childhood caries (ECC) and future caries experience. ECC is the presence of one or more decayed, missing or filled tooth surfaces in any primary tooth in a child under the age of six. It can be a particularly aggressive form of cavities, beginning soon after tooth eruption, developing on smooth surfaces, progressing rapidly, and having lasting damaging impact on the teeth. Strep mutans is present in babies’ mouths even before their first teeth erupt.

    • But how do young kids acquire it?

      Here’s the rub: When we parents lovingly smother our babies with sweet kisses, we’re actually transferring our strep mutans to the little cherubs through our saliva. So, if someone in the family has a high cavity rate, the bacteria get passed along. That’s one of the many reasons it’s so important for everyone in the family to have healthy teeth.

      “Expecting mothers and family members should brush and floss daily, have routine professional cleanings, take care of active cavities and maintain a balanced diet,” Dr. Fong says. “And be sure to pass down those healthy habits to your children straight out of the gate.”

      The most effective way to help prevent cavities is by brushing your kids’ teeth twice a day with fluoridated toothpaste for two minutes at a time. The American Academy of Pediatric Dentistry recommends assisting kids with brushing their teeth until they’re eight years old to ensure the teeth are being brushed effectively. Be sure to help with flossing, too.

      For children who are more at risk for caries, the ADA recommends professionally-applied fluoride treatments. Other ways to help prevent caries in children is to avoid high-frequency consumption of liquid and solid foods containing sugar.

      Dr. Fong shares these recommendations for all new parents:

      • Never put your baby to sleep with a bottle filled with milk or liquids containing sugar.
      • Avoid “ad-lib” or “snack” breast-feeding after the first primary tooth begins to erupt and other solid foods are introduced.
      • Get into the habit of cleaning your baby’s gums after every feeding. A wash cloth or a soft, infant toothbrush and a little water is all you need.
      • Bring your baby in for his first checkup by the time his first tooth erupts or at least by his first birthday.
      • Be sure to switch from a bottle to drinking from a cup as she approaches her first birthday.
      • Wean your baby from the bottle by his first birthday.