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Baby Teeth are Different:

I often inform parents that their child's teeth are different than ours!  Teeth are not just teeth.  Baby teeth have very thin enamel, the hard protective outer layer, whereas permanent teeth have much thicker enamel.  As a result of thinner enamel, it does not take much for a small cavity that may go untreated to turn into a large cavity that may need a pulp or nerve treatment along with a crown.  And yes, baby teeth need crowns too.  It basically boils down to how large the cavity is.  That is one reason to respect those little teeth, they can get out of hand quickly, just like the behavior of our little guys!

Many times when children complain of intense tooth related pain, it may be too late to save the tooth.  This means that the bacterial infection has reached the nerve of the tooth.  In this area there is no density, consisting of blood vessels and nerves.  If the infection goes through the root of the tooth, then this process is manifested by an abcess, a swelling (liquid infection) in the gum tissue near the tooth.  In these situations, the tooth must be "helped out for the tooth fairy!"  Because the teeth behind that tooth want to move forward and would block the eruption of the permanent tooth, then we must place a space maintainer.

Just as if you are sick and don't feel well, your immune system must work harder.  Just as with our bodies, in our mouth it is no different.  If there is active/untreated decay present, it is more difficult for the other teeth to ward off those evil cavities (and especially of concern as we get those permanent teeth).

Parents often may say, "But she is the one that brushes 3 times a day, hardly ever eats sweets, and loves water!  My son was the one I was worried about, he eats what he wants and brushes only once a day, on a good day!  How did she get the cavities?"

This happens, and it doesn't mean that you either get cavities or you don't.  Just as some kids seem to be sick more often with ear infections or colds and others seem to never be sick, so is true with teeth.  It is all a result of a bacterial infection, just different locations.


We as parents or other family members/ caregivers first pass our bacteria to our children.  As babies, this can be through kissing, fingers in the mouth, sharing utensils, etc.  If we have had a past history of cavities or we have been slacking in our own dental care, then this is passed over to our kids.  Then that bacteria is dependent on certain factors: 

1) diet- fermentable carbohydrates, sugars, beverages   

2)  amount of plaque and oral hygiene care(brushing and flossing) 

3)  the pH and flow of the saliva (different per individual, affected by medications) 

4)  strength and development of the enamel

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Brad Singleton, DDS Board Certified, Diplomate American Board Groovy Molar