The #1 Kids' Disease: Tooth Decay

It can start with your baby's bottle, so early checkups are important.

While childhood obesity is on many parents’ radars as a big health concern, it may be surprising to learn that childhood tooth decay is a more prevalent problem.

According to the American Academy of Pediatric Dentistry (AAPD), tooth decay is the most common U.S. chronic childhood disease, affecting four times more children than obesity. Both conditions have a common enemy: sugary drinks and foods. Healthy habits and regular visits to your child’s dentist help prevent pediatric tooth decay.  

Pediatric Dentists

The difference between a pediatric dentist and a general dentist is similar to that of a pediatrician and a family doctor. “Pediatric dentists have focused their energy and education on dealing with children,” says Moorestown, NJ dentist Susan Armstrong, DDS.

Most pediatric dentists have received an extra two or three years of training as child specialists.

For more information, visit the Parent Resource Center of American Academy of Pediatric Dentistry,

The AAPD recommends that children see a dentist when their first tooth erupts, or by their first birthday. During this first visit, the dentist will counsel parents about food choices and diet for the child. Sugary foods that stick to teeth should be avoided, says Susan Armstrong, DDS, a pediatric dentist practicing in Moorestown, NJ. While taffy is an obvious no-no, some parents don’t realize that raisins and fruit roll-ups can be harmful to teeth as well. After the initial dental session, children should return every six months for a professional cleaning and a check-up, just like adults.

Baby Bottle Tooth Decay

Baby bottle tooth decay, or early childhood caries (EEC) results from unhealthy habits such as allowing an infant to fall asleep with a bottle. Problems can begins when the last gulp of liquid a child drinks before sleep stays in his mouth all night. The tongue holds the liquid —  whether it’s juice or breast milk — against the top front teeth, allowing sugars it contains to cause decay. While EEC can lead to dramatic tooth decay, it is treatable, says Dr. Bresler.

He says to prevent EEC:
•    Do not put a child to sleep with a bottle of anything other than water.
    Toddlers should be encouraged to drink juice from a cup rather than a bottle.
    Juice should only be offered at meal and snack times.
    Do not allow babies with teeth to fall asleep while nursing.

Baby Teeth

Why bother taking care of baby teeth?  They’re just going to fall out, right? “That’s the old thinking,” says David A. Bresler, DDS, a spokesperson for the American Academy of Pediatric Dentistry with practices in several PA offices.  “We know much better today.”  

He cites four reasons why baby teeth are important:
    Primary teeth pave the way for good nutrition by allowing a child to chew food properly.
    Teeth are essential to speech formation.
    Primary teeth are space holders for the permanent teeth.
    A healthy smile is an important social tool that breeds confidence at any age. 

Supplemental Fluoride

Although most communities have had fluoridated water for decades, giving kids supplemental fluoride is controversial. “Parents get confused and frightened,” says Dr. Armstrong. Fluoride’s benefits in preventing tooth decay have been proven, but too much fluoride can cause fluorosis, which can lead to discoloration in developing teeth. Talk to your dentist to determine whether your child’s intake of fluoride through water and toothpaste is adequate.


During early dental visits, hygienists will demonstrate how to brush teeth properly. At home, parents should dispense toothpaste to make sure kids don’t use too much. A smear of toothpaste is appropriate for kids under 2. Preschoolers ages 2-5 need a dollop of toothpaste about the size of a pea.

Kids should brush their teeth twice each day, ideally after breakfast and before bed, for two minutes each time. Keep an eye on brushing technique well beyond toddlerhood, advises Gregg Fink, DMD, a general dentist practicing in Newark, DE.  “Children don’t always brush every time they say they have,” Dr. Fink says. He advises that parents monitor their children’s brushing until the age of 8 or 9, when they can be sure that kids have the dexterity to do a good job. 

Suzanne Koup-Larsen is a contributing writer to MetroKids.

Categories: Food & Nutrition, Health & Nutrition