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Ask the Pediatrician


Cavities common in young children

By Dr. Rhonda Patt
Dr. Rhonda Patt
Dr. Rhonda Patt is a pediatrician with Charlotte Pediatric Clinic and past president of the Charlotte Pediatric Society.

Q. We recently took our 2-year-old son to the dentist for his first visit and was shocked to discover he already had several cavities. Are there any medical reasons for cavities at such a young age? What can I do to protect him from future cavities?

A. Dental decay is incredibly common during childhood. Nearly 4 million preschoolers suffer from tooth decay in the United States, making it one of the most common childhood health problems.

From an early age, a child’s mouth becomes colonized with bacteria. Certain types of bacteria adhere to the teeth and gums, forming a sticky substance called plaque. When exposed to sugar, these same bacteria will form acid that can erode tooth enamel and lead to cavities.

Certain strains of bacteria are more aggressive than others and can be passed from parent to child in saliva. For this reason, parents are discouraged from allowing their young children to share their toothbrushes or eating utensils.

Although cavities may occur despite perfect dental hygiene, parents should be aware of and avoid the following risk factors:

Frequent snacking: Sugar provides food for oral bacteria, which increases acid production. Multiple snacks throughout the day increases the risk of tooth decay, and sticky sugary foods are particularly bad for teeth.

Sipping: Sugar-containing beverages such as milk and juice (even if diluted) should be limited to mealtime. Between meals, children over the age of 12 months should drink water.

Nighttime feedings: After the first tooth has erupted, it is important to clean the teeth with a cloth or toothbrush with water before bed. If an infant takes a bottle or breastfeeds before bed, then brush teeth after this feeding. Frequent overnight feedings increase the risk of tooth decay.

Inadequate fluoride: Well water and bottled water are often deficient in fluoride. If your child is drinking well or bottled water exclusively, check with his health care provider to see if he needs supplemental fluoride, because excess fluoride can be dangerous as well.

For more information about caring for young teeth, visit the American Academy of Pediatric Dentistry's website,

Rhonda Patt is a pediatrician with Charlotte Pediatric Clinic. Email; put “pediatrician” in the subject line.
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