After you've made it through those rough teething days and nights, you finally get to see your little one's sweet smile full of pearly whites. If you want to keep that little smile healthy, it's important to know the signs of baby tooth decay in case you need to take action.
Erin Issac, DMD, tells Romper that the "gradual process" of tooth decay (technically called "caries") will ultimately lead to holes in the teeth known as cavities. This decay is a result of "bacteria in the mouth [attaching] to tooth surfaces... [and releasing] acid which dissolves tooth structure," Kevin Donly, DDS, tells Romper. Dr. Issac says this acid is produced when the mouth's natural bacteria metabolizes "sugary or high carb foods" as a source of fuel. This is why dentists urge parents to limit their child's exposure to things like sugary juices.
In order to understand what tooth decay looks like, it's important to first understand what a healthy baby tooth looks like. Rocky Napier, DDS, tells Romper that "newly erupted teeth are generally relatively white, have smooth surfaces, are shiny in nature, and appear to have a normal shape and consistency." Dr. Issac adds that they might even have a "slightly more translucent or even gray appearance towards the edge of the tooth."
Unfortunately, Dr. Donly says there is no way to tell whether or not your baby will have tooth decay "until the teeth erupt into the oral cavity." So, it's a wait and see situation. Once the teeth have come in, whether it's only a few teeth or a full smile, there are some telltale signs of decay.
1. Yellow, Brown, Or Black Marks
Since healthy baby teeth are so white, decay can be very easy to spot in its early stages. Dr. Issac says decay "will appear typically as a brownish/yellowish spot on the tooth." She also adds that this decay can happen "soon after eruption of baby teeth." So, essentially, as soon as that first tooth comes in, be on the lookout.
2. Irregular White Marks
Even though baby teeth are already white, they can get spots that are even whiter. Dr. Issac explains that "chalky white areas, especially near the gum line" are a common sign of decay. Dr. Napier adds that it may look like "white spots and/or lines" and that they typically "circle the tooth" but start to form along the gum line or "on the tongue side of the upper front teeth." These spots are areas where the tooth's "enamel has subsurface mineral loss," according to Dr. Donly.
3. Rough Texture
Healthy baby teeth are generally smooth in nature, so a rough texture is a sign of trouble. Dr. Napier explains that teeth that have "rough rather than smooth shiny surfaces could be a result of malformation and/or dental decay." He says that this type of decay is often "secondary to home care, feeding habits, and/or the nutritional content of the daily diet."
4. Your Child's Behavior
Older children whose permanent teeth haven't come in are usually able to clearly tell you when a tooth hurts. Since younger children can't communicate as effectively, Dr. Issac advises you to be on the lookout for behavioral changes which may include "complaining of pain, changes in eating and sleeping patterns, and sensitivity to hot and cold foods/drinks." She also adds that "if the cavity progresses to true infection" from not being treated, you may notice "swelling and redness" in your child's mouth.
5. Tooth Strength & Fragility
Have you ever seen a piece of sidewalk chalk that has been left outside, rained on, and then later dried out from the hot sun? As it dries out, the chalk can get little holes in it, causing it to break if you try to color with it, or even crumble in your hand if you put too much pressure on it. Similarly, if a tooth is decaying or if it already has a cavity (which is a hole) it also becomes more fragile. Dr. Issac says you may notice this kind of decay if the tooth is "chipping or breaking for no apparent reason," such as a direct injury.
Thankfully, there are a lot of things parents can do to help prevent tooth decay in their children. First and foremost, Dr. Donly says parents should establish a "dental home no later than the first birthday" and should schedule regular maintenance from then on. Additionally, Dr. Napier recommends parents refrain from letting their child drink anything but water from a sippy cup once they reach their first birthday. He also says that if your child is thirsty outside of mealtime, stick to water and save milk or (limited) juice to breakfast, lunch, or dinner.
Dr. Issac says moms of breastfeeding babies (who are also eating table food) should "wipe [their] baby's teeth with a gauze or washcloth before putting them down so that the sugars from the breast milk don't sit on the teeth all night long." Finally, she also recommends brushing teeth as soon as they start coming in and flossing between any teeth that touch.
All three experts agree that parents should take baby tooth decay seriously. Even though your child will ultimately lose the tooth, dismissing decay can lead to infection in the mouth which, left untreated, can even spread into the body. Regardless of the cause of tooth decay, it should be evaluated by a dentist so that your child's smile, and body, can stay as healthy as possible.
Kevin Donly, DDS, MS, President, American Academy of Pediatric Dentistry
Erin Issac, DMD, Diplomate, American Board of Pediatric Dentistry, Assistant Clinical Professor at the University of Pittsburgh School of Dental Medicine
Rocky Napier, DDS, Spokesperson for the Academy of General Dentistry, a Pediatric Dentist from Aiken, South Carolina