Having knowledge of the cause of the disease will undoubtedly help us in prevention of this disease. As we continue on the path of Oral Health for our child, the forthcoming script will deal with the basic components that lead to decay of teeth or dental caries.

However, beyond mere awareness, implementing practical steps is crucial. Parents can take an active role in their child’s oral hygiene regimen by teaching them how to avoid tooth pain through consistent brushing, flossing, and limiting sugary snacks and beverages. Moreover, regular dental check-ups play a pivotal role in early detection and intervention. By scheduling routine visits to the dentist, parents can ensure that any potential issues are addressed promptly, mitigating the risk of more significant problems down the line. Emphasizing preventive measures not only promotes dental wellness but also instills lifelong habits that contribute to overall well-being.

What causes dental caries and in such a young age, in milk teeth as well as permanent teeth?

Like any other disease, the cause is multifactorial. There are basically four components, the interactions between which will lead to dental caries. Namely, the Susceptible tooth, the Bacteria or Germs, the Substrate or sugary and starchy food and lastly is Time, i.e. repeated interactions between the aforementioned factors.

Tooth – A susceptible tooth is one which is not well protected by saliva and neglected in terms of oral hygiene by us. Sometimes, teeth can have defects in enamel, its outer cover, which can become decayed easily. These are called hypoplastic teeth, which are caused by defective development of the teeth due to various causes like fevers during pregnancy, vitamin deficiencies, premature birth, etc. The affected areas can be deformed, weakened or even missing.  The teeth that have not been exposed to proper amounts of Fluoride before and after eruption have weaker enamel leading to easier dissolution by the acids. Also, fluoride in the saliva helps in repair of damaged enamel. So, adequate amount of fluoride through various medium is a must to have good teeth.

Bacteria – There are various types of bacteria (Streptococcus mutans, Lactobacillus sp., etc.) which can lead to dental caries. They are acidogenic as they can form acid after using fermentable carbohydrates which in turn leads to attacks on the teeth and thus demineralization.

So, how does the infant or the child get these in their mouth?

These bacteria (S. mutans) are transmitted to the oral cavity of the child from the mother or the closest caregivers. This infection can occur by the sharing of food stuff, blowing over food, prechewing, kissing, using same utensils and toothbrushes, especially with the contact with saliva.

Studies have shown that the child whose mothers have poor oral health and high levels of oral bacteria are at greater risk of having oral infections at a younger age and thus developing dental caries early in life.

Food or Substrate – Foods high in added sugar and starches can cause decay, as can sugar-containing beverages like milk or even fruit juice. Bacteria can use both added sugar and natural sugar to cause decay. Use of pacifiers dipped in sugary substances like honey, syrup, etc. will promote tooth decay. Many medications for children contain sugar and some, a lot of it, which can lead to decay if given for a long duration of time. So, clean your child’s teeth after giving a sugar-containing medicine.

Time – As mentioned before, the carbohydrates in food are turned into acid by the bacteria which in turn attack the tooth and cause demineralization which, on repeated exposure for a longer duration of time leads to CAVITIES or CARIES.

Acids attack the teeth after some time of taking a meal.  Each exposure can damage the teeth. Therefore, the more often we eat food, the more attacks our teeth are exposed to, and the more likely we are to develop a cavity.

What commonly causes Early Childhood Caries? – Something that each parent should know mandatorily.

When you put your child to bed with a bottle with anything other than water in his/her mouth, you are putting him/her at a greater risk of developing caries. During sleep, the flow of saliva, which is caries protective is minimum leading to, increased exposure of the teeth to milk or any other liquid given. Babies who sleep with their mother and suckle repeatedly throughout the night expose their teeth to the natural sugars of breast milk and can get decayed. Also, the frequency of drinks from a bottle or cup and snacks with sugary and starchy food plays a major role in decay of teeth i.e. the more frequently sugars come into contact with the tooth surface, the more damage they can cause.  Babies carrying a bottle or no-spill cup around with them and sipping from it constantly or even snacking frequently are more likely to develop decay.

It is always the neglect of simpler things that lead to unnecessary problems in life. Understanding these simple points and trying to implement these in our daily life, which is not that difficult if one tries, might bring us less trouble and more happiness. Prevention of caries is not a big deal if we put into action what we know and have learnt.

[Editor’s Note: Dr. Poojan Shrestha is a dentist at Patan hospital.]