Good oral health is essential for our general health, well-being, confidence, and quality of life. People of all ages are at risk of tooth decay, though the issue is particularly prevalent in children. It’s important to ensure your children learn good oral hygeine habits with their primary teeth (commonly referred to as‘baby’ teeth) before their permanent teeth come through. So, what are the signs of tooth decay in children, and what can you do about it? In this guide, we explain what causes children’s teeth to become rotten and how you can prevent the decay from progressing further.

What is Tooth Decay?

All children and adults have bacteria in the mouth. This bacteria forms a film over the teeth, which is called dental plaque. The bacteria in our mouths feed on the sugars from the food we eat and the drinks we consume. This causes more plaque to build up.

When the bacteria gathers energy from these sugars, it produces an acidic substance. The acid chips away at the enamel, which is the outer surface of the teeth. Our saliva actually helps to repair this damage, but the enamel tends to wear down faster than the saliva can do its reparation work. As the enamel wears down, a cavity begins to form.

Cavities are holes in the teeth. They start as small as a pin-prick, but open up into larger holes deeper into the tooth. This exposes the dentin, the bone-like matter below the tooth enamel, to the bacteria in the mouth. Once bacteria reaches the dentin, this accelerates the tooth decay.

If left to progress, the bacteria can enter the pulp of the tooth, which is where the blood and nerve endings sit. When the bacteria reaches this centre-point of the tooth, the decay is considered advanced and is often accompanied by pain and sensitivity.

How Common is Tooth Decay in Children?

Unfortunately, tooth decay is prevalent in Australian children.

At age 12, the majority of children have lost all of their primary teeth and have developed their permanent teeth. Therefore, data for children below age 10 refers to primary teeth, while data for children over age 10 relates to permanent teeth.

The National Child Oral Health Survey in 2012-14 found that approximately 42% of children aged 5 to 10 experienced decay in their primary teeth.

Tooth decay disproportionately affected Indigenous children. 6 in 10 Indigenous children and 4 in 10 non-indigenous children experienced rotting in their primary teeth.

Instances of tooth decay increased with age. 38% of older children aged 12 to 14 and 23% of children aged 9 to 11 experienced tooth decay.

What Causes Tooth Decay in Children?

There are a few different factors that contribute to tooth rotting in children, including:

  • High levels of bacteria in the mouth
  • A diet high in sugars and carbohydrates
  • Consumption of water containing little or no fluoride
  • Poor oral hygeine
  • Unusually low levels of saliva in the mouth

The Stages of Rotten Teeth in Children

Tooth decay progresses in stages. It’s important to be aware of the early warning signs and to have dental rotting treated early to prevent the decay from worsening.

Advanced tooth decay is very dangerous for a child’s overall health. When a tooth is severely decayed, the bacteria overgrowth can cause infections to form in the pulp of the tooth, which may spread to the bone and through the body via the bloodstream.

Rotten Teeth in Kids: The Early Stages

In its early stages, tooth decay often appears as white, chalky areas developing on the surface of the primary teeth. The upper four front teeth are most commonly affected.

You may also notice a dull white band on the tooth surface, close to the gumline. These are the first signs of decay, and they can be difficult to notice.

From here, cavities begin to form in the teeth. They look like light brown spots on the tooth, and they can cause discomfort. Your child may complain of pain or tooth sensitivity when consuming sweet, cold, or hot food and drink.

Black Teeth in Kids: Advanced Decay

If decay is not addressed in the early stages, it will continue to progress. The first sign of advanced decay is a yellow, brown, or black band around the tooth surface closer to the gumline.

At this stage, cavities tend to become deeper, so the brown or black spot will become more prominant on the tooth.

When left untreated, advanced decay can quickly worsen, and the teeth may turn into brown or black stumps.

When rotting reaches this stage, it is usually untreatable and the tooth will need to be removed.

What to do About Children’s Rotten Teeth

If you’ve noticed tooth rotting in your child — regardless of the stage of decay — it’s important to have it seen to by a dentist as soon as possible.

Your dentist will be able to recommend treatment to prevent further health issues from developing as a result of the decay.

Treatment for Tooth Decay in Children

Treatment options will vary depending on the child’s age, overall health, the severity of the decay, and whether the decay is affecting primary or permanent teeth.

Treatment for Minor Decay

Tooth decay is most easily treated when caught in the early stages.

If your child is showing early signs of discolouration and minor wear-down of the enamel, your dentist will give the teeth a good clean and remove any signs of decay.

They may also apply a fluoride varnish to the teeth to strengthen the enamel and ward away plaque.

Your dentist will likely recommend dietary changes to prevent decay from worsening.

Treatment for Moderate Decay

For children who have cavities, fillings will be required. There are two types of fillings, also known as restorations.

Direct restorations are used to treat minimal decay, and can be completed in a single appointment. Your dentist will apply a local anaesthetic to numb the area, then remove the decayed part of the tooth and directly fill the cavity with a filling. The filling will likely be made out of amalgam, resin, silver, or acrylic.

For more prominent cavities, an indirect restoration may be required. These include inlays, onlays, veneers, bridges, and crowns made from ceramic or composite resin. The crown procedure often requires two dental visits. Your dentist will numb the area and remove a layer from the tooth’s outer surface. They will then create a mould of the tooth to match the colour of the teeth. The crown will be fixed into the tooth using dental cement.

Treatment for Advanced Decay

In instances where decay has progressed, your dentist may determine that the tooth cannot be restored. In this case, the tooth will need to be removed.

If the affected tooth is a primary tooth, your dentist may remove the tooth and clear up any signs of infection. They may order X-rays to assess the state of the permanent tooth below the gumline.

For children whose permanent teeth are significantly decayed, tooth extraction and a dental implant may be necessary. Your dentist will first remove the affected tooth, then fit a replacement implant.

Unlike dentures, dental implants cannot be removed. Traditional dental implants are used to replace single or multiple missing teeth. All On 4 dental implants are designed to replace an entire set of missing teeth. All On 4 implants may be the best option if your child has multiple severely decayed teeth. The implants are made from porcelain or composite resin.

Visit this dedicated blog for a closer look at what the dental implant procedure entails.

How to Prevent Tooth Decay in Children

The best thing you can do for the health of your child is prevent tooth decay from developing in the first place.

To keep your child’s teeth clean and healthy:

  • Brush your child’s teeth as soon as their first primary tooth arrives.
  • Take care to brush your child’s teeth, tongue, and gums twice a day.
  • For children under the age of 3, use a very small amount of toothpaste (about the size of a grain of rice).
  • For children over the age of 3, you can use a pea sized amount of toothpaste.
  • When your child turns 2, begin flossing their teeth once a day.
  • Teach your child how to brush their teeth properly, ensuring they do so for 2 minutes twice a day.
  • Ensure your child consumes a well-balanced diet. Limit food and drinks that are overly sticky or high in sugar.
  • If your child requires a bottle at bedtime, do not fill it with juice or formula, as these products contain sugar. Fill it with water instead.
  • Avoid sharing utensils with your child or cleaning your child’s dummy with your saliva. This transfers bacteria from your mouth to theirs.
  • Book your child in for a dental check every 6 months

Key Takeaways

  • Children are at risk of developing tooth decay in their primary and permanent teeth.
  • The bacteria in our mouths feed on sugary foods and drinks, and produce an acid that wears down tooth enamel. This causes cavities to form.
  • If left untreated, bacteria enters the cavities and reaches the pulp of the tooth, which can cause pain, sensitivity, and infection.
  • In its early stages, childhood tooth decay appears as white chalky areas and dull white bands on the tooth surface.
  • Advanced tooth decay presents as yellow, brown or black bands around the teeth. Eventually, the teeth will resemble black stumps.
  • Depending on the severity of the decay, treatments include fluoride gel, fillings, crowns, tooth removal, and implants.
  • Practise good oral hygeine with your child by brushing their teeth for two minutes twice a day, flossing their teeth regularly, limiting sugary food and drinks, and keeping up with biannual dental check-ups.

At Kew Dentistry, we offer a family dentistry service dedicated to treating tooth decay, tooth sensitivity, and gum disease in children.

If your child is feeling a little anxious about visiting the dentist, we can work with them to alleviate those fears and answer any questions they may have.

You can request an appointment with us via our website.

Kew Dentistry