Cavities in Children

When your child visits the pediatric dentist for an exam the question most asked by the parent is, "Are there any cavities"?  At any age the concern about cavities is the health concern.

But what causes cavities?  I will try to explain cavities or caries from the knowledge base perspective and try to leave out the anecdotes.  Cavities are caused by germs, specifically bacteria and therefore cavities are a form of dental disease.  The germs are always present in the oral cavity and when they find a susceptible tooth with a favorable environment the decay process will begin.  Streptococcus mutans is the most notable bacteria causing cavities.

So, cavities are caused by three factors, namely germs, susceptible teeth and a favorable environment for the bacteria.

Where does the bacteria come from in a young child?  The usual sources of the bacteria in children are from other people the child comes in contact with.  Most often its the parents, most notably the mother.  This have been shown by genetic studies of the bacteria and can go back several generations.  The child's exposure to other people with dental disease can also be a factor.  We all know that the oral cavity gets all kinds of interaction with a variety and organisms just from the environment, foods, hands, playing etc.  The world is not sterile.  However, our bodies have learned to accommodate to most of these organisms.

The next factor is a susceptible tooth.  Just as each person is different so are teeth different.  Some teeth are better calcified and well formed than others.  Some teeth have grooves and pits that are not well formed.  Some teeth do not calcify or form properly.  Some teeth are cleaned better that others.  Some teeth are decalcified by certain acidy foods.  Some teeth are more dried out and do not have the saliva naturally cleaning them.

The last factor is a favorable environment for the bacteria to cause a cavity.  This factor has a large and varied number of components.  The bacteria like certain foods growth areas called substrates.  A substrate is the stuff that makes the bacteria grow.  The germs that cause cavities like to live in an environment that lets them attach to the tooth and form acids.   The acids the bacteria produce eat away at the tooth creating an even better attachment area as the tooth is slowly rotted away.  Foods that are sugary, starchy, acidy, grainy and mealy, and sticky are primary culprits or the favorites of the germs.  The sticky mass they live in on the tooth is called plaque.

On other posts I will discuss more specifics of prevention and the necessity for repairing decay.