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Kids and Cavities

Two young girls sitting in the grass sharing lollipops The triggers and mechanisms of tooth decay have been well-understood for more than half a century, and yet childhood tooth decay remains a significant problem in most of the developed countries around the world. Access to fluoride in toothpaste or water can be helpful, but the truth is that tooth decay develops because of what we eat and how we clean our teeth, not because of a lack of fluoride.

A proper diet combined with brushing and flossing correctly twice each day is enough for most people to avoid developing tooth decay for an entire lifetime. So why are people – and especially children – still getting cavities? Let’s take a look at some of the ways even the most well-intentioned parents can be fooled by food labels, product marketing, and health trends.

Hidden Sugar

We all know that sugar promotes cavities, and it’s easy to identify the obvious dietary sources of sugar like soda, candy, cookies, and other dessert-type treats. You don’t have to read a label to know that allowing your child to eat these things regularly and excessively will contribute to the development of cavities. But many other processed or prepackaged meals and condiments can contain excessive amounts of sugar in multiple forms in order to enhance flavor. Ketchup, barbecue sauce, frozen pizza, many ‘healthy’ cereals, and even canned soups and vegetables can all contain added sugar. The problem is that many of these products don’t actually list the word ‘sugar’ as a primary ingredient.

When considering a canned or processed food product, always read the label and look for the following ingredients:
•  Glucose
•  Sucrose
•  Fructose
•  Maltose
•  Dextrose
•  Lactose
•  Maltodextrin
•  Concentrated juices or juice extracts
•  Evaporated cane juice
•  Any kind of syrup or nectar (especially high fructose corn syrup)

These are all different forms of sugar that can be just as harmful to your child’s teeth as plain old white sugar. Limit or eliminate them from your family’s diet as much as possible.

Natural and Organic Food Labeling

There’s a general misconception that as long as food is labeled natural or organic, then it must be better for you. Certainly choosing a soda that has no chemical additives and is sweetened with real sugar instead of high-fructose corn syrup is less offensive to your body than a chemically-enhanced soda. However, it’s still a soda that is high both in acid and in sugar. It doesn’t matter how natural it is—it will still promote tooth decay and contribute to other blood sugar disorders when consumed regularly and excessively.

When making choices for yourself or your children, don’t be fooled into thinking that the following ‘healthy’ labels on prepackaged and processed foods automatically make those foods good for you:
•  Healthy
•  Organic
•  Whole-Grain
•  Probiotic
•  All Natural
•  Non GMO
•  RBST Free
•  Hormone Free
•  Antibiotic Free
•  Fat Free
•  Preservative Free

Certainly some of these labels are worth searching for as long as the foods you are considering are not overloaded with sugar, acid, or highly refined flours. Always read the labels, and remember that cookies, candy, soda, cake, ice cream and other sweet treats will all promote cavities even when they are natural, organic, or even homemade.

Grain-Based Carbohydrates

One of the biggest hidden dietary contributors to tooth decay is refined white flour. Pasta, bread, cereal, tortillas, and other grain-based staples made with white flour can be just as damaging to the teeth over time as sugary treats. Products that use whole-grain flour are a better choice, but be careful when choosing cereal, bread and pasta for your children. Many products advertise that they contain whole-grain or whole-wheat flour, but when you read the ingredients, you may find that white flour is actually listed first as a primary ingredient. Look for products that list whole-grain flours first and have little or no added sugar.

Fruit Juices, Fruit Leather, and Dried Fruit

Close up of a child's cavity Fruit juice has long been considered a healthy alternative to soda, but unfortunately that simply isn’t true. Fruit juice contains all the simple sugar from the original fruit itself, without the balancing fiber and other important nutritional components contained within the pulp and skin. Eating a whole fruit is always a better choice for your child than drinking juice, no matter how old or young they may be. Children under the age of two should not drink fruit juice or soda at all, and bottles should never contain any beverage other than water, breast milk, or formula.

Fruit leather and dried fruit may retain much of the fiber and some of the nutritional components within the fruit’s skin, but the process of dehydration concentrates the sugar and delivers it in a very sticky form. Frankly, dried fruit may actually be worse for your child’s teeth than a small piece of chocolate precisely because of its sticky quality. The longer the dried fruit stays lodged against a tooth, the more oral bacteria can feed on its simple sugars. Bacterial feeding and reproduction is the primary cause of tooth decay.

Cleaning your child’s teeth after he or she eats dried fruit or fruit leather as soon as possible is important in limiting the damage that bacteria can do if they continue to feed on the sticky remnants left on the teeth. More importantly, however, the damage can be reduced significantly (or even eliminated) if your child’s teeth are also clean before he or she eats the dried fruit (or any other sugar, for that matter).

Bacteria in the mouth will break down sugar and starches almost instantaneously. It is impossible to remove all of this bacteria, but the less bacteria that are present when any kind of sugar or starch is introduced into the mouth, the less likely decay is likely to occur. Brushing alone is not enough to reduce the numbers of these bacteria on and in-between the teeth. Flossing regularly and correctly to remove the bacteria that live in the crevices between the teeth is a crucial step in fighting tooth decay at any age.

Rinses, Flossers, and Fancy Toothbrushes

Teaching your child to clean their teeth properly is a long-term endeavor and it is not easy. Many oral care companies may try to convince you that a particular rinse or a mechanical toothbrush will make the job easier for you, but the truth is that there simply is no substitute for regular old brushing and flossing twice a day. The key for children is not in the blinking toothbrush or the bubblegum-flavored mouth rinse—it’s in the day-in, day-out routine of parental supervision to make sure that they are using these tools correctly.

Children require help and supervision sometimes even up to the age of 10 or 11 in order to develop the necessary skill and finger dexterity to clean their teeth properly. Get in the habit of brushing and flossing together with your child everyday so that you can make sure he or she is doing it correctly. For more in-depth tips on teaching your child good brushing and flossing habits at home, please read A Parent’s Guide to Oral Health for Kids and Teens.

Why Cavity Prevention Matters

Toddler eating a lollipop Tooth decay can become a serious and chronic disease for children and adults. Not only can teeth be permanently damaged or lost, but left untreated, tooth decay can turn into a systemic infection that spreads beyond the mouth and into the body. It is extremely rare, but in the most severe and unfortunate cases, a systemic infection caused by tooth decay can actually be fatal.

Thankfully, most children who develop cavities do not ever get that sick. Dentists can remove the decayed tooth structure and a filling can be placed. If the original cause of the cavity is addressed through changes in diet or home care, it is likely that the child may never need to experience a cavity or filling again.

However, any time a tooth is drilled and filled, the overall tooth structure is weakened. As your child grows into an adult, the likelihood that the filled tooth may crack or break increases. The filling itself is also likely to break down within 10 to 20 years of being placed. In other words, every permanent tooth that is filled during childhood will likely need to be retreated 2 to 3 times during an average lifespan. The more you can help your child limit the incidence of decay, the better their oral health will be for a lifetime.

Related Articles:
A Parent’s Guide to Oral Health for Kids and Teens.
How to Brush and Floss Your Teeth
A Guide to Added Sweeteners
Drinks That Eat Teeth
The Acid Test

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Dr. Martha Rich, DMD, 833 SW 11th Ave, Suite 405 Portland, OR 97205, (503) 228-6870,, 5/15/2024, Related Phrases: dentist Portland OR,