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Why the Dramatic Improvement? | What Can be Done About Cavities? | Does Where You Live Matter? | Will There Be Fewer Problems? | Is Your Baby Bottle-Fed? | Do You Have the Right Attitude?

As hard as it may be to believe, a child's visit to the dentist can be an easy and enjoyable experience! The major reason for this turnabout is that tooth decay, formerly the most common of human diseases, is fast becoming a thing of the past.

Studies have shown that water fluoridation has reduced the rate of tooth decay by 20-40%. Many of today's children are cavity-free, which is a huge success story in modern preventive healthcare.

Why the Dramatic Improvement?

Fluoride and preventive dentistry have been the biggest contributors to improved oral health in children. Fluoride is available in toothpastes, mouth rinses, gels applied in the dental office, and tablets prescribed by dentists. In many communities, fluoride is also found in drinking water.

However, excess fluoride can stain the teeth; so adults should pay close attention as small children brush. Children should be taught to use only a little fluoridated toothpaste, about the size of a pencil eraser. Stress the importance of spitting out toothpaste and mouthwash and not swallowing them after use.

What Can be Done About Cavities?

Cavities occur when the bacteria in plaque produce acid that destroy your tooth enamel. Cavities are more common among children. Nearly half of children under age 11 have had dental caries in their baby teeth.

In addition to good oral hygiene practices, the easiest way to maintain tooth enamel is the placement of sealants by a dentist. Children should get sealants on their permanent teeth as soon as they come in. A painless procedure, sealants are applied to teeth in a process known as "bonding." The sealant covers the pits and depressions in the teeth and prevents bacteria from entering. This protects teeth from decay.

Because of their softer enamel, baby teeth are more prone to cavities than adult teeth. In addition, small children may neglect or do a poor job with brushing. The result is that kids aged 5-9 years old have more cavities in baby teeth than adult teeth. Your dentist might suggest sealants for your child's baby teeth if they have deep pits or grooves.

Does Where You Live Matter?

While all areas of the US show improvement in oral health, there are still important regional differences in cavity rates. The cause for these differences is not quite understood, although fluoridation of water supplies may be one reason.

Will There Be Fewer Problems?

As today's kids grow to adulthood, fewer cavities now mean fewer dental problems later. These future adults will need fewer root canal treatments, extractions, crowns (caps), bridges, and dentures than the prior generations. Fluoridating water also saves money. A person can have a lifetime supply of fluoridated water for the same price as one dental filling.

Is Your Baby Bottle-Fed?

Tooth decay is a bacterial disease. Cavity-causing germs love to feed on sugars and cooked starches. The longer these carbohydrates keep in contact with teeth, the greater the chance that bacteria will thrive and begin to produce decay-causing acids. Constantly bathing the teeth in sugars and cooked starches is especially harmful. This problem is most acutely observed in small children who are bottle-fed fruit juice and/or milk between regular feedings and while in bed at night. What commonly results has been called "baby bottle tooth decay." To avoid this problem, bottle-fed children should be given only plain water as a beverage between meals and at bedtime.

Do You Have the Right Attitude?

As a parent, you should speak to your children in positive terms about seeing the dentist. If you are positive, it is likely your child will be positive, too. This will hopefully lay the groundwork for a lifetime of great dental health experiences.


American Academy of Pediatric Dentistry


American Dental Association



Canadian Dental Association


The Canadian Dental Hygienists Association



Decay. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/d/decay.aspx. Accessed August 27, 2012.

Dental caries (tooth decay) in children (age 2 to 11). National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/DataStatistics/FindDataByTopic/DentalCaries/DentalCariesChildren2to11. Updated March 2011. Accessed August 27, 2012.

Fluoride. American Dental Association Mouth Healthy website. Available at: http://www.mouthhealthy.org/en/az-topics/f/fluoride.aspx. Accessed September 5, 2012.

Fluoride for prevention of dental caries. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/. Updated May 9, 2012. Accessed August 27, 2012.

A healthy mouth for your baby. National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/ToothDecay/AHealthyMouthforYourBaby.htm. Updated June 2011. Accessed August 27, 2012.

Seal out tooth decay. National Institute of Dental and Craniofacial Research website. Available at: http://www.nidcr.nih.gov/OralHealth/Topics/ToothDecay/SealOutToothDecay.htm. Accessed August 27, 2012.

Last reviewed August 2012 by Brian Randall, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

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