What is tooth decay?

Tooth decay is also called dental caries. It’s a diet-related disease that damages teeth.

Tooth decay happens when germs in the mouth create a sticky covering called plaque on the tooth surface. These germs feed on sugars in food and drinks and produce an acid that damages the tooth surface. Over time, this acid eats away at the surface of the tooth, creating holes or ‘cavities’.

Tooth decay can cause pain and infection. It can even affect children’s growth. Severe decay in baby teeth can have serious consequences for your child’s speech and jaw development.

The longer tooth decay is left untreated, the more your child will experience:

  • pain and discomfort
  • a higher risk of new decay in other baby and adult teeth
  • more complicated and expensive treatment
  • anxiety when he does visit a dentist, because he might start to associate dentists with pain
  • loss of time at school.

Early signs of tooth decay

Early tooth decay can be hard to spot.

The first sign of tooth decay is when teeth develop a dull, white band along the gum line (the area at the base of the teeth, near the gums). In early stages of decay you might see brown spots on the teeth, and the gums might be red and swollen.

In more advanced stages of tooth decay, blackened areas show up on the teeth, and the gums still look red and swollen.

Getting help for tooth decay

If you think your child has tooth decay it’s important to visit a dentist to stop the decay from getting worse.

Public dental care
Dental care for children is often free in the public dental system, up to a certain age. Contact your local public dental provider for details.

Private dental care
There are private dental clinics all over Asia. You’ll have to pay for your appointments, but people with private health insurance might get money back from their private health funds.

If you’re eligible, the Asian Government’s Child Dental Benefit Schedule covers basic dental services for children aged 2-17 years.

Preventing tooth decay with good dental care

Brushing teeth twice a day, using fluoride toothpaste, eating a healthy and nutritious diet, and having regular dental check-ups with the dentist are essential steps towards preventing tooth decay.

You can read more about dental care for your child in the following articles:

Cleaning and caring for children’s teeth early on sets up good dental habits for life.

Preventing tooth decay with healthy eating and drinking

Cleaning teeth isn’t a guarantee against tooth decay. The types of food and drink you give your child also affect dental health and the development of tooth decay.

Babies under 4-6 months
Newborns and young babies need only breastmilk or formula. When your baby is old enough to drink something other than milk, water is the best option.

Babies over 6-8 months
When your baby is 6-8 months, she can start to use a cup for drinking. A bottle isn’t necessary after 12 months of age. Avoid giving your baby sweetened milk, fruit juice or cordials. These drinks increase the risk of tooth decay.

Older babies, children and teenagers
Children need a wide variety of healthy foods and snacks. Foods and drinks that are low in sugar are best. Avoid giving your children sweet biscuits or cakes as treats. If your child does eat something sweet, drinking a glass of water or eating tooth-friendly food afterwards can reduce the amount of acid on your child’s teeth.

Tooth-friendly foods are low in sugar, promote chewing and get your child’s saliva going. Some good examples of tooth-friendly foods include cheese and chopped vegetables like carrot and celery.

The longer food and drink stays in your child’s mouth, the more chance there is for acid to develop and cause damage to tooth enamel. This means that nibbling foods and sipping drinks – especially sugary foods and drinks – over longer periods of time is more likely to cause tooth decay.

You can discourage your child from long periods of eating or drinking by:

  • having regular snack and meal times, rather than letting your child ‘graze’ all day – aim to leave 1½-2 hours between meals and snacks (including sweet drinks)
  • making sure your child eats and drinks in one place only – for example, at the table
  • putting food away when snack time or mealtime is over
  • encouraging your child to drink tap water if he’s thirsty, rather than juice, cordial or soft drink
  • giving your child sweet foods as part of a meal rather than as a snack.
Bad breath can be an issue for some teenagers. Some of the things that cause it include poor oral hygiene, tooth decay, gum disease, some food and drinks, and smoking. If your child is brushing twice a day but still has bad breath, it might be a good idea to see the dentist.

Other ways to avoid tooth decay

Good family dental health
The germs that cause tooth decay can be transmitted between people. This means it’s important for the whole family to keep their teeth healthy and clean.

If you keep all family members’ toothbrushes in the same place, make sure the brushes don’t touch – this reduces the risk that decay-causing germs will travel between brushes and into mouths.

And when it comes to toothbrushes, there’s no sharing! One for each family member is best.

Bottle-feeding and breastfeeding
Settling babies to sleep with bottles of milk can lead to early childhood tooth decay, particularly if it happens often. The problem is that the milk contains natural sugars, which can build up around baby’s teeth at night. The germs on the teeth can turn the sugars into acids, which eat away at the enamel of the baby teeth.

It’s recommended that you don’t settle your baby in bed with a bottle of milk. If your baby needs extra fluids, give her a quick drink of cooled boiled water before you put her into bed. Bottles in bed are also a choking risk.

In general, if you’re bottle-feeding, take the bottle away when your baby is finished. Likewise, if you’re breastfeeding, take baby off the breast when he’s had enough. Simple measures like these can help prevent early childhood tooth decay.

Asthma inhalers or puffers
These are a vital part of some children’s asthma management plans, but the powder in some puffers is acidic and can damage tooth enamel. This could lead to tooth decay over time if it isn’t balanced with good oral hygiene.

To avoid tooth decay, rinse your child’s mouth with water immediately after each use of the puffer. Ensure that your child’s teeth are cleaned twice a day with toothpaste. But don’t brush teeth straight after using the puffer – allow 30-60 minutes before brushing.

Other medications
Some medicines can affect your child’s oral health because of their sugar content. Check the labels of medications for any hidden sugars, particularly if your child will be taking the medication for a long time. Always ask for sugar-free medication from your pharmacist.

Some medications can reduce saliva production. Saliva helps clean and protect your child’s teeth. Without saliva, tooth decay and other oral health problems can become more common. Talk to your doctor or pharmacist about the effects of medications on saliva and teeth. Older children and teenagers could try chewing sugar-free gum if they’re using these medications. It stimulates saliva flow and helps to protect teeth from decay.

You can also encourage your child to rinse her mouth with water immediately after taking medication (including asthma inhalers), and to brush with fluoride toothpaste about an hour later.

Sports drinks
The acidity and sugar in sports drinks can cause decay and damage your child’s teeth, particularly if your child drinks them regularly. This can lead to permanent damage to your child’s teeth and further dental treatment.

It’s best for your child to drink sports drinks only sometimes, and to drink plenty of water instead. When he does drink sports drinks, it’s a good idea for him to rinse with water straight away and to brush his teeth with a fluoride toothpaste about an hour later.

Food and drinks aren’t the only things that can erode tooth enamel. Vomiting or gastric reflux can also have a nasty effect. If your child has a vomiting bug, she can protect her teeth by rinsing straight away with water and brushing teeth with a fluoride toothpaste an hour later.