September 19, 2020
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Preventing tooth decay in children

By: George Malkemus
May 3, 2019

Having the smile of a lifetime starts at an early age. A baby’s toothless grin warms the cockles of our hearts. By the time that baby enters kindergarten, that grin could still be toothless due to decay - not a pretty sight!

For children, a decay-free mouth is critical to a long healthy life.  Establishing good eating habits and good dental hygiene habits at an early age is the key to preventing decay throughout one’s life. 

Having a good experience at the dental office at a young age is critical for establishing lifelong health as well.  Adult dental fears usually originate from a remembered terrifying childhood experience.   These patients often need conscious sedation in my practice.    

Tooth decay is the number one chronic childhood disease. In fact, more than half of children as old as nine have at least one cavity or filling.

According to the Surgeon General, over 51 million school hours are lost every year because of dental-related illness.  Decay can cause a child to have chronic pain that prevents him/her from concentrating in school.  That child can end up suffering a lifetime of dental issues. 

Importance of mom’s dental health

Childhood decay is preventable, and prevention begins with mom. An individual’s bacterial flora, both in the mouth and gut, originates from their mother.  So bacteria that cause gum disease and decay can be transmitted from mother to child. Mothers share a lot with their children: hugs, kisses and cookies, but one thing a mother should not share is tooth decay.

Bacteria are transmitted through saliva.  When a mother kisses her baby, or a baby’s hands are put in a mother’s mouth and then his/her own, or they taste/share food or touch a pacifier together, then bacteria are transferred. The bacteria wait patiently for the baby’s teeth to erupt and then begin destroying the baby’s teeth, a process called decay. 

So mothers need to be vigilant with their own dental care, with good oral hygiene, regular cleanings and dental check-ups to prevent gum disease and decay. That is the first line of defense for your child, starting during or before pregnancy. 

Maintaining a baby’s smile

 A baby’s mouth and gums should be cleaned after every feeding. Use a soft, clean, wet washcloth or gauze to gently wipe the gums. This helps to remove decay-causing bacteria. A wet washcloth gently rubbed on the gums when baby is teething will also feel good.

Begin baby’s brushing routine as early as six months of age, just before the teeth appear. Use a soft-bristle brush to gently massage (brush along) baby’s gums during teething. Not only will this help to soothe the baby from teething pain, but will allow the baby to become accustomed to the toothbrush, a positive reinforcement for using the brush when older.

Once teeth erupt, babies should not be put to bed with a bottle containing a sugary liquid or a liquid with a high concentration of carbohydrates, which includes breast milk and formula. These liquids continually bathe the mouth and teeth with sugar that oral bacteria feed on and ultimately cause tooth decay. Exposure to sugary liquids can result in a condition called “baby bottle syndrome.” The acids produced by the bacteria feeding on the sugary liquids attack a baby’s first teeth, and the teeth literally rot away.  One trick to wean a baby off the bottle is to slowly dilute the juice in the bottle while providing a more concentrated juice in a cup.

People often do not associate a crying, fussy baby with tooth decay.  Pain related to tooth decay could be missed by the parent for way too long. There is nothing more heartbreaking than finding out a child has extensive decay causing their discomfort.

The importance of maintaining healthy baby teeth  

I often hear “they are just baby teeth; let’s pull them.”  However, the permanent teeth need to follow the baby teeth into normal position.  If the baby teeth are taken out too soon then the adult teeth will become crooked, making them more difficult to clean and increasing the possibility of decay and gum disease. Orthodontic braces become necessary to correct the misalignment of the teeth.  

 Baby teeth have thinner enamel than permanent teeth, so they are more vulnerable to decay. So early detection from frequent dental examinations and treatment with fillings as needed is necessary. 

If a child takes medications for special needs or has a systemic condition such as diabetes, there is an even greater chance of having dental issues because of a reduced immune response and/or many medications taken can decrease saliva production. Saliva helps to protect one’s teeth by washing destructive bacterial plaque off the teeth.

 Important advice to help your child stay healthy:

 * Take your child to the dentist twice a year.

* Choose healthy foods for the entire family.  Fresh foods are usually the healthiest foods.

 * Brush teeth at least twice a day with toothpaste that contains fluoride. [Careful to use a small amount of toothpaste and then swish, spit and rinse with water after brushing.]

* Limit sodas and candy.

Soda and candy contain a lot of sugar, which causes cavities, and replaces important nutrients in your child’s diet.  Soda and candy also contribute to weight problems, which may lead to other diseases, such as diabetes.  The less your child eats candy and drinks soda, the better!

Remember, your child is not healthy and ready for school if he or she has poor dental health! Brushing, flossing, fluoride, sealants and regular dental check-ups all help to promote healthy teeth.  A healthy smile can put a child on the right track toward a bright future.


George Malkemus has a Family and Cosmetic Dental Practice in Rohnert Park at 2 Padre Parkway, Suite 200. Call 585-8595, or email info@  Visit Dr. Malkemus’ Web site at