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Cris Gilb, PHN and Executive Director

Keeping a child’s baby teeth cavity-free is important

Cris Gilb, RN, PHN, MHA
Executive Director, Minnesota Oral Health Project

Dental cavities in the baby teeth of Minnesota’s children is a silent epidemic, even though cavities are preventable. An alarming number of children, nearly half of all children ages 2 – 11, have cavities in their primary (baby) teeth. Over half of children starting Kindergarten have already had a cavity. The numbers are even greater in children who come from families that near or below the Federal Poverty Level or are children of color. Keeping a child’s baby teeth healthy has become a public health crisis!

Boy Cleaning Teeth

The pain these children endure is inconceivable and the treatment that is needed is extensive. Public health nurses frequently see young children with a mouth full of cavities. The revolution in better dental care is not reaching all of America’s children.

Elise Sarvas, a board-certified pediatric dentist on faculty at the University of Minnesota and Dental Director for MNOHP, says, “a child’s oral health can determine their oral health for the rest of their lives. Early prevention efforts can have life-long benefits.” Contrary to popular belief, dental care for baby teeth is very important in the normal, healthy development of the child. Keeping a child’s baby teeths affect nutrition, speech, play, and smiles.

Smiling Baby with two teeth

There are twenty baby teeth and they usually come in starting at about 6 months to 1 year. Children usually have their full set of baby teeth by the time they are three years of age. Baby teeth do not typically begin to fall out until a child is 5 or 6. Children will have lost their baby teeth and have a full set of up to 32 permanent teeth when they are 12 – 13 years old. However, the last four teeth are called wisdom teeth and often erupt when the child is 17 or older.

What is dental caries and what are cavities? Caries is the process that results in cavities. Caries occur when sugar from food or drink combines with normal bacteria in the mouth and forms an acid that damages the enamel of the teeth. Because caries is an infectious process, it can cause pain, low grade fever, and general malaise. It also means that it is preventable. As damage to the tooth continues, a hole forms called a cavity. If untreated, the tooth begins to decay. A baby tooth will fall out early when damaged in this way.

Childhood caries often cause children to lose their teeth early, a situation that does not benefit children or their health. The American Dental Association and American Academy of Pediatric Dentistry note that childhood caries is a significant public health problem. Caries in young children is considered a “silent epidemic”. It is very common and no one talks about it. The great news about caries is that it is almost 100% preventable!

Baby teeth fall out anyway, why worry about keeping a child’s baby teeth?  For one thing, when teeth fall out early, it is difficult for the child to eat healthy food. It is hard to chew or bite off pieces of food without front teeth. Children need healthy teeth in order to chew thoroughly and enjoy fresh fruits and vegetables and lean proteins, and to get the full nutritional value from them. Cutting food into tiny pieces or pureeing them when you can’t chew is really not that appetizing. Some children don’t eat well at all when they have lost teeth or when they have cavities or untreated tooth decay in their mouths.

Not only are teeth good for chewing, they are important for development of clear speech. The tongue and teeth work together to form certain sounds. When you make the “t” sound, your tongue touches the inside of your front teeth, and the “th” sounds requires your tongue to go between the top and bottom teeth. The same is true when you make the “l” sound. Sing a song – la la la la la and try it out.

Dr. Elise Sarvas also notes that baby teeth are important placeholders for a child’s permanent teeth. They hold space for the permanent tooth to come in nice and straight. When the baby tooth is not there, other baby or permanent teeth take advantage of the open space and move right in, not leaving enough space for the permanent tooth that is supposed to be there. That ends up causing crowded teeth, crooked teeth, and an unbecoming smile. As the child ages, braces or other dental procedures are necessary to fix the problem.

Mother Nature knows when it is time for the baby teeth to fall out and the permanent teeth to erupt. Don’t call the tooth fairy too early – prevent cavities in those teeth and keep a child’s baby teeth as long as possible.

Video from Mouth Healthy, a program of the American Dental Association

Prevent cavities starting at birth.

  • Wipe out the newborn’s gums after feedings to keep the gums clean and reduce cavities and decay that can begin when that first tooth comes through.  It also helps to familiarize the child with oral care, making it easier to start cleaning teeth when teeth come through.
  • Avoid sharing of bottles, pacifiers, and sloppy kisses to avoid passing bacteria between children or from adults to children.
  • When the first tooth erupts, clean it with a smear of fluoridated toothpaste on a damp cloth or soft brush and wipe out the excess toothpaste.
  • Offer public fluoridated tap water between meals in bottles and sippy cups, so as not to continually bathe the teeth with sugar in milk, juice, or pop.
  • Make an appointment with your dentist when that first tooth comes in or by age one at the latest.
  • If you don’t have a regular dentist consult your primary care medical provider to learn about healthy dental hygiene and have fluoride varnish applied to strengthen the enamel of the teeth as protection against the caries process.


  1. smetoxen on July 5, 2017 at 4:56 pm

    This is so true. I remember people saying that baby teeth were just temporary, and that when the adult teeth come in that is the “second chance”. But it is one of those myths we need to put an end to.

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