A young girl with brown hair

You work so hard to take good care of your child’s teeth, only to find that your child has a cavity. Again. It just doesn’t make sense, you think. You give your child fewer sugary treats than any of your friends give their children, and yet none of your friends’ kids ever get cavities. What gives?

If this sounds even vaguely familiar, this article is for you.

Contrary to common perception, whether or not a child will get cavities depends on much more than simply whether the child brushes frequently or eats lots of candy. In fact, tooth decay is the result of a complex interplay between a variety of biological, environmental and behavioral factors. In this article, we will explore some of the most important factors that affect a child’s chances of developing cavities and discuss strategies for minimizing the risk of tooth decay.

What Causes Cavities in Children and Babies?

As mentioned above, there are a wide variety of factors that influence a child’s chances of developing cavities. It is beyond the scope of this article to address every such factor – and indeed, identifying all the factors that affect tooth decay is an area of ongoing research – but below we discuss some of the most important ones.

1. Oral Bacterial Colonization

Did you know that tooth decay in children is not caused by sugar directly? Rather, it is an infectious, transmissible bacterial disease. Certain harmful bacteria inside our mouths produce acid, which damages our teeth and eventually causes cavities. The connection between sugar and tooth decay is that these harmful bacteria feed off sugars. Whenever we consume sugary foods (or foods that break down into sugars inside our mouths), these bacteria feast on the sugars, using them to grow and multiply and metabolizing them into a harmful acidic waste product.

Cavity-causing bacteria can be transmitted to children through saliva. Often, these bacteria are transmitted to children from their mothers, but anyone can transmit the bacteria, including other children. The more frequently a child’s mouth comes into contact with saliva containing cavity-causing bacteria, the more likely it is that harmful bacteria will colonize the child’s mouth. And if cavity-causing bacteria colonize the child’s mouth, the child is more likely to develop cavities.

You can help minimize the chances that cavity-causing bacteria will be transmitted to your child by reducing the amount of contact your child has with the saliva of others, especially the saliva of people who may have untreated cavities. For example, avoid sharing eating utensils with your child and always clean toys that other children may have had in their mouths before allowing your child to play with them.

2. Dietary Habits

Given that cavity-causing bacteria love sugar, it is not surprising that frequent consumption of sugary drinks and snacks increases children’s risk of developing cavities. But when it comes to the connections between food and cavities, there is a lot most parents don’t know. If your child is prone to cavities, talking to a pediatric dentist about your child’s diet is an excellent way to help identify potential problem areas. Here are a few examples of diet-related facts that surprise many parents:

Sweets Are Not the Only Problematic Foods

Any food that contains fermentable carbohydrates – that is, carbohydrates that are broken down into sugars while still inside your child’s mouth – can feed cavity-causing bacteria. This means that it is not only sugary foods that are bad for your children’s teeth, but also processed, starchy foods like chips, white crackers and white bread.

It’s Not Just About the Total Amount of Sugar Consumed

Studies have shown that a child’s risk of developing cavities is affected less by the total amount of sugars and fermentable carbohydrates that a child consumes than by the frequency with which the child consumes such foods and the amount of time those foods spend in the child’s mouth. This isn’t to say that consuming a large, sugary dessert after dinner every night won’t affect your child’s teeth, but it does mean that snacking on sugary foods throughout the day is worse for your child’s teeth than eating the same total amount of sugary treats all at once, immediately after a meal. And sugary and starchy foods that linger in your child’s mouth for a long time, such as hard candies or sticky foods like raisins and toffee, are worse for your child’s teeth than foods that are cleared out of the mouth quickly, like yogurt.

For this reason, the American Academy of Pediatric Dentistry recommends against giving children sugary beverages like juice – yes, even 100% juice contains sugar and increases children’s risk of cavities – in bottles and sippy cups. If you give your child juice, we recommend restricting it to mealtimes. When a child is allowed to carry juice or other sugary drinks around in a bottle or sippy cup, it can be tempting for the child to sip on the liquid slowly throughout the day, leading to repeated damaging acid attacks and increasing the risk of cavities.

Babies Should Not Be Put to Bed with Bottles

The American Academy of Pediatric Dentistry recommends against putting babies and toddlers to bed with bottles, especially bottles containing sugary liquids like juice. When a child is put to bed with a bottle of juice, the juice can pool up around the child’s upper front teeth, leading to rapid destruction of those teeth. Even putting your toddler to bed with a bottle of a milk can potentially lead to cavities in your toddler’s teeth. Although milk itself does not cause cavities, bottles obstruct the flow of saliva, which is your child’s natural tooth cleaning agent. (You can read more about this in our article on cow’s milk and children’s teeth.)

3. Dental Enamel Defects

Dental enamel is the hard, protective outer layer of a tooth. Certain types of enamel defects, such as enamel hypoplasia, may increase a child’s risk of developing tooth decay. These defects can be hereditary, or they might be a result of environmental factors like low birth weight, viral and bacterial infections, or dental trauma.

A pediatric dentist can diagnose dental enamel defects during your child’s regular dental check-up and work with you and your child to develop an appropriate plan for reducing the risk of cavities. For more information, see our article on enamel hypoplasia, as well as our article on developmental enamel defects generally.

4. Oral Hygiene Habits

As you might expect, poor oral hygiene habits in children increase the risk of developing cavities. What you might not have realized is that it is extremely important to begin brushing your baby’s teeth twice a day as soon as your baby’s very first tooth emerges, and to begin flossing as soon as your child has two teeth that touch. If that seems early to you, check out our article on early childhood caries to see why it is essential to start brushing and flossing your child’s teeth at such a young age.

Brushing your child’s teeth helps to remove cavity-causing bacteria from the teeth, and using fluoride toothpaste helps strengthen your child’s dental enamel. Flossing your child’s teeth removes harmful bacteria from the surfaces between the teeth where a toothbrush cannot reach.

Not sure how to brush your baby’s teeth? Unsure if you’re using proper flossing technique? Take a look at our brushing and flossing guides for tips.

5. Mouth Breathing

Saliva is our teeth’s natural protector. It helps wash away food particles and repair damage that cavity-causing bacteria do to our teeth. Children who breathe through their mouths instead of their noses often have dry mouths, making it unsurprising that they are at increased risk for developing cavities.

If mouth breathing is an issue for your child, a pediatric dentist may be able to help correct the condition using interceptive orthodontic appliances.

How to Prevent Cavities in Children & Babies

In addition to following the tips provided in each of the sections above, one of the best ways to keep your baby’s teeth free of cavities is to schedule a check-up with a pediatric dentist as soon as your baby’s first tooth emerges, and no later than your child’s first birthday. Establishing a dental home early in your child’s life and continuing to bring your child to the dentist regularly for professional cleanings are easy, yet extremely effective ways to help prevent cavities in kids.

A trained pediatric dentist can assess your child’s risk of developing cavities and provide you with the education and guidance you need to help prevent your child from developing oral diseases like cavities in the first place. Furthermore, regular check-ups and cleanings allow your child’s pediatric dentist to detect any issues and intervene early before the problem worsens. After all, wouldn’t you prefer to be able to stave off a developing cavity in your child’s teeth with a small filling rather than waiting until the cavity progresses to the point of requiring pediatric pulp therapy?

Prevention and Treatment of Cavities for Kids in Hurst, TX

If your child keeps getting cavities and you aren’t sure why, it’s time to speak with a pediatric dentist about what changes you can make to protect your child’s teeth.

Hurst Pediatric Dentistry’s Dr. Jin Lin is a board-certified pediatric dentist who is specially trained in the prevention and treatment of cavities in children, including in advanced diagnostic and treatment procedures like early childhood caries risk assessments in infants and pediatric pulp therapy treatments. Call us today at (817) 510-6400 to book an appointment for your child!

Hurst Pediatric Dentistry is located in Hurst, Texas, and serves children from Hurst, Euless, Bedford, North Richland Hills, Colleyville, Keller, Fort Worth, Watauga and the surrounding area.

This article is intended to provide general information about oral health topics. It should not be used to diagnose or treat any disease or as a substitute for the advice of a healthcare professional who is fully aware of and familiar with the specifics of your case. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.


Dr. Jin Lin

Doctor Jin Lin, Board Certified Pediatric Dentist

Dr. Jin Lin is a board-certified pediatric dentist with a passion for helping children achieve healthier, more beautiful smiles. He earned his Bachelor of Science degree from Cornell University and his Doctor of Dental Medicine (D.M.D.) degree from the Harvard School of Dental Medicine. After graduating cum laude from dental school, he completed his post-doctoral pediatric dentistry training at Boston Children’s Hospital and the Harvard School of Dental Medicine, where he served as chief resident and worked with children with a wide variety of special medical and dental needs, including children with rare syndromes.