preventing & treating cavities in preschoolers

Preschoolers are prone to cavities, it's a fact. So here are expert tips you can follow to help prevent them, and what you can do if they appear.

Dr. Steven Grossman, a pediatric dentist based in New York City, and Michael J. Hanna, DMD of Robinson Township, PA, compiled these tips on preventing and treating cavities in preschool-aged children.

Preventing Cavities

The best way to avoid tooth decay is to ensure that your child brushes her teeth daily. Once in the morning, and once at night before bedtime. Ideally, your child's teeth should be brushed after each meal. Proper dental hygiene is the best way to keep tooth decay at bay, and here are some additional steps you can take to prevent cavities:
  • No Bedtime Bottles or Juice Drinks
    Limit the amount of sugary juices your child drinks from his sippy cup throughout the day. In addition to being high in sugar, fruit juices can also be highly acidic, so it's a good idea to dilute your child's juice for her. And never let your child fall asleep with a bottle of milk or juice at bedtime. The acid from milk and juice sitting in your child's mouth can eat away at the enamel, damaging not only his baby teeth, but potentially his adult teeth as well.

  • Limit Sugary Sweets
    Some sweets are better than others, but only in moderation. "I'm a big advocate of plain chocolate as a special treat," says Dr. Hanna, "Saliva washes away much of the chocolate, so it's much less likely to cause decay than a cookie or a cracker that gets mashed into the teeth, where it can remain for a long time."

  • Ask About Tooth Sealants
    Ask your dentist about tooth sealants that can protect grooved and pitted surfaces of teeth--such as the chewing surfaces of molars, where most cavities in children are found. These clear or shaded coatings are beneficial if your child has deeply grooved molars that trap food particles.

  • A Note on Sealants
    Dentists can seal teeth of kids as young as 2 1/2, but generally this procedure is reserved for older kids because the patient needs to sit still and keep her mouth open while the sealant material sets up. Teeth with pre-existing cavities or decay should never have sealant applied to them.

The Fluoride Factor

QUESTION: We have fluoride in our water, so does my child need a fluoride rinse, too? What about fluoride drops and tablets?
  • The fluoride added to municipal water sources works internally (or systemically) to protect and strengthen developing teeth while the fluoride in toothpastes and rinses work topically to help protect teeth that have already erupted. So, fluoridated rinses and toothpastes are an extra step in avoiding tooth decay.

  • Pediatric dentist A. Jeffrey Wood, the chair of the Department of Pediatric Dentistry at the University of the Pacific, in San Francisco, believes that both topical and systemic fluoride are essential to the health of your child's teeth. Dr. Wood believes fluoride rinses are especially beneficial when used right before bedtime.

  • If your water isn't fluoridated, or if your family drinks only well or bottled water, your dentist can prescribe fluoride tablets, lozenges, or drops. Don't buy fluoride over the counter though, because fluoride dosage needs to be tailored to each child's needs .

  • Fluoride rinses should not be used by children under the age of 4. Be sure to supervise your child while he is rinsing, to ensure that he is spitting out all of the product and not swallowing it. Ingesting fluoride rinse can lead to spots on permanent teeth.

Cavities in Baby Teeth

QUESTION: Is it necessary to fill cavities in my 3-year-old's baby teeth?
  • Dr. Grossman's answer is yes. "If it's a primary front tooth, your child will have that tooth for another three or four years. And a primary molar might remain for another six or seven years, so the decay should be taken care of before it gets worse." If the decay is not stopped, it might necessitate removing the tooth prematurely. "And taking out a tooth can lead to spacing problems that will need to be monitored closely as the secondary teeth come in," says Dr. Grossman.

  • "If left untreated, bacteria in one cavity can spread, seeding your child's mouth with bacteria that may infect permanent teeth as they erupt through the gums," adds Dr. Hanna.

  • If your preschooler does have a cavity that needs filling, talk with your dentist to help her determine if your child can sit still for the procedure. She might suggest waiting until your child is a little older before filling the cavity.
Help your child avoid the stress and pain of tooth extraction or cavity filling, by taking the proper steps to ensure that your child's teeth are properly cleaned daily. Schedule bi-annual dental exams once your child's baby teeth are all in, and act promptly if you think your child has a developing cavity, or if a baby tooth begins to darken.

Important Disclaimer: This information is not meant as a substitute for professional medical advice, diagnosis, or treatment. Always consult a doctor with questions about your or your child's condition. does not recommend or endorse specific tests, products, procedures, opinions, or other information provided by any sponsors or other third parties. Please also see's Terms of Use.
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