Mamelons on Teeth: Statistics, Why They Appear, & More

You may have noticed small bumps on your teeth when you look in the mirror, or perhaps on your child’s teeth when you look at them closely. Dentists have a name for those little bumps: mamelons. Are mamelons normal, or is something wrong?

Mamelons are small ridges on the tips of the upper and lower 4 front teeth, which gives them a scalloped appearance. They’re not harmful and usually wear down and go away as you get older. If you’re worried about how mamelons make your teeth look, your dentist can offer treatments.

What teeth can have mamelons?

Mamelons appear on the incisors, the flat teeth at the front of the mouth. The rounded protuberances are usually found on the adult teeth (permanent teeth), although some children have them on their baby teeth (also called milk, deciduous, or primary teeth).

Mamelons appear most often on the maxillary central incisors (the upper 2 front teeth), but they can appear on any of the other incisors as well.

What Mamelons Look Like

Mamelons look like little bumps on the incisal edge of the upper and lower front teeth. Genetics determine most of their shape and size. Mamelon shape and number among children varies more on the top teeth than the bottom teeth. 

 
 
 
 
 
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What are mamelons? Why do they appear?

Mamelons are small extensions of enamel, the hard outermost layer of the tooth. As the tooth develops, the enamel grows out toward the edge of the tooth. As the tooth finishes growing, small bumps or protrusions of enamel form at the end, creating a scalloped look.

A vast majority of children (more than 90%) have mamelons on their permanent incisors. The mamelons gradually wear down as they use their teeth to bite during normal chewing. In most cases, the incisors appear smooth by early adulthood, depending on how the person chews.

Mamelon Frequently Asked Questions

With the prevalence of mamelons, it’s common to hear questions about them. Here are some of the most-asked queries.

  • How are mamelons formed on teeth? Mamelons are formed on teeth as they develop in the jaw. The front side of each incisor develops as 3 separate lobes that eventually fuse together. Mamelons form when the lobes don’t fuse completely at the tip of the tooth.
  • What is the purpose of mamelons? Most scientists agree that the purpose of mamelons is to help teeth break through the gums when they erupt, though there is still some debate on why they develop. Mamelons can also make it easier to bite and shear off pieces of food.
  • Why do my teeth have mamelons? Your teeth have mamelons because your genetic code caused your teeth to develop them. Your parents probably had mamelons, too. Mamelons can be advantageous to young children because they can help with teething and chewing.
  • What is the difference between mamelons and ridges? The difference between mamelons and ridges is placement: mamelons are on the chewing edge of incisors, and ridges are a generic term that can be used for any bumps on the teeth.

How Long Mamelons Last

Mamelons typically begin to wear down within months of teeth erupting through the gums. They usually wear away by the time a child turns 10. However, it’s not uncommon for children to have mamelons into their teens, particularly if the mamelons were large to begin with.

Females are more likely to have mamelons that don’t wear away when they chew than males. 

Mamelons also tend to stay around longer if you have a bite problem or occlusion like:

  • Anterior open bite, when the front teeth from touching when the mouth is closed.
  • Overbite or deep bite, a malocclusion in which the top front teeth largely overhang and cover the bottom teeth.
  • Underbite, or when the front lower teeth sit in front of the front upper teeth.
  • Crossbite, when some teeth are in an underbite position and others are in an overbite position.

Orthodontic treatment can help correct these bite problems, which would allow the teeth to chew correctly and eventually wear down tooth mamelons naturally.

Mamelons Removal: How It’s Done

Dentists frequently remove mamelons by contouring the edge of the front teeth. It’s also called tooth reshaping or recontouring. Mamelon removal typically doesn’t require an anesthetic, so it’s a painless and relatively simple procedure. 

To prepare for tooth reshaping, your dentist will take x-rays of your front teeth to ensure that your child is a good candidate for the procedure and the enamel is thick enough and avoid exposing the dentin layer underneath the enamel.

During reshaping, the dentist will gently file or grind away the enamel at the very edge of the tooth. They may use a dental file, a disk, or a drill to remove the enamel and smooth the edge, removing the mamelons in the process. 

Dentists specializing in cosmetic dentistry and pediatric dentistry do most tooth reshaping. If you’re considering having your child’s mamelons removed, be sure their dentist has experience contouring teeth so they can have the best smile possible.

Almost all mamelons will disappear on their own with time, so if your child has them, it can be beneficial to wait before opting for a procedure.

Pros And Cons Of Mamelon Removal

It’s important to note that most mamelons wear away over time without any intervention. This means that for many children, a procedure to remove mamelons is unnecessary. However, if they persevere into adulthood or are causing your child distress, tooth reshaping is available.

Here are some common reasons why it’s done:

  • Tooth reshaping can help improve your child’s self-esteem if they’re self-conscious about their mamelons.
  • It’s a cost-effective way to improve the beauty of your child’s smile.
  • There’s no recovery time.

The potential drawbacks of mamelon removal include:

  • It may not be the right treatment option if your child has very large, deep mamelons or thin enamel.
  • The reshaped areas may be sensitive for a while, particularly to cold or acidic foods and drinks. (Proper dental care and using a hydroxyapatite toothpaste can help combat sensitivity if it develops.)
  • Your child could be at a higher risk of their teeth breaking.
  • Your child may be more likely to develop cavities where the enamel has been removed.
  • Most mamelons disappear naturally with no need for surgery.

Because mamelon removal is a cosmetic procedure, it’s usually not covered by insurance. Most patients pay between $50 and $500 out of pocket per tooth for tooth reshaping. 

Ways To Support Developing Teeth

Just like the rest of the tooth, mamelons form long before teeth erupt through the gums. A vital part of giving your child healthy teeth is supporting the development of new teeth long before you can even see them.

Here are some ways you can help your child develop healthy teeth:

  • Eat whole foods: The food your child eats becomes the teeth and bones in their body. They need plenty of calcium and vitamins that help their teeth grow and stay strong, like vitamin D3 and vitamin K2.
  • Good oral hygiene: Healthy baby teeth are essential to developing healthy adult teeth. Be sure your child is brushing their teeth at least twice a day with a soft toothbrush and flossing at least once a day. Flossing is imperative to prevent cavities between teeth.
  • Use hydroxyapatite toothpaste: Hydroxyapatite toothpaste works just as well as fluoride toothpaste without the nasty side effects. It will help restore the enamel of your child’s teeth and prevent tooth decay. Brushing your teeth also helps prevent gum disease.
  • Use a high-quality probiotic: Probiotics help keep the healthy microbes in your mouth and body healthy. Your microbiome keeps your body, teeth, and gums healthy, so be sure to take care of it!
  • Curb snacking: Constant snacking gives cavity-causing bacteria the fuel they need to grow and damage your child’s teeth. (Even non-sugary snacks like crackers can feed pathogenic bacteria!) Snack on whole foods and in moderation to help prevent cavities.
 
 
 
 
 
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Taking proper care of your child’s teeth as they develop and emerge is an investment in their future health. It’s much easier to maintain healthy teeth and treat possible root causes than to fix the issues that come with dental decay.

If your child has mamelons, they will likely disappear with time. If not, minimally invasive procedures are available to treat this minor cosmetic issue.

Sources

  1. Teeth as age estimation tool in children and adolescents 
  2. Intra- and Inter-population Variability in Mamelon Expression on Incisor Teeth 
  3. Incomplete mamelon fusion – A rare developmental anomaly

White Spots On Teeth: 6 Causes, Treatments, & Prevention

Most people want to have a bright white smile, but occasionally teeth aren’t evenly colored. Some people have white spots on their teeth that don’t go away when they brush or floss. If your child’s teeth have these mystery spots, don’t panic — they’re not uncommon.

White spots on the teeth look like small patches of bright white color that are lighter than the rest of the tooth. Most are relatively small, although the patches can get quite large in some cases. Whatever their size, white spots can make people feel self-conscious about their smile.

Do white spots on teeth go away? White spots on teeth don’t go away on their own, but effective in-office and at-home treatments can make them less noticeable.

6 Potential Causes of White Spots On Teeth

White spots on teeth aren’t all caused by the same issue. Several different issues can create the spots, and usually, it takes a dentist to figure out exactly why they have appeared. 

6 common causes of white spots on teeth include:

  1. Fluorosis
  2. Poor diet
  3. Demineralization
  4. Enamel hypoplasia
  5. Mouth breathing
  6. Braces that aren’t cleaned properly

1. Fluorosis

Fluorosis happens when children ingest too much fluoride when their teeth are developing, usually through drinking water, fluoride supplements, or accidentally swallowing toothpaste.

In mild cases, the excess fluoride causes white spots on the teeth. In more severe cases, brown patches and even small pits develop in the tooth enamel (outer tooth layer). Fluorosis usually isn’t painful, but severe cases can cause emotional distress because of how the teeth look.

Dental fluorosis is one of the many reasons why your family should avoid fluoride. Hydroxyapatite toothpaste works just as well as fluoride toothpaste without the nasty side effects. 

2. Poor Diet

White spots on your teeth can also be caused by acidic foods and drinks eating away at the enamel of your teeth. If the acid sits on your teeth long enough, it will start to demineralize (break down) the enamel, which can change the color of that part of the tooth.

3. Demineralization

When the outer enamel starts to break down and demineralize, it can cause white spots to form. The outermost layer of enamel begins to lose hydroxyapatite crystals, the molecules made of calcium, phosphorus, oxygen, and hydrogen. These are the building blocks for teeth and bones.

Demineralization (also called decalcification) spots form when poor oral hygiene leads to plaque buildup. Plaque bacteria damage the enamel, creating a white spot and eventually a cavity.

4. Enamel Hypoplasia

Enamel hypoplasia is a condition where the teeth form with a layer of enamel that’s thinner than average. Patients with enamel hypoplasia will most often have brownish discolorations on their teeth, but white spots can also be a sign of thinly-formed enamel.

5. Mouth Breathing

Mouth breathing causes significant damage to tooth enamel. When you breathe through your mouth, it dries up your mouth. This means your saliva isn’t there to protect your teeth and gums. 

Your saliva helps remineralize your teeth in places where acid (including acid produced by plaque bacteria) has weakened the enamel. If mouth breathing dries up your saliva, it won’t be able to remineralize your teeth. A dry mouth can lead to tooth decay and/or white spots on the teeth.

6. Braces

When an orthodontist places braces on the teeth, they first glue brackets onto the teeth that hold the wire in place. The bracket attachment can actually cause discoloration of the teeth, particularly if you have poor dental hygiene.

Additionally, the area around brackets is a prime spot for plaque-causing bacteria to grow. If you don’t carefully remove plaque buildup around the orthodontic appliances, it can discolor your teeth and cause white spots. Eventually, this can lead to tooth decay.

What causes white spots on teeth? White spots on teeth are caused by fluorosis, eating acidic foods, demineralization, thin enamel (enamel hypoplasia), mouth breathing, or improper cleaning of braces. 

Pictures Of White Spots On Teeth

White spots on teeth can vary in appearance, depending on the cause, size, and tooth structure. Some teeth have minor white marks that are barely noticeable, while others have a mottled appearance. Every case is unique.

Here are examples of white spots on teeth:

 
 
 
 
 
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A post shared by Roxana Y. Solis Ortega (@dentista.roxsolis1)

Treatment Options For White Spots

If you feel embarrassed by the appearance of white spots on your teeth, there’s good news: white spots on teeth are pretty easy to treat. Most solutions are simple and painless and can be done easily by your dentist in their office. Just ask during one of your annual checkups.

Some dentists recommend teeth whitening or teeth bleaching to eliminate the appearance of white spots, but whitening isn’t an optimal treatment. The bleach solution contains harmful chemicals that contact your teeth and potentially your gums during the whitening procedure.

It’s best to use natural treatments for white spots instead of whitening treatments. The best treatments for white spots that don’t use a lot of noxious chemicals include:

  • Enamel Microabrasion: In enamel microabrasion, your dentist will apply a naturally occurring acid and gentle abrasive to your teeth and gently polish the surface of your teeth.
  • Remineralization: When white spots on teeth are caused by demineralization, remineralization with hydroxyapatite is the best solution.
  • Porcelain Veneers: If you have extensive damage to your tooth enamel or a large area of white spotting on your teeth, dental veneers may be a good option. Your dentist bonds a layer of porcelain on top of your teeth to improve their appearance.

How do you get rid of white spots on your teeth? You get rid of white spots on your teeth by restoring tooth enamel or gently polishing the surface of your teeth, depending on the root cause of the white spots.

How To Prevent White Spots On Teeth

As a firm proponent of functional dentistry, I know it’s essential to treat the cause of dental health problems, not just the symptoms. Prevention is vital to your overall health and for preventing white spots on your teeth, too. The best ways to prevent white spots on teeth are:

Diet

Healthy tooth enamel is the biggest key to avoiding white spots on your teeth, and your diet is one of the best ways to support your tooth enamel. You need to eat plenty of calcium to help your body remineralize your enamel. 

Your body also needs vitamins like vitamin D3, vitamin A, and vitamin K2 to absorb and use calcium. Make sure you’re eating a well-rounded diet with lots of fruits, vegetables, and protein to get the nutrients you need to keep your teeth healthy.Proper diet is particularly important for young children who are still growing adult teeth. In many cases, white spots actually form while the teeth are developing. If your child gets the vitamins and minerals they need, they’ll be less likely to have white spots on their teeth.

 
 
 
 
 
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Good Oral Hygiene

Preventing plaque buildup can help prevent white spots from forming on your teeth, and it’s excellent for your dental health, too. Proper oral hygiene makes sure you keep your teeth and your gums healthy, which in turn keeps your entire body healthy.

Regular flossing and brushing knock back plaque-causing bacteria, reducing your chances of developing white spots at the same time. And, you’ll reduce your risk of getting cavities, too.

Restore and Protect Your Tooth Enamel

The health of your tooth enamel has a direct impact on the appearance of white spots on your teeth. While you’re brushing to remove harmful bacteria in your mouth, make sure you’re using hydroxyapatite toothpaste to protect and restore your enamel.

Unlike fluoride toothpaste, hydroxyapatite toothpaste won’t accidentally lead to more white spots on your teeth. Fluoride is neurotoxic and can negatively affect brain function and development in children. Hydroxyapatite is the same material your tooth enamel is made of — it’s 100% natural.

 
 
 
 
 
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Support Your Oral Microbiome

A healthy oral microbiome helps knock back plaque bacteria and yeast, which in turn helps support the health of your tooth enamel. Maintaining the good bacteria in your mouth can make sure plaque bacteria aren’t creating white spots on your teeth.

The best ways to support your oral microbiome are:

  • Brush with hydroxyapatite toothpaste.
  • Use a tongue scraper to help remove more harmful bacteria from your mouth.
  • Take an oral probiotic.
  • Add a gut probiotic to help your body absorb calcium and the vitamins it needs to remineralize your teeth.
  • Eat fermented foods, which help support the microbiome throughout your body.

When you have a healthy microbiome, your entire body functions optimally. Your microbiome will support the health of your teeth and tooth enamel, which can keep white spots on teeth from forming in the first place.

You have many options for both treating and preventing white spots in your teeth. Take care of that enamel and enjoy your healthier, happier smile.

Sources

  1. PMID: 21504777
  2. PMID: 27695330
  3. PMID: 25610848
  4. PMID: 22820538

 

Does My Child Need Dental Sealants? Pros, Cons, and Costs

Dental sealants are a preventive treatment that protects permanent teeth from tooth decay and cavities (dental caries). Sealants are particularly popular in pediatric dentistry because they can be applied to new teeth as they come in, protecting them immediately.

Even with all the best precautions like good oral hygiene and dental care, some children still develop cavities. Dental sealants can be a valuable part of your child’s oral health if the benefits outweigh the risks, like if they’re at extreme risk of developing tooth decay.

What Are Dental Sealants?

Dental sealants are a thin plastic coating placed on the chewing surfaces of the back teeth (molars) to prevent tooth decay. Acids produced by cavity-causing bacteria can’t reach the tooth through the coating, so cavities can’t form.

Sealants can be applied to permanent molars (first molars and second molars) directly after they erupt through the gums. They sometimes also apply sealants to premolars or smooth surfaces of the incisors, but those applications are less common.

Sealants are sometimes called pit and fissure sealants because they are principally used to fill in fissures and pits (which look like deep grooves) in the molars.

Dental Sealants By The Numbers

According to the CDC, dental sealants prevent 80% of cavities in molars in the first 2 years after they’re applied. About 90% of cavities form in molars, so it’s particularly important to protect these teeth. After 4 years, sealants still protect against 50% of cavities.

Sealant use is rising, particularly due to school-based sealant programs for low-income children at greater risk of developing cavities. Between 2011 and 2014, 39% of low-income and 48% of higher-income children had sealants on their teeth.

Do dental sealants last forever?

Although dental sealants have fairly good retention rates, they don’t last a lifetime. At most, they’ll stay on for about a decade. 

Factors that affect sealant durability include:

  • Eating acidic food
  • Chewing on hard items, such as ice or candy
  • Chewing on non-food items like fingernails
  • Tooth grinding
  • Using teeth to open containers
  • The material used to make the sealant
  • How well the sealants are applied

How long do dental sealants last on your teeth? Dental sealants last several years on your teeth, usually at least 2-4 years. However, they can stay on teeth for up to 9 years if they’re properly cared for.

If your child’s sealants come off, it’s possible to reapply them. Just another reason to take your child to their routine dental check-ups — during these visits, their dentist can check the sealants for damage.

Benefits of Sealants

What are the benefits of sealants? The benefits of sealants center around cavity prevention. They’re painless to install, and they last for years, unlike other tooth decay preventions.

Sealants can protect minor or deep grooves or pits that toothbrushes can’t reach. Occasionally, teeth have small dips that are too small for even a single bristle of a toothbrush to clean. Sealants can stop cavity-causing bacteria from growing in these spots.

Recently, public health officials have placed a significant emphasis on dental sealants, particularly for children at a higher risk of developing cavities, and they’re less likely to have sealants on their teeth. 

However, it’s possible that poor oral hygiene or poor diet could be driving these disparities, not sealants.

Risks of Sealants

What are some of the problems associated with dental sealants? Some of the problems associated with dental sealants include damage that can actually cause cavities and exposure to harmful chemicals like BPA.

If a sealant becomes cracked or chipped, bacteria can get into the space between the sealant and tooth, where they can cause major decay. It’s imperative that you have your child’s sealants checked regularly so that this trapped bacteria doesn’t happen.

One of the biggest risks of sealants is the plastic used to seal the teeth usually contains BPA (bisphenol A). BPA is a known endocrine disruptor that may increase the risk of developing certain types of cancer, cause infertility, and bring about early puberty.

It’s best to avoid products that contain BPA, but in the case of sealants, the benefits can outweigh the risks in certain cases. If your child is at an abnormally high risk of developing cavities, sealants may be a good option despite the risk of BPA exposure.

The Best Candidates for Dental Sealants

Children who have exceptionally deep grooves in their molars are ideal candidates for dental sealants. This is because food particles can get stuck in the nooks and crannies of the molars, feeding the bacteria that cause cavities.

Some childrens’ teeth are more prone to decay, like children who have abnormally thin tooth enamel (enamel hypoplasia). Sealants protect the already thin enamel from dental caries and other oral health issues. These kids may need sealants on both baby teeth and adult teeth.

Children who breathe through their mouths often can be candidates for dental sealants. Saliva protects teeth and fights cavity-causing bacteria. Unfortunately, mouth breathing dries out saliva, leaving mouth breathers at higher risk of tooth decay.

If you have a special needs child, you should ask their dentist whether they need sealants. Children with special needs often experience problems with their dental health, and sealants can help prevent some of those oral health problems.

At what age are dental sealants most effective? Dental sealants are most effective when applied right after molars erupt, around 6, 12, and 18 years of age. Sealants are also applied to premolars after they erupt through the gums between 9 and 13.

How are dental sealants applied?

Having your child’s dentist apply sealants is a relatively straightforward process. Sealant application is routine, and dentists perform in the dental office. It’s completely painless, so the process is also easy on kids.

If you choose to have sealants applied to your child’s teeth, here are the steps your dentist will take:

  1. The dentist or dental hygienist cleans the chewing surface of the tooth.
  2. The dentist dries the teeth that will be sealed.
  3. Cotton is placed next to the tooth so it will stay dry.
  4. The dentist applies an acid solution to roughen the tooth’s surface, ensuring that the sealant sticks.
  5. The acid is rinsed off and the tooth is dried.
  6. The dentist may paint a bonding material onto the tooth if needed.
  7. The dentist paints the sealant material onto the tooth and applies a curing light to harden it. 

Your child can eat and drink right away after the sealant is cured.

Costs for Dental Sealants

What is the cost of dental sealants? The cost of dental sealants averages between $30 and $60 per tooth. Your dental insurance or health insurance may cover most or all of the cost of your child’s dental sealants.

More Ideas for Cavity Prevention

Dental sealants can reduce your child’s risk of dental caries, but they can’t completely stop tooth decay from happening. 

Cavity prevention has many important parts, including:

  • Flossing: Flossing is incredibly important to prevent cavities, especially cavities between the teeth (interproximal cavities). The American Dental Association (ADA) recommends flossing daily to remove plaque that can cause tooth decay.
  • Brushing with a soft-bristle toothbrush and toothpaste: Ensure that your child is brushing at least twice a day, ideally after every meal. I recommend using fluoride-free hydroxyapatite toothpaste.
  • Get regular dental care: Getting regular dental check-ups is one of the best ways to maintain dental health. Your child’s dental hygienist will remove plaque and tartar your child has missed while brushing, and their dentist can catch tooth decay early.
  • Eating a tooth-friendly diet: The foods your child eats have a substantial impact on their oral health. A diet rich in fruits, vegetables, and lean protein gives your child the vitamins and minerals they need to grow and support healthy teeth and gums.
  • Use oral probiotics: There are both “bad” and “good” bacteria in your mouth. Good bacteria actually fight cavity-causing bacteria and promote oral health. An oral probiotic will help support the good bacteria in your child’s mouth.

The Last Word on Dental Sealants

Dental sealants are worth getting if your child is at extraordinary risk for tooth decay, which would mean the benefits outweigh the risks. Dental sealants have significant downsides, however, and if your child doesn’t truly need them, it’s not worth it. 

Good oral hygiene is much better at preventing cavities than sealants are. Combined with a healthy diet, good hygiene is the best way to maintain oral health and prevent tooth decay.

Sources:

  1. PMID: 25905651
  2. PMID: 17825522
  3. PMID: 18922505

Best Baby & Toddler Toothpastes 2021 [Plus Brushing FAQs]

Your child’s oral health is just as important as their physical health. The health of the mouth and body are highly connected. Poor oral health can cause significant problems throughout the body later in life, including heart disease, Alzheimer’s disease, diabetes, and more.

Choosing the best options for your child’s oral care isn’t always as simple as grabbing the first thing you see at the grocery store. It’s essential to choose the right toothpaste for a small child to ensure brushing is helpful and not harmful to their health.

As a pediatric dentist, I’ll talk you through selecting the best baby and toddler toothpastes for oral health and avoiding cavities in your child’s teeth.

Disclaimer: This post may contain affiliate links. That means I make a little money when you purchase the products I recommend through my links. (Don’t worry—you’ll pay the same price!) I only recommend products that I truly believe in and would give to my own children.

 
 
 
 
 
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Should Babies Use Regular Toothpaste?

Babies should not use regular toothpaste. In fact, you shouldn’t use regular toothpaste, either! Fluoride toothpaste can have many side effects.

Traditional toothpaste can contain nasty ingredients like:

  • Artificial colors
  • Artificial sweeteners
  • Artificial flavors
  • Artificial preservatives like parabens
  • Detergents like sodium lauryl sulfate (SLS) that can cause mouth ulcers and damage the lining of the mouth
  • Gluten (found in some children’s toothpaste)

I certainly wouldn’t let my little ones brush with that!

I recommend using fluoride-free toothpaste that contains hydroxyapatite, a mineral that makes up the majority of your tooth enamel. Many natural toothpaste brands contain hydroxyapatite, which offers excellent cavity protection. 

Hydroxyapatite works like fluoride to protect tooth enamel, but without the nasty side effects. It helps fill in any weak spots in the enamel, keeping your teeth strong and free of dental caries. In fact, it can actually work better than fluoride!

What is the difference between baby and adult toothpaste? The difference between baby and adult toothpaste is the amount of fluoride in the toothpaste. Traditional baby toothpaste generally doesn’t contain fluoride. Kids’ toothpaste usually has less fluoride than adult toothpaste.

Again, I recommend fluoride-free toothpaste for children.

Why can’t toddlers use normal toothpaste? Toddlers can’t use normal toothpaste with fluoride because they are still developing their swallowing reflex. Swallowing too much anticavity fluoride toothpaste can cause stomach upset and even cause fluoride toxicity

When Should I Start Brushing My Child’s Teeth?

Proper oral hygiene begins before your baby starts teething. Before your child’s teeth come in, you should care for their gums like you would their teeth. 

After feeding, you should gently rub your baby’s gums with a moist washcloth or gauze pad to remove any bacteria growing there. You can also buy xylitol wipes for your baby’s gums, which can be great if you’re in a rush.

When should babies use toothpaste? Babies should use toothpaste when their first tooth begins to come in. The American Academy of Pediatrics (AAP) and the American Dental Association (ADA) recommend using toothpaste when a baby’s teeth start to erupt through the gums. 

Even if your baby’s teeth are barely coming through their gums, it’s imperative to brush them. Breastmilk itself doesn’t cause cavities, but it accelerates tooth decay when it mixes with sugars from food in the mouth. Don’t skip brushing your baby’s teeth!

The best way to brush a baby’s teeth is with a baby toothbrush or a small soft-bristle toothbrush. Start with a squeeze of toothpaste the size of a grain of rice for kids under the age of 3. Brush at least twice a day and always before bed.

Gently brush all sides of each tooth and along the gumline. Once there is a possibility of little teeth touching, it’s time to start flossing as well. You should floss between your baby’s teeth at least once a day. Be sure to floss behind the back molars, too, after they come in.

Toddlers should brush their teeth just like you would brush a baby’s teeth. Use a small amount of toothpaste on a soft toddler toothbrush to clean all surfaces of the teeth. After your child turns 3, they should start using a pea-size amount of toothpaste to brush their teeth.

The best toothpaste for a 2-year-old or 3-year-old is the same toothpaste you would use for your baby. It should be fluoride-free and SLS-free and should have hydroxyapatite to strengthen enamel.

A simple manual toothbrush is wonderful for babies and toddlers. But, as your child gets to preschool age and older, electric toothbrushes can be a great way to get them excited about brushing their teeth, especially if they’re into tech and toys. 

Diet: The Key to Healthy Teeth

Choosing the right toothpaste is important, but brushing teeth isn’t the only factor in your little one’s dental health. 

Dental health actually starts with what you put in your body. If your child isn’t getting the nutrients they need, that can affect their mouth and teeth. In fact, diet is the foundation for oral care — though it doesn’t get the attention it deserves.

It’s essential to eat an all-around healthy diet packed with whole foods, but here are a few nutrition tips to follow for optimal oral health:

  • Eliminate refined carbohydrates: One of the key changes you can make in your child’s diet is eliminating refined sugar and flour. Refined carbohydrates like chips, crackers, and cookies cause cavity-causing bacteria to release a surge of acid that erodes tooth enamel.
  • Calcium: The enamel of your teeth is made of calcium phosphate. Your body needs calcium to keep your enamel strong and to help fight tooth decay.
  • Vitamin D3: Our bodies need vitamin D3 to absorb calcium properly. 
  • Vitamin K2: Vitamin K2 works alongside vitamin D3 to bring calcium into your teeth and bones.
  • Probiotics: A healthy oral microbiome (good bacteria in your mouth) is beneficial to the health of your mouth. Probiotics will help you support these good microbes.

If you’re breastfeeding or pregnant, be sure you’re taking good care of your own diet to ensure they’re getting essential nutrients as teeth grow. Teeth begin forming long before the teething stage.

Best Baby Toothpaste: 4 Fluoride-Free Options

Choosing the right toothpaste for your toddler or baby can be difficult. With so many options, how do you know you’re picking the right one? Here are my best tips as a pediatric dentist to help you choose the best baby toothpaste.

Avoid all kids fluoride toothpastes. You’ll also want a toothpaste that’s SLS-free. Avoiding fluoride and other harmful ingredients means passing on common store brands like Colgate, Orajel, or Crest Kid’s toothpaste.

Read the label of your baby’s toothpaste carefully. Even brands labeled as natural toothpastes often make kid’s toothpaste that contains fluoride and SLS.

Here are the top baby toothpaste brands I recommend.

1. RiseWell Natural Kids Toothpaste

One of the best toothpaste for babies is RiseWell Natural Kids Toothpaste. It’s made with hydroxyapatite, which helps remineralize the teeth and fight cavities. It’s a better alternative than fluoride and works just as well at preventing cavities.

RiseWell’s kids’ toothpaste also tastes like cake batter, which kids absolutely love. It contains xylitol, which helps fight the bacteria that cause bad breath and cavities. It’s made with natural flavors and tooth-friendly sweeteners. I recommend it because my own kids love it!

3. Jack N’ Jill Natural Kids Toothpaste

Jack N’ Jill Natural Kids Toothpaste is a fluoride-free toothpaste with xylitol for extra cavity protection. It comes in kid-friendly fruity flavors like strawberry, raspberry, and banana. It also comes in milkshake and bubblegum flavors, and there’s a flavor-free version, too.

3. Dr. Brown’s Natural Baby Toothpaste

You can find Dr. Brown’s Natural Baby Toothpaste on its own or as part of a toothbrush set. It comes in two mild fruit flavors: strawberry and apple pear.

4. Hello Toddler Training Toothpaste

Hello’s fluoride-free kids toothpaste is SLS-free. While many of their flavors contain fluoride, the apple does not. 

 
 
 
 
 
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Should Kids Have Fluoride?

No, kids should not have fluoride unless they have a specific medical reason to need it. (Adults shouldn’t have it, either!) In rare cases, the benefits of fluoride outweigh the risks. Your pediatric dentist can help you make the right decision for your child.

What does fluoride do? Fluoride helps strengthen the enamel on the outside of the teeth and prevents tooth decay. Most municipalities in the United States have fluoridated water because they believe it will help protect their citizens’ teeth.

Unfortunately, too much fluoride can have serious side effects, especially in kids. Research has shown that fluoride exposure can lead to symptoms of inattentive ADHD, tooth discoloration, and altered sleep patterns by the time they’re teens.

To prevent tooth decay, give your children toothpaste with hydroxyapatite. It’s much safer than fluoride toothpaste, and studies have shown that it works just as well.

Other Ideas for Strong Teeth

Though a diet full of nutritious whole foods is the foundation for strong teeth, it’s not the only component. There are also a few dental care items you can give to babies and young children to keep their teeth healthy and strong.

  • Infant Probiotic: An infant probiotic will help establish a healthy microbiome in your baby’s mouth. The beneficial microbes reduce your baby’s risk of getting cavities.
  • Cod Liver Oil: Cod liver oil is full of nutrients that support oral health, like vitamin D3, vitamin K2, and omega-3 fatty acids.
  • Primal Life Organics Tooth Powder: This tooth powder works like toothpaste to help clean and polish teeth. It comes in several kid-friendly flavors like bubblegum and cool orange.

These supplements will help you create a well-rounded foundation for your child’s oral health.

The Bottom Line: Healthy Teeth for Baby

It may seem like your baby is too young to go to the dentist, but that’s simply not true! I recommend bringing in your baby for a dental checkup within their first year.

During that first checkup, your pediatric dentist can make sure the child’s teeth and airways are developing correctly. A pediatric functional dentist can answer any questions you might have about taking care of their teeth, like choosing the right natural toothpaste.

To make shopping for a healthy mouth and baby easier, I’ve put together my favorites in my Amazon shop. There, you can find toothpastes, toothbrushes, and more. Happy brushing!

Sources

  1. PMID: 30839136
  2. PMID: 8653493
  3. PMID: 21504777
  4. PMID: 1607442
  5. PMID: 30316181
  6. PMID: 31818308

Cavity Between Teeth: Causes, Treatments, and Prevention

interproximal cavity child at dentist's office

One of the most common places to get a cavity is between the teeth. Technically called an interproximal cavity, these types of dental cavities (also called caries or tooth decay) often happen in tight spaces that are difficult to brush or floss.

Cavities happen when the hard outer layer of the teeth, the tooth enamel, starts to break down. The enamel is made of minerals like calcium and phosphate. As teeth lose these minerals in a process called demineralization, enamel gets weaker and more prone to cavities.

It’s easy to prevent interproximal cavities, luckily. It’s also relatively simple to treat cavities between your teeth if you catch them early enough. Regular dental checkups are essential so that your dentist can spot these cavities early in their development.

Signs Of A Cavity Between The Teeth

Cavities between the teeth can be difficult to see until they’re sizeable. That’s why they’re usually first found at a dental checkup. Your dentist takes bitewing x-rays to look for and identify interproximal cavities before they get too big. 

If you’re concerned you’ve developed a cavity (interproximal or otherwise) since your last dental visit, here are the most common symptoms:

  • Tooth sensitivity
  • Toothache or pain in your teeth, especially if it shows up suddenly
  • Pain when you eat or drink cold, hot, or sweet foods or beverages
  • Pain while chewing
  • Brown, yellow, or black spots or stains on the teeth
  • Pits or holes on the surface of the teeth
  • Bad breath

Is a cavity between the teeth painful? A cavity between the teeth can be painful if it reaches through the enamel to the second layer of the tooth, called dentin. Sensations travel more easily through the dentin to the nerves in the teeth, causing pain.

Can cavities spread to other teeth? Yes, cavities can spread to other teeth. An interproximal cavity on one tooth can create a home for cavity-causing bacteria. They secrete acids between teeth, which over time cause a cavity in the adjacent tooth.

Why Do Cavities Form Between Teeth?

Cavities form when enamel starts to weaken due to poor oral hygiene. Regular brushing and flossing help remove the bacteria that cause cavities. These habits are crucial in breaking up colonies of plaque that attempt to attach to the teeth. 

Proper dental care is one of the best ways to prevent cavities from forming between the teeth and elsewhere in the mouth.

Cavities form when bacteria in the mouth begin to proliferate after you eat sugary foods. As these bacteria multiply, they create plaque buildup, a biofilm that protects them and makes them harder to remove while brushing.

Without regular brushing and flossing, or when the oral microbiome is out of balance, bacteria can hide out between the teeth in crevices or places where they touch.

Over time, plaque hardens and turns into tartar, which is essentially impossible to remove with a toothbrush and dental floss. You’ll need to see your dentist to have it removed. 

As they grow, the bacteria secrete acids that break down and demineralize tooth enamel. Eventually, a small pit or hole forms in the enamel. Bacteria stick to the pit, where they’re even harder to remove, secreting more acid and making the cavity worse.

If you have regular dental checkups, your dentist can usually catch interproximal cavities before they get too deep. 

If you don’t treat the cavity early, the bacteria will eventually erode through the enamel and dentin and reach the pulp of the tooth, which will be painful and require more invasive treatment.

What causes cavities between teeth? Not flossing properly causes cavities between the teeth in most cases. People either don’t do a good job of flossing between their teeth or skip it altogether, allowing cavity-causing bacteria to build up in the crevices between the teeth.

In some cases, mineral deficiencies also allow the cavities between the teeth to develop more quickly.

What Do Cavities Between The Teeth Look Like?

Cavities between the teeth are difficult to spot unless they’ve gotten very large. If you see any discolored patches between your teeth that appear yellow, brown, or black, go see a dentist.

Early detection of interproximal cavities usually happens with bitewing x-rays at the dentist. When your dentist reviews your x-rays, they may see areas of enamel and dentin that look darker than the rest of the tooth. That’s a sign of a cavity, and they’ll recommend getting a filling.

 
 
 
 
 
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Interproximal Cavity Treatments & Costs

Can cavities between teeth be fixed? Yes, cavities between teeth can be fixed. The recommended treatment depends upon the size of the cavity and where it’s located.

You can heal a cavity yourself if it’s not too deep. If a cavity is forming in the outer half of the enamel, you can heal it by remineralizing the enamel there. Use hydroxyapatite toothpaste to remineralize and harden the enamel so that you won’t need a filling.

If the cavity goes through more than half of the enamel, or if it’s reached the dentin layer underneath, you’ll need a filling or more substantial work. Dental fillings are made of a composite resin — I strongly discourage amalgam — that bonds to teeth and replaces the decayed enamel. 

Fillings aren’t the same thing as dental crowns. Fillings are used to treat smaller cavities, while dental crowns replace the entire surface of the tooth. They’re used when a cavity is so big that the remaining tooth can’t support a filling.

If the cavity isn’t treated in the early stages and the inner pulp becomes infected, you’ll need a root canal. After a root canal, your dentist will usually cover the tooth with a dental crown. 

If the infection from a cavity is severe, the tooth may need to be extracted and replaced with a dental implant.

Here’s the cost by treatment:

  • Cavity: It usually costs between $150-$250 to get a cavity filled. Dental insurance will generally cover most or all of the cost after your deductible is met. 
  • Dental crown: Crowns run between $800-$3,500 without insurance. 
  • Root canal: A standard root canal can cost upwards of $1,800. You’ll likely also need to pay for a crown if a root canal is necessary.

How To Prevent A Cavity Between Teeth

Getting a cavity is no fun, but luckily you can avoid them altogether. 

Here are the top ways to prevent cavities from forming between your or your child’s teeth:

  • Having good oral hygiene
  • Using hydroxyapatite toothpaste
  • Eating a healthy diet
  • Avoiding snacking
  • Eating more calcium
  • Eating more vitamin D3 and K2
  • Taking oral probiotics
  • Breathing through your nose
  • Oil pulling
  • Dental sealants

Let’s break down each of these preventative measures.

Good Oral Hygiene

Proper dental hygiene, such as flossing every day and brushing at least twice a day, is the best way to prevent interproximal cavities. It’s crucial to floss carefully between the teeth and below the gum line to make sure you remove as much plaque as possible.

Use Hydroxyapatite Toothpaste

Brush with a hydroxyapatite toothpaste instead of fluoride toothpaste. You’ll help restore your enamel without all of the nasty side effects of fluoride.

Traditional dentistry recommends a fluoride gel to remineralize teeth, but fluoride can cause many concerning side effects. Instead, I recommend using hydroxyapatite to remineralize teeth. Hydroxyapatite works just as well as fluoride, but it’s safer to use.

Make sure to brush all of the flat surfaces and chewing surfaces of the teeth. You should always brush your teeth before bed to avoid overnight plaque buildup.

Eat a Healthy Diet

Eating a healthy and well-balanced diet full of fruits, vegetables, and other whole foods is one of the best things you can do to support your oral health. You’ll give the body the nutrients it needs to support healthy teeth.

Skip Snacking

Avoid snacking, which gives cavity-causing bacteria more fuel to grow and spread. If you can’t resist, be sure to brush your teeth after you’re done.

Be particularly mindful not to snack on foods with refined sugars or refined flour, like crackers. Crackers are terrible for kids’ teeth! 

Get The Right Nutrients

Eat more vitamins K2 and D3, or take a supplement that contains these vitamins. These vitamins work in conjunction to help your body absorb calcium from the foods you eat, preventing tooth decay and demineralization.

In conjunction with vitamins K2 and D3, make sure you’re getting enough calcium, which your body uses to strengthen and remineralize enamel. Calcium-rich foods include leafy green vegetables, legumes, tofu, seafood, and dairy products.

Oral Probiotics

Chewing an oral probiotic supports the healthy flora in your mouth. Unlike a typical probiotic that you swallow, an oral probiotic works right where the cavity-causing bacteria live. Probiotics help buffer enamel-harming acids and actively fight against pathogenic bacteria.

Breathe Through Your Nose

Mouth breathing negatively impacts teeth. When you breathe through your mouth instead of your nose, it dries the saliva in your mouth. Saliva helps kill the bacteria that create cavities, and without it, you’re much more likely to have cavities and other oral health problems.

Oil Pulling

Oil pulling is a great way to prevent cavities naturally, including cavities between your teeth. Oil pulling helps reduce plaque and gingivitis and fights cavity-causing bacteria in both kids and adults. Pulling oil can also reach between teeth, complementing a flossing habit.

Oil pulling is simply swishing organic oil (my favorite is virgin coconut oil) in your mouth for several minutes before spitting it out. I recommend starting out by swishing for a minute or two, then gradually working your way up to swishing for 20 minutes.

Dental Sealants

If you or your child have thin enamel due to enamel hypoplasia or another condition, dental sealants could be a good option. They provide a protective barrier over the enamel so bacteria can’t cause tooth decay.

 
 
 
 
 
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Why Are Interproximal Cavities So Common?

Interproximal cavities are so common because most people don’t floss properly or frequently enough. Many people skip flossing because they think they don’t have the time. 

It’s better to spend a few minutes flossing today than a few hours in the dentist’s chair later. Flossing is perhaps the most important thing you can do to improve your oral health overall. 

Careful flossing can reduce kids’ risk of getting cavities between the teeth by 40%. Unfortunately, many children and teens feel unmotivated to floss, which is why so many get cavities. I like to read to my children or have a dance party as we floss to make flossing fun.

The average person only removes 60% of the plaque between teeth when they floss. It’s a good idea to spend a little extra time flossing to make sure you’re removing everything you can. Supervise your kids’ flossing as much as possible to make sure they’re effectively flossing.

Cavity Between Teeth: The Final Word

Cavities between teeth are extremely common, but they’re also highly preventable. If you and your kids have good oral hygiene and eat a healthy diet full of essential nutrients, you’ll be well on your way to preventing interproximal cavities. 

Sources

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Enamel Hypoplasia: Signs, Prevention, and Treatment Options

girl smile
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Enamel hypoplasia is one of the less-discussed conditions that can affect children’s teeth as they come in. If you’re interested in prevention or your child has been diagnosed, don’t panic! Here’s what you need to know about the signs, prevention, and treatment of enamel hypoplasia.

What is enamel hypoplasia? Enamel hypoplasia occurs when a growing tooth has too thin or incomplete enamel. Dental enamel is the hard outer layer of the tooth that protects the inner, sensitive parts of your teeth from injury and bacteria. 

When a tooth doesn’t have enough enamel, it’s more likely to develop cavities (also called dental caries or tooth decay). 

Enamel hypoplasia is primarily diagnosed in children. Sometimes dentists notice it in the primary teeth (also called baby teeth or deciduous teeth), but occasionally it happens in the permanent teeth. Early detection is one of the reasons I recommend a first dental visit within the first year.

Pediatric dentists are trained to look for enamel defects that can cause problems later in life. Because enamel hypoplasia can cause so many major dental issues, treatment is an essential part of an affected child’s oral health.

Can you fix enamel hypoplasia? Enamel hypoplasia is treatable, fortunately. Pediatric dentistry can use a variety of methods to treat enamel hypoplasia. These treatments include applying materials to strengthen the enamel and protect the layers underneath. 

You can even help protect and repair enamel at home using diet, oral hygiene, and proper breathing.

Enamel Hypoplasia Symptoms

What are the symptoms of enamel hypoplasia? The symptoms of enamel hypoplasia include changes in how the teeth look and feel. Patients with hypoplastic enamel can have discolored, sensitive teeth with lesions that are prone to decay.

What does enamel hypoplasia look like? Enamel hypoplasia often looks like:

  • Small grooves on the surface of the tooth enamel
  • Pitting of the enamel
  • White spots on the surface of the teeth, often on the central incisors
  • Yellow-brown discoloration

Thin enamel lets you see through to the dentin, the second layer of the tooth. Dentin is generally a grayish-yellow color, which is why teeth with hypoplastic enamel often look yellowed or dingy.

Other symptoms of enamel hypoplasia include:

  • Tooth sensitivity (because there isn’t enough enamel to protect the tooth)
  • A high number of cavities (caries)

Is enamel hypoplasia painful? Yes, enamel hypoplasia can be painful. Enamel helps protect the sensitive pulp of the tooth. The thinner the enamel is, the more sensitive the tooth will be. 

Mild cases of enamel hypoplasia may experience general tooth sensitivity, but severe cases may be painful.

Causes of Enamel Hypoplasia

What causes hypoplastic enamel? Enamel hypoplasia is caused by genetics, environment, or sometimes a combination of both. During tooth development, something goes wrong with the matrix formation of enamel. The enamel is very thin and weak or is deposited unevenly.

Genetic Causes of Enamel Hypoplasia

There are a handful of genes that are strongly associated with enamel hypoplasia. In these cases, the condition is called amelogenesis imperfecta. 

In amelogenesis imperfecta, the genes that control enamel formation and development don’t function properly in the ameloblasts, cells that create the teeth. Teeth often develop with very little enamel. Thankfully, there is a very low prevalence of this condition.

Environmental Causes of Enamel Hypoplasia

Enamel hypoplasia can also be caused by environmental factors. When an infant or child experiences certain conditions while the teeth are developing, they may grow hypoplastic enamel.

Common environmental factors that cause enamel hypoplasia include:

  • Tooth injury
  • Infections
  • Calcium deficiency
  • Vitamin A, C, or D deficiency
  • Maternal health
  • Premature birth
  • Low birth weight
  • Celiac disease
  • Fluorosis (too much fluoride)

The good news is that we can address many of these environmental factors to reduce the risk of your child developing enamel hypoplasia.

Do humans have thick enamel? Humans have thick enamel when compared to the dentition of closely related species like chimpanzees and gorillas. In fact, it’s roughly as hard as steel.  Scientists think that our thick enamel helps us chew hard foods that other animals can’t eat. 

Risks and Complications

The primary complication of enamel hypoplasia is tooth decay. Because the enamel layer is so thin, people with hypoplastic enamel are at a much higher risk of developing caries. Untreated tooth decay can lead to severe pain, root canals or tooth extraction, or even infections.

What happens if you have no enamel on your teeth? If you had absolutely no enamel on your teeth, they would be quite sensitive to hot and cold food and drinks. They would be a brownish-yellow color and have a rough texture. 

Your teeth would also decay and get cavities quickly. Fortunately, it is rare to have no enamel whatsoever. Most people have at least some enamel on their teeth. 

Treatment Options

What is the best way to fix enamel hypoplasia? There are several very effective treatments for enamel hypoplasia. These treatments all focus on maintaining a thick protective layer over the tooth, either by strengthening the existing enamel or putting another material on top.

Maintaining Thin Enamel

It’s best to maintain the existing enamel, if possible. In mild and moderate cases of enamel hypoplasia, dentists will apply treatments to the enamel to help harden it. Severe cases generally require more extensive procedures to preserve the tooth.

At home, make sure your child is brushing your teeth twice a day with a hydroxyapatite toothpaste and a soft toothbrush. It’s also important to floss at least once a day to protect the enamel between the teeth. 

Tongue scraping will help remove harmful bacteria from the mouth so they can’t cause tooth decay. Consider adding oil pulling, too, to reduce inflammation and balance the microbiome.

 

What Your Dentist Can Do

There’s a lot your child’s dentist can do to help keep their enamel and teeth healthy. Here are a few of the most popular in-office treatments for enamel hypoplasia:

  • Resin-bonded sealant: Sealants are frequently used on the permanent molars to provide an extra protective barrier over the enamel. 
  • Dental bonding: A dentist bonds resin to the tooth, covering any weak enamel. This is similar to a composite filling.
  • Composite fillings: If there is already tooth decay, your dentist may recommend a composite filling. (Amalgam fillings are not recommended for children under 6 years of age. However, I suggest avoiding them for all ages since they contain mercury).
  • Dental crowns: Dental crowns may be the best choice for teeth with a lot of damaged enamel. It completely covers the tooth, fully protecting it.
  • Tooth extraction: As a last resort, highly damaged teeth may need to be removed.

Some dentists recommend a fluoride varnish, but I think there are preferable and less risky ways to protect young teeth. As mentioned in one of the previous sections, fluorosis can cause some cases of hypomineralization.

How much does it cost to fix tooth enamel? Here are the average costs of the most common enamel hypoplasia treatments:

  • Sealant: $30-$40 per tooth
  • Bonding: $200-$600 per tooth
  • Fillings: $150-$550 per tooth
  • Crowns: $500-$2,000 per tooth
  • Tooth extraction: $150-$650 per tooth

Insurance often covers at least part of the cost of these procedures, so your out-of-pocket expense may be lower.

How To Prevent Enamel Hypoplasia in Kids

Prevention is critical, especially when it comes to the enamel of your kids’ teeth. Enamel can be strengthened and reinforced, but it can’t be replaced.

Here are some great ways to help your children take care of the enamel on their teeth:

  • Healthy diet for breastfeeding mothers: Your baby’s teeth are developing inside their gums as you’re breastfeeding. It’s vital that they get the vitamins and minerals from breastmilk they need to build strong teeth. Make sure you’re eating plenty of whole foods and a variety of fruits and vegetables. I recommend taking vitamin D3 and K2 supplements as well.
  • Wipe your baby’s gums: Wiping your baby’s gums with a soft cloth or toothbrush breaks up bacterial colonies that might be growing on the surface. Practicing good oral hygiene with your infant can prevent infections that might lead to enamel hypoplasia later. It also sets the stage for healthy brushing habits once their teeth come in.
  • Feed your kids healthy foods: As I always say, be sure to eat the rainbow! Avoid the malnutrition that causes developmental defects of enamel by eating a diet full of healthy, whole foods. They should be eating foods rich in calcium, vitamin A, and vitamin D.
  • Avoid sugary, gummy foods: Certain foods like fruit snacks or crackers can stick to teeth and promote tooth decay. Try to keep processed, high-sugar, and high-carb foods out of your kids’ diet as much as possible, or choose xylitol candy when a sweet tooth strikes.
  • Practice good oral hygiene: Patients with hypoplastic enamel need to do everything they can to prevent tooth decay. Regular brushing with a hydroxyapatite toothpaste and flossing can also help strengthen the enamel your child does have. 
  • Use alkalizing mouthwash: Acids can weaken and break down tooth enamel. Alkalizing mouthwash counteracts the acids by neutralizing the mouth’s pH, which can help kill harmful bacteria growing in the mouth. 
  • Don’t breathe through the mouth: Mouth breathing dries out the mouth, which creates a friendlier environment for harmful bacteria. Help your child breathe through their nose as much as possible to keep bad mouth bugs at bay.
  • Oral probiotics: You may already take a probiotic to support the beneficial bacteria in your gut. Consider adding oral probiotics to your kid’s daily routine to support the good bacteria in their mouth.

A diagnosis of enamel hypoplasia may sound scary, but there are a lot of things you can do to protect your child’s teeth. Better yet, it’s possible to prevent it from happening in the first place, whether in baby or permanent teeth.

When To See A Dentist

If your child has any of the symptoms of enamel hypoplasia, you should bring them to see a dentist. A pediatric dentist will look for proper enamel development at each exam. I recommend bringing children in before their first birthday.

The most effective enamel hypoplasia treatments will address both the teeth and the root cause of the weakened enamel. Functional dentistry encourages parents to take an active role in their child’s oral health by feeding them the right foods and practicing good dental hygiene.

No matter how much enamel your child has, you and your dentist can create a plan for a nutritious diet and fantastic oral hygiene that improves their oral health and quality of life.

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How to Get Rid of Cavities: 9 Home Remedies + Prevention

smile teeth happy
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There are several home remedies to get rid of cavities, as well as effective prevention methods that anyone can (and should) do for their dental health — and overall wellness.

It’s the dreaded phrase no one wants to hear at their annual exam: “you’ve got a cavity.” It’s important to understand what that phrase means, how some cavities can be treated at home, and how to prevent more cavities.

What causes cavities? Plaque and acid sitting on the teeth cause cavities. Pathogenic (bad) bacteria in the mouth produce acids that eat away at a tooth’s enamel. Enamel erosion causes demineralization and tooth decay. Small holes (dental cavities) begin to form in the tooth.

Now, for the good news: In some cases, you can get rid of a small cavity without a filling. Some smaller cavities can be reversed through a process called remineralization.

Remineralization restores weakened enamel, replacing essential minerals to strengthen the tooth’s outer layer. We’ll discuss the top 9 ways to remineralize and reverse small cavities, all of which double as prevention methods for cavities.

What are some symptoms of a cavity? The symptoms of a cavity include:

  • Tooth sensitivity
  • Pain in the tooth
  • Toothache
  • Bleeding or swollen gums
  • Tooth discoloration
  • Small hole in the tooth
  • Bad breath (halitosis)

Unfortunately, not all cavities are treatable with remineralization. This option will only work in the early stages of tooth decay, or the pre-cavity stage.

If you notice pain, visible holes, or bleeding accompany your cavity, it’s time to see a functional dentist, who will tell you if remineralization is still an option.

If the damage is treatable, here are 9 ways to reverse your cavity at home and prevent future decay.

1. Use hydroxyapatite toothpaste.

Not enough people know about hydroxyapatite toothpaste. It’s as effective as fluoride toothpaste but without most of the potential side effects.

For years, fluoride toothpaste has dominated the market, but mainstream toothpastes often come with concerning chemicals. One of the problematic materials is SLS, which causes skin irritation and ulcers, and is often found in laundry detergent.

Other troubling ingredients include triclosan, which may trigger allergic reactions or antibiotic resistance, and silica, which wears down enamel.

Fluoride itself has a long list of concerns as well, including neurotoxicity in large doses, staining teeth, and even weakening bones. Particularly for kids, it’s bad news. Honestly, a wet toothbrush without toothpaste might be overall better than fluoride toothpaste.

That’s why I recommend hydroxyapatite toothpaste. This fluoride-free toothpaste is just as effective at cavity prevention, but with far more benefits. Hydroxyapatite is:

  • Microbiome-friendly. Fluoride kills bad bacteria, but also some good ones. Hydroxyapatite balances your oral microbiome and makes it more difficult for bad bacteria to attach to teeth.
  • Biocompatible. Hydroxyapatite is safe to swallow — enough so that you could swallow a whole tube! Especially since kids are still developing their swallowing reflex, this can bring a lot of peace of mind since swallowing fluoride can lead to fluorosis.
  • Naturally whitening. Hydroxyapatite naturally helps the teeth to appear whiter. Instead of the discoloration that fluoride treatments can induce, hydroxyapatite improves tooth coloring and appearance.
  • Reduces sensitivity. Hydroxyapatite is a natural way to treat tooth sensitivity, reducing the pain that comes from worn-down enamel.

Seeing as hydroxyapatite makes up 97% of enamel, it’s simply a better way to remineralize the teeth.

While you’re practicing your dental hygiene, don’t forget to…:

  • floss, which is crucial for controlling interdental plaque.
  • …scrape your tongue with a metal tool can also help to balance oral bacteria.
  • …skip the mouthwash since most mouth rinses dry out the mouth and kill good bacteria.

2. Eat a tooth-friendly diet.

What you eat provides the building blocks for your teeth, either contributing to decay or preventing it. Eating sugary foods or simple carbs like crackers and chips or drinking sweet beverages like juices and sodas can speed up cavity development.

The bottom line for tooth-friendly foods: Avoid carbohydrates and sugar intake!

What is the best way to prevent cavities? The best way to prevent cavities is to eat a diet that strengthens your teeth while practicing proper oral hygiene.

For a tooth-friendly diet, you’ll want to eat primarily whole foods:

  • Fruits
  • Vegetables
  • Grass-fed dairy and meats
  • Pastured eggs
  • Wild-caught fish
  • Fermented foods

I tell people to shop the perimeter of the grocery store instead of opting for processed foods in the middle aisles.

It’s also important to “eat the rainbow,” choosing many different colors of fruits and vegetables to ensure you’re getting the most nutrients possible.

You’ll want to opt for remineralization-friendly foods full of vitamin D, calcium, omega-3 fatty acids, and antioxidants to “get rid of” small cavities. In other words, reduce and remineralize.

 
 
 
 
 
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3. Chew sugar-free gum.

Sugar-free gum, specifically gum sweetened with xylitol, can be a powerful agent in cavity prevention. Make sure to grab a piece after meals for a sweet treat that’s kind to teeth.

Chewing xylitol gum after a meal can wash away harmful bacteria and food particles in your teeth, removing them before they become a problem.

If your microbiome needs help, xylitol can also reduce the overall number of harmful bacteria in your mouth. While it’s balancing bacteria, xylitol is also able to make plaque less sticky, inhibiting it from clinging onto your teeth as effectively and making it easier to brush off.

Sugar-free gum should be your go-to after eating out or a quick snack. Those are amazing benefits from a piece of gum!

Warning: Don’t let your dog accidentally consume xylitol. Their digestive systems don’t know how to handle it.

4. Oil pull.

Oil pulling is growing in popularity as people understand its myriad benefits. While the name may sound mysterious, the process is simple: Swish organic oil around the mouth for up to 20 minutes, then spit it into the trash.

Oil pulling has been practiced for thousands of years in Ayurvedic medicine, and modern science recommends it as well. Research has shown that oil pulling can:

You can start with as little as a minute or two and work your oil pulling up to higher lengths of time. It’s possible to pull with many different types of oil, but my personal favorite is coconut oil.

5. Chew oral probiotics.

The mouth has its own distinct combination of bacteria and microorganisms. An oral probiotic can boost the amount of helpful bacteria in your mouth, and chewing them is the most effective delivery system.

People who are more cavity-prone, as well as those trying to reverse a cavity, can benefit from oral probiotics introducing more of these helpful bacteria.

Gut probiotics are more common to see and help maintain a positive bacterial balance in the digestive system. However, the oral microbiome has different native bacterial strains and therefore needs its own supplement.

Oral probiotics can prevent and combat tooth decay with little to no side effects. They typically come in chewable tablets or lozenges, and are best taken in the morning right after your A.M. dental care routine.

6. Breathe through your nose.

Dental health is closely linked to your airway health. Mouth breathing or sleep disorders can cause the oral tissue to dry out, reducing the saliva that protects the teeth and leaving the teeth exposed to decay.

People who breathe through their mouth are much more likely to experience gum issues and dental caries.

Common signs of daytime or nighttime mouth breathing include:

  • Snoring
  • Misaligned teeth
  • Chronic cold or stuffy nose
  • Feeling fatigued even after a full night’s rest
  • Sucking on the thumb or fingers (in children)
  • Behavioral issues (particularly in children)

All of these symptoms can indicate airway issues. A functional dentist can look at these issues and treat the root cause, preventing cavities and clearing up the airway for optimal health. If you are trying to reverse a cavity, mouth breathing is not an option.

Breathing through the nose not only keeps the mouth moisturized. It provides valuable nitric oxide that helps the body heal and supports cardiovascular health. You’ll be preventing cavities and feeling rested in no time.

7. Consider dental sealants.

Dental sealants are thin coatings that are adhered to the surface of back teeth. Covering the molars and premolars can be an excellent option for certain patients, keeping bacteria away from the enamel and providing added protection for hard-to-reach teeth.

Dental sealants are primarily used in children and early teenagers. They can be a good option for cavity prevention in the following types of patients:

  • Little ones with a particularly high cavity risk, whether genetic or due to lifestyle factors
  • Kids who naturally have deep grooves in their molars, which can trap bacteria and be difficult to brush
  • Children who have just had their first set of molars erupt, around age 6
  • Adolescents who have just had their permanent molars or premolars erupt, around age 12
  • Children who have special needs that make brushing and flossing a challenge

However, dental sealants are not a good option for children who have existing decay on the back teeth, grind their teeth, or have acid reflux. These factors can wear down the sealant material.

Also, technique matters! Ideally, look for a dentist who uses cavity-detecting cameras or scanners prior to placing them. Using ozone to disinfect is another great sign that a dentist is looking out for your overall health.

A good dentist should use biocompatible materials for dental sealants and fillings. Ceramic-based sealant material is far superior to BPA or bis-GMA plastics. The material used should also be based on your child’s tooth anatomy and cavity risk.

8. Supplement with vitamins D3 and K2.

Even when eating a tooth-friendly diet, it can be challenging to get every nutrient in large enough quantities to remineralize the teeth. Vitamins D3 and K2 are two crucial nutrients for oral health that most people are deficient in — up to 90% of the population could use more!

When trying to reduce and remineralize cavities, vitamins D3 and K2 build healthy layers of enamel and dentin while helping your body absorb the calcium it needs. Together, they contribute to a robust outer surface for the tooth.

Other tooth-friendly supplements include licorice root, calcium, and hydrolyzed collagen.

 
 
 
 
 
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9. See your dentist.

Don’t skip your twice-yearly visits to your dental practice. Regular checkups and cleanings can help catch cavities early, when they can still be remineralized with home remedies. 

Additionally, once plaque is allowed to sit undisturbed for 48 hours, it hardens into tartar that only a dentist can remove. Frequent cleanings are crucial in preventing tooth decay and gum disease caused by tartar under the gumline.

Left untreated, larger cavities will spread into the inner layers of the tooth, hitting the sensitive dentin and even infecting the soft tissue (pulp). Other treatment options may be necessary as the cavity progresses, depending on the severity of the decay.

Here’s what your dentist can provide for you, depending on the level of decay:

  • Fillings. These minor procedures treat small cavities that are still contained to the enamel surface of the tooth.
  • Crowns. Crowns can be used when there are large cavities, or when the decay has reached the dentin layer. They cover the entire surface of the tooth.
  • Root canals. Root canal procedures remove the soft tissue from inside the tooth, then cover that tooth with a crown.

No matter what stage your decay is, there are treatment options available. You can always get rid of cavities: at home in the early stages, or with your dentist in later stages.

Want more free dental health tips and tricks? Sign up for my email newsletter. I promise, your teeth will thank you.

 

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What Is Tooth Enamel? How To Avoid Enamel Erosion

tooth enamel cute boy smile

Perhaps you’ve just visited your dentist and have questions. Maybe you’re just starting to explore the world of dental health (in which case I’m glad you’re here)! Either way, you’ve got foundational questions about the structure of teeth — like tooth enamel.

What is tooth enamel? Tooth enamel is the outermost layer of the tooth surface. Enamel is a hard shell made up of minerals that covers and protects more sensitive tooth tissue. It does not contain living cells. The color of healthy enamel ranges from gray- or blue-white to light yellow.

What is the role of tooth enamel? The role of tooth enamel is to guard your teeth against decay, bacteria, plaque, acids, and any daily wear or tear that threatens your tooth’s health. It is the hardest substance in the human body and has a Mohs hardness scale similar to steel.

While the definition of tooth enamel is widely agreed upon, how to care for it is a different story. Integrative dentistry believes in treating root causes of enamel issues and building stronger enamel to promote overall health. 

Tooth enamel loss can be prevented, and in some cases, even restored. Let’s dive into defining tooth enamel and how to avoid enamel erosion.

What causes tooth enamel loss?

Tooth enamel is a changeable substance within the body. It can be reinforced or reduced, depending on many environmental erosive factors. 

There are several causes of tooth enamel loss, AKA dental erosion:

  • Abrasion. This is physical wear and tear on the outer layer of the tooth, which can be caused by improper use of floss, toothpaste, or a toothbrush, chewing on hard objects like pens and nail biting, and chewing tobacco use.
  • Attrition. This is the deterioration of teeth due to friction with other teeth. The most likely culprit here is bruxism, or tooth grinding, which is related to stress. Bruxism often affects the molars, though it can occur on any tooth.
  • Abfraction. Flexing or bending the tooth beyond its capacity can crack the tooth and cause a form of erosion known as abfraction.
  • Corrosion. This is tooth decay caused by acid attacking the enamel surface. It may occur from very acidic food, GERD (gastroesophageal reflux), acid reflux, fruit juices, vomiting (especially due to bulimia or alcoholism), aspirin, excessive whitening, or vitamin C tablets. These culprits eat away at the surface of the tooth over time.

Signs of Enamel Erosion

How do I know if I have enamel erosion or not? You can quickly see if you have enamel loss by looking at two things: color and condition. A yellowish color or cracks and damage to the tooth structure may indicate thinning tooth enamel.

What are the main signs of enamel erosion? The main signs of enamel erosion include:

  • Mild sensitivity. When enamel begins to wear away, it can expose the more sensitive layer below, called dentin. Dentin quickly registers changes in heat, cold, and sweets (which feed the acids that cause tooth decay).
  • Intense sensitivity. Sharp, severe pain from the hot, cold, and sweet sensations in the mouth can occur in the later stages of enamel erosion.
  • Discoloration. The teeth can take on a yellowish color when more of the dentin layer is exposed.
  • Cracks and chips. The edges of teeth take on a more jagged appearance, feeling rougher and more irregular as the enamel wears down.
  • Indentations. Also known as cupping, small dents can appear in your teeth as enamel wears thin.

Tooth enamel can also begin to develop dental caries (tooth decay) more easily. If you’re experiencing frequent dental issues or cavities, eroded enamel may be to blame.

Can you rebuild tooth enamel?

You can restore demineralized tooth enamel, but you cannot rebuild tooth enamel entirely once it’s gone. When you notice weakening enamel, make necessary changes in your diet, lifestyle, and oral care.

The first step in losing tooth enamel is called demineralization. This occurs when the acid produced by bacteria eats away at the minerals that make up the enamel. These minerals include fluoride, hydroxyapatite, and the calcium and phosphate ions that help to restore teeth.

Teeth can also be remineralized. In this process, you can replenish the minerals that have worn away, weakening the enamel. Fluoride and hydroxyapatite treatments aim to remineralize tooth enamel.

Protecting Your Tooth Enamel

In functional dentistry, addressing root causes of demineralization is preferable to dealing with cavities down the road. Protecting your tooth enamel is undeniably a better option than trying to remineralize your teeth after the enamel has eroded away.

How do you stop enamel loss before it starts? Stopping enamel loss before it starts involves a combination of several preventative measures:

  • Get the best nutrients. Vitamins K2, D3, and essential minerals are all crucial dietary factors to build healthier teeth.
  • Avoid mouth breathing. Breathing through the mouth can dehydrate oral tissues, creating a friendlier environment for bacteria to demineralize the teeth. Mouth taping at night or retraining yourself or your child to breathe through the nose during the day can help!
  • Oral probiotics. Oral probiotics are a great option to balance the microbiome in the mouth and fend off an acid attack.
  • Limit phytic acid intake. Often found in whole grains, legumes, nuts, and plant-based oils, phytic acid reduces your ability to absorb certain minerals that help build tooth enamel. Try sprouting, fermenting, or soaking the phytates in your diet — particularly when kids are involved.
  • Practice oral hygiene. Both brushing and flossing are vital in preventing demineralized enamel for children and adults. I also recommend tongue scraping to keep the oral microbiome well-balanced.
  • Flossing. Flossing removes buildup of plaque from in between teeth. This prevents plaque bacteria from eating away at the tooth enamel that toothbrushes don’t reach.
  • Alkalizing mouthwash. An acidic oral environment can promote enamel loss. An alkalizing mouthwash neutralizes the harmful bacteria that break down tooth enamel.

For more on prevention, diet, and handy oral health tips, check out my Instagram!

Treatment of Enamel Loss

While prevention is the best possible outcome, it’s simply not possible in some cases where enamel loss has already begun. 

How do you fix tooth enamel? You can often fix tooth enamel by restoring the minerals it has lost. This process is called remineralization. The best ways to rebuild demineralized teeth are to change your lifestyle and diet and to practice holistic oral hygiene. 

Minerals to add back to tooth structure include calcium phosphate, magnesium, potassium, and hydroxyapatite.

Consider an oral probiotic to restore the good bacteria and other organic material within your oral microbiome.

Dietary Overhaul

Diet is the key to overall health, and changing what you eat can give your body the essential minerals it needs to remineralize enamel.

Ensure these vitamins are in your diet for optimal dental health:

  • Vitamin K2
  • Vitamin D3
  • Vitamin A
  • Vitamin E

Essential minerals for restoring teeth include:

  • Calcium
  • Magnesium
  • Phosphorus

I recommend eating the rainbow, with lots of whole fruits and vegetables, as well as grass-fed dairy and meats.

Oil Pulling

Oil pulling involves swishing organic oil around in the mouth for up to 20 minutes. This habit can moisturize the mouth, inhibit plaque, and support strong enamel.

Additionally, oil pulling doesn’t have the same drying effect as many traditional types of mouthwash. Conventional mouthwash kills positive bacteria in the mouth and promotes dry mouth. Please, don’t use alcohol-based mouthwash.

Personally, I prefer organic coconut oil for this healthy practice.

Hydroxyapatite Toothpaste

Hydroxyapatite toothpaste is one of the best options for your oral hygiene routine.

Hydroxyapatite makes up 97% of the tooth. A toothpaste containing hydroxyapatite crystals can help restore the minerals that build strong enamel.

My personal favorites are Risewell (use my code DOCTORSTACI for 10% off) and Boka (use my code DOCTORSTACI for 20% off).

Switch to Sugar-Free Gum 

Saliva contains calcium and phosphorus, agents that assist in remineralizing enamel. Chewing on sugar-free gum can help increase the saliva circulating through the mouth.

I recommend xylitol gum, which seems to promote oral health beyond just saliva production. Xylitol is almost 0-calorie but still sweet because it’s a sugar alcohol. (Definitely don’t let your dog eat any xylitol products.)

A Note On Toothpaste

Many traditional dental professionals suggest fluoride toothpaste. However, I do not recommend it to my patients for their overall health care. 

Hydroxyapatite toothpaste is proven to work as well as fluoride toothpaste, but without the potential side effects.

When to Visit the Dentist

In some more severe cases of enamel loss, remineralization is not possible. The enamel may be extremely damaged, or lifestyle changes may not be the right choice for that specific case.

What happens if tooth enamel is gone? If tooth enamel is gone, certain dental procedures like fillings, crowns, or veneers may be necessary. Make sure to use biocompatible materials, not heavy metals like mercury amalgam.

If you are experiencing painful tooth sensitivity, cracking and chipping in the teeth, or cupping in the teeth, it’s time to see a dentist and create a plan for treating enamel loss.

Sources

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Tooth Decay: Symptoms, Stages, Causes, and Prevention

Smile happy girl pink

Tooth decay is a pressing topic across all ages. 

42% of children ages 2 to 11 have cavities in their baby teeth, and 21% of children in that age range already have developed them in their permanent teeth. 

For adults, 92% of us have experienced tooth decay.

Here’s the good news: even if you have a history of dental issues, you can skip the headache (and the toothache) moving forward, stopping cavities before they start. 

Let’s take a look at the symptoms, stages, causes, and prevention techniques you need to know to send away tooth decay.

What is tooth decay?

Tooth decay refers to small spots where tooth enamel or dentin has been eaten away by acid, eventually growing and spreading throughout the tooth. Advanced tooth decay, also called cavities or dental caries, is the number one preventable disease in the world.

This decay process can happen on any part of the tooth: on the smooth surface of the sides, at the root, between teeth (interdental spaces), or on the ridges at the top.

Tooth decay damages and eventually begins to break down the teeth if left untreated. Even a small cavity or spot is worth taking seriously.

If you’re caring for your children’s teeth, it’s crucial to be proactive about cavities. The Centers for Disease Control and Prevention (CDC) calls it “the most common chronic disease in children ages 6 to 11.”

Everyone from nursing children to dentists ourselves can develop tooth decay. It’s essential to understand how a cavity can develop so you can catch and prevent its spread.

 
 
 
 
 
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How does a cavity develop?

To understand how a cavity can develop and make its way through your tooth, we need to know how a tooth operates. Let’s talk about the four layers of teeth, according to the American Dental Association (ADA):

  • Enamel. This is the hard outer layer that you can see on the surface of your tooth. It is the hardest substance in your body, made up of several minerals.
  • Dentin. This second layer of the tooth contains the tiny tubules and living tissues that communicate with the nerves located farther inside the tooth. 
  • Cementum. The cementum is also quite hard, covering the bottom half of the tooth’s root and anchoring the tooth in the gum.
  • Pulp. The pulp is softer than the other layers and is found in the middle of the tooth. It acts as a casing for the nerves, blood vessels, and connective tissue.

In the beginning stage of tooth decay, a layer of clear, sticky film called dental plaque builds up and coats the tooth. Plaque is teeming with pathogenic (disease-causing) bacteria that produce acids that can damage your teeth and cause gum disease.

Unfortunately, this acid that comes from plaque eats away at the minerals that make up the enamel. Over time, it can begin to demineralize and eventually break down the enamel layer, continuing to cause damage deeper into the tooth.

Symptoms of Tooth Decay

It’s relatively easy to see or feel dental cavities forming once they progress throughout the tooth. But your best bet is to catch this decay as early as you can before tartar build up and damage become irreversible.

Knowing the symptoms of tooth decay and catching it in the early stages can save you from more intensive procedures, possible infection, and bigger dental bills. 

The signs and symptoms of tooth decay include:

  • White spots or a chalky appearance on the surface of the tooth
  • Small holes on the surface of the tooth
  • Tan, brown, or black spots 
  • Sensitivity to hot or cold food and beverages
  • Pain and swelling at a tooth
  • Bleeding or swollen gums
  • Discomfort when chewing
  • Persistent bad breath
  • Unpleasant taste in the mouth

So, knowing the symptoms, how is tooth decay diagnosed? 

Tooth decay can only be accurately diagnosed by a dental professional. While you may see the symptoms, it’s tough for an untrained eye to tell the extent of the damage and the best treatment plan. Your dentist will use a physical examination and, in many cases, x-rays to diagnose cavities and determine the appropriate treatment.

Head to the dentist if you notice any of these symptoms. The sooner you can catch tooth decay, the better. This is one of the many reasons it’s wise to keep your dental checkups scheduled every 6 months. 

Plus, we like seeing you!

Tooth Decay Stages (with Pictures)

What are the stages of tooth decay? Tooth decay has 5 stages, growing more severe as it progresses. Here’s how it develops, from the initial stages to the end result, if left untreated:

  1. Demineralization. In the first stage of tooth decay, acid produced by the bacteria in plaque begins to break down the minerals that make up tooth enamel.
  2. Decaying enamel. Once the enamel has lost its minerals, it is left weakened, and bacteria can eat through the enamel of the tooth, causing a hole that will need to be filled.
  3. Decaying dentin. The bacteria has passed through enamel and now begins to damage the dentin layer. In this stage, increased sensitivity in the tooth may occur since it is linked to the tooth’s nerves.
  4. Damage to the pulp. After the bacteria has penetrated through the dentin layer, it has now reached the sensitive pulp. This may cause swelling and more acute pain as the bacteria irritate the nerves inside the tooth.
  5. Abscess. At this stage of tooth decay, the pulp is infected. A pocket of pus can form at the base of the tooth, called an abscess, and pain may spread into the jaw, swollen lymph nodes, or fever. If you have an abscess, do not wait. Go see your dentist immediately to keep the infection from spreading.

While advancing tooth decay can cause significant pain and trouble, a tooth abscess is dangerous to your overall health. Untreated abscesses can cause life-threatening complications.

Causes

There are many possible contributors to decay in the teeth, or dental caries. These include, but are not limited to:

  • Consistent snacking. Food can cling to the teeth between meals, especially on sugary foods and carbohydrates that break down into food for oral bacteria.
  • Poor oral hygiene. It’s important to brush and floss regularly and for your kids to do the same. I recommend brushing 3 times a day and flossing at least once.
  • A consistently dry mouth. This can be caused by mouth breathing at night, stress, or even overusing mouthwash.
  • Acid reflux disease. Stomach acid can enter the mouth and cause wear and tear on the enamel.
  • Medical conditions. Some forms of treatment for cancer in the head and neck can increase the likelihood of dental caries.
  • Improper nutrition. You need a healthy intake of vitamin D3, vitamin K2, and calcium to build healthy enamel. For children, these nutrients also support jaw development and can help reduce the risk of orthodontic problems.

As you can see, many of these causes of tooth decay are preventable with intentional oral care. 

Risk Factors

Interestingly, not all mouths, or even all teeth, are at the same risk for decay. 

These factors make teeth more susceptible to bacteria:

  • Location. Your molars are often harder to reach when brushing. They also have many grooves and places for food to hide. The back teeth are more likely to experience decay.
  • Age. Young children under 12 and older adults are more likely to have tooth decay than other groups.
  • Brushing and flossing. Not brushing 3 times a day after meals or flossing regularly raises the risk of tooth decay. 
  • Old dental fillings or devices. If fillings and crowns are not looked after, they can become weaker and create a place for decay to build underneath.

What are the long-term effects of tooth decay?

The long-term effects of tooth decay include abscesses, potential root canals, and even tooth loss. Gum disease can also occur when plaque and tartar go unchecked — cavities and gum disease run hand in hand.

What happens if tooth decay is left untreated? Tooth decay that is left untreated has the potential to continue to spread throughout the whole tooth. It can continue its movement to infect the mouth and head, or even the jawbone in the late stages. These later stages pose a risk to both your dental and whole-body health.

Treatments

Can you fix tooth decay? Yes, there is a treatment for each stage of tooth decay. No matter what stage of tooth decay you are experiencing, let a dentist help. We can alleviate discomfort, find solutions, and put your mind at ease. 

From fillings to extractions, you or your child will be numbed and comfortable through the procedure. Don’t let fear of pain stop you from treatment. Here are the most common treatments for tooth decay.

1. Reversal

When tooth decay is caught early on, it is possible to reverse it. My top recommendations are diet changes to incorporate more vitamins like D3 and K2 and minerals like calcium for strong teeth.

In addition to a diet overhaul, oral probiotics, tongue scraping, and nasal breathing  help reverse tooth decay. I also recommend oil pulling and certain dietary supplements, depending on the situation.

Another great option to rebuild enamel is hydroxyapatite toothpaste. Hydroxyapatite is the primary mineral that teeth are made of, and brushing it on can help to restore the structure of your teeth. 

What is the best toothpaste? The best toothpastes to restore enamel are Risewell (use code: DOCTORSTACI for 10% off) or Boka (use code: DOCTORSTACI for 20% off); I highly recommend both for their hydroxyapatite content and fantastic flavors.

Fluoride toothpaste is associated with more systemic risks to children than HAp toothpaste, but it can also support remineralization of the teeth to support cavity reversal in certain high risk situations, although I find hydroxyapatite to be superior and without the worry..

2. Fillings

Once bacteria have broken a more significant hole into the enamel, fillings will be necessary. Your dentist will clear out the area of decay and then place a composite material into the tooth to fill the gap.

3. Pulpotomy/Root Canal

What is a root canal? A root canal is a procedure that removes infected pulp from within the tooth before cleaning and filling the cavity inside the tooth. After this is complete, a crown is placed on top of the tooth.

A root canaled tooth is essentially “mummified.” It is no longer living, changeable tissue but cut off from the body’s blood supply. 

In baby teeth, this procedure is called a pulpotomy and removes less pulp than a root canal to avoid excessive damage to the tooth.

4. Extraction with Implant

In more severe tooth decay cases, it may be necessary to extract the tooth if the infection has spread or irreparably damaged the tooth. After removing a permanent tooth, it’s possible to have a new, false tooth implanted into the jaw, maintaining the health of the mouth.  Primary, or baby, teeth do not need replacement but may need a space maintainer.

However, if a child loses a permanent tooth, kids generally cannot have dental implants until they turn 17-18 yo (because the jaw and palates continue to grow). Instead, talk to your dentist about a spacer to prevent orthodontic issues.

How to Prevent Cavities

We’ve talked about diet and brushing directly after meals, but there’s much more you can do to be proactive against cavities.

You may be wondering how to prevent cavities, or more practically, “How can I prevent tooth pain?” You can prevent tooth pain with the following tips to avoid cavities and minimize tooth decay:

Managing Mouth Breathing

Breathing through the mouth can cause tooth decay, not to mention facial development issues in children. In fact, chronic nighttime mouth breathing can present in children similar to ADHD.

Try mouth taping overnight for adults. Bring a child who breathes through the mouth regularly into their pediatric dentist to check for underlying issues and discuss treatment with your pediatric dentist. A visit to other specialists like an ENT or myofunctional therapist may be indicated.

Floss

Flossing daily removes bacteria that your toothbrush can’t reach, preventing hardened plaque called tartar from attaching to the teeth.

Tongue Scraping

Tongue scraping can help remove the aggressive bacteria from the mouth and balance out the oral microbiome. I’ve found that kids love the silliness of tongue scraping, which is a bonus!

Oral Probiotics

There are good bacteria in your mouth, not just bad ones, and they help fight off tooth decay. Taking oral probiotics can increase the ratio of good bacteria in your mouth, aiding in the battle against cavities.

Other Approaches

Many dentists will recommend dental sealants or fluoride treatments (fluoride varnish) to prevent cavities. However, studies have shown that hydroxyapatite is as effective as fluoride but with fewer side effects. 

Dental sealants are an option for some families but merit an in-depth conversation about what materials they’re made of and what technique is used to ensure bacteria or early cavities are not getting trapped underneath as these sealants are sitting in your child’s mouth indefinitely and should be taken very seriously.

 
 
 
 
 
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When to See Your Dentist

How can I remove tooth decay myself? Unfortunately, you can’t remove tooth decay yourself. Come see your dentist, and some x-rays and a quick conversation will give you a plan you can smile about.

The best way to prevent tooth decay is to practice prevention and see your dentist every 6 months. We’re here to help, and we can catch demineralization before it progresses. We want to see you empowered, not afraid, so you can live without tooth decay.

Sources

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  10. Surtel, A., Klepacz, R., & Wysokińska-Miszczuk, J. (2015). The influence of breathing mode on the oral cavity. Polski merkuriusz lekarski: Organ Polskiego Towarzystwa Lekarskiego, 39(234), 405-407. Abstract: https://pubmed.ncbi.nlm.nih.gov/26802697/ 
  11. Bordas, A., McNab, R., Staples, A. M., Bowman, J., Kanapka, J., & Bosma, M. P. (2008). Impact of different tongue cleaning methods on the bacterial load of the tongue dorsum. Archives of oral biology, 53, S13-S18. Abstract: https://pubmed.ncbi.nlm.nih.gov/18460399/ 
  12. Shakib, P., Rouhi, S., & Zolfaghari, M. R. (2020). The role of probiotics in preventing dental caries. Plant Biotechnology Persa, 2(1), 55-58. Full text: http://pbp.medilam.ac.ir/article-1-40-en.pdf 
  13. Amaechi, B. T., AbdulAzees, P. A., Okoye, L. O., Meyer, F., & Enax, J. (2020). Comparison of hydroxyapatite and fluoride oral care gels for remineralization of initial caries: a pH-cycling study. BDJ open, 6(1), 1-7. Full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7376056/

Children’s Oral Health: Hygiene, Diet, Sealants, & Fluoride

happy girl

Helping your children to have a lifetime of healthy teeth is an important part of basic health care, and it is possible… if you have accurate information and tools to help you on your way. 

When it comes to children’s dental health, you may already know that diet plays a role in cavity formation. But did you also know that what your child eats (or doesn’t eat) can even help to prevent or reverse dental decay? 

The American Dental Association’s National Children’s Dental Health Month is right around the corner in February. So, let’s talk about the key nutrients to include in your child’s diet to boost dental health and also some major things to avoid (like cavity-encouraging snacks, questionable sealant ingredients, and more!).

You’re probably wondering: How do I teach my child dental health? Teaching your child good dental hygiene begins with establishing a healthy routine as soon as their first tooth erupts. You can even start wiping their gums daily prior to tooth eruption.

As children get older, the work of brushing a child’s teeth transfers hands, literally, from caregivers to child. If the importance of pediatric dental health is established at a young age, children will see it as a non-negotiable part of their day. They’re also likely to take pride in their own ability to care for the health of their teeth and mouth.

Why is good oral health important for children?

How does a child’s oral health impact their overall health? Your child’s oral health has a significant impact on their overall health — if the teeth and gums are healthy, it’s more likely the rest of the body will be, too. 

When pediatric oral health is not optimal, it can cause problems throughout the entire body. There is a direct link between the health of our mouths and the health of our entire bodies (often called the mouth-body connection or the oral-systemic connection).

How can children’s poor dental health affect their health? The mouth is a gateway or “mirror” to the entire body. Cavities and gingivitis aren’t just oral health issues — they point to a compromised immune system, an unhealthy microbiome, and problems in the diet.

Deep, untreated cavities can eventually cause pain, infection, or more dangerous systemic complications. These complications can range from dental abscesses to perpetuating painful periodontal disease. 

Periodontal (gum) disease is associated with chronic health conditions including diabetes, Alzheimer’s, heart disease, and obesity.

Taking care of your child’s teeth and gums is not only a preventive measure when it comes to cavities and gum disease, but it can also ward off other major health concerns.

My Favorite Things for Great Oral Health in Kids

Flossing

Once a child has baby teeth that are touching, flossing should become a daily habit. The number one place I find cavities in kiddos (adults, too!) is in between the back molars.

Not only does flossing help to prevent dental caries (tooth decay), it also helps to keep our gums healthy, which leads to better systemic health. As I like to say: Floss is 100% boss!

Vitamin D3 and K2

How can you strengthen your child’s teeth? To strengthen your child’s teeth (both the baby teeth and the permanent teeth!), try to incorporate the dynamic duo of D3 and K2 into their diet on a regular basis. 

D3 and K2 (along with calcium) prevent cavities, benefiting remineralization of teeth, and can keep the oral microbiome in check.

Limit processed foods

Refined sugars and flours are not ideal for our teeth. They’re sticky and highly processed nature break down into sugars and acids quickly, increasing cavity risk. If they do that to your teeth, imagine what these sugary foods might be doing to the rest of your body?!

Many people think crackers, Goldfish, and similar foods are healthier for their kiddos than candy and sweets. 

In reality, crackers and other foods that contain processed carbohydrates are about the same for your child’s teeth as a pack of candy. In other words… they’re not good for strong teeth.

Hydration

Water is helpful to every system in our bodies, including our mouths. Not only does water help rinse off food debris and leftover sugars and help to neutralize the mouth, but it also helps to keep our saliva healthy and enzyme-rich, protecting our teeth and oral structures. 

If your child drinks some fruit juice, encourage a few sips of water afterward to clear away the sugar and acids. Also, make sure to only give plain water as a beverage after brushing and flossing before bed.

Nasal Breathing

Nasal breathing is a hot topic right now, and for good reason! Getting back to nasal breathing is critical for the well-being of the entire body. 

Mouth breathing leads to dry mouth and lowered pH (think dysbiosis or imbalances in the bacteria in the mouth) and can cause major issues. 

Often, when families are doing “everything right” and their child is still getting cavities, it is due to mouth breathing during the day and/or during sleep.

Oral Probiotics

Strains of probiotics specifically designed to support oral health are called oral probiotics or dental probiotics. 

These chewable supplements are loaded with commensal bacteria that your mouth’s mini-immune system uses to fight decay, bad breath, gingivitis, and even respiratory infections!

Children’s Oral Health Statistics

Tooth decay is the most prevalent chronic disease in children even though it is preventable, according to the National Institute of Dental and Craniofacial Research.  

Some interesting children’s oral health facts in the United States from the Centers for Disease Control and Prevention (CDC):

  • About 20% of children aged 5 to 11 years have at least one untreated decayed tooth.
  • Around 13% of adolescents aged 12 to 19 years have at least one untreated decayed tooth.
  • Children aged 5 to 19 years from low-income families are twice as likely to have cavities, compared with children from higher-income households.
  • Cavities left untreated can lead to pain and infections that cause problems with eating, speaking, playing, and learning. 
  • Children with poor oral health often miss more days of school and get lower grades compared to children with good oral health.

Tooth Decay in Kids

Why does tooth decay happen? In simple terms, tooth decay happens when your teeth are demineralized (broken down) more than they are remineralized (built and strengthened). The primary cause of demineralization is acid excretion by pathogenic bacteria in the mouth. 

When cavity-causing bacteria in your mouth find sugar molecules to eat, they gobble them up and “poop” out acid. The acid eats away at your teeth. When bacteria are allowed to gather on concentrated areas of your teeth, these acid excretions cause tooth decay.

Mouth breathing and diet (specifically, a diet high in carbs and processed foods, not just sugar) are 2 of the overlooked reasons why these bad bacteria flourish and children develop tooth decay. Those are also 2 of the big factors behind bad breath in children. 

What are the factors that may lead or contribute to tooth decay?

  • Poor dental hygiene
  • Dry mouth/mouth breathing
  • A diet high in sugar, acid, and highly processed foods 
  • A diet low in vitamins and minerals
  • Poor hydration
  • An unbalanced oral microbiome
  • Certain medications 
  • Genetic or developmental predisposition

What does a cavity look like? While cavities are not always visible with the naked eye, signs of a cavity include tooth discoloration, black spots, or holes. Toothache or tooth sensitivity can also be a sign of a cavity. Regular dental visits are a very important way to catch cavities early and possibly even reverse them. 

A Tooth-Friendly Diet

To promote children’s oral health and prevent dental decay, limit processed foods as much as you can. 

I know this can be tough, but many packaged foods marketed to kids are truly terrible for their teeth. They are highly processed with many artificial flavors, coloring, refined flours, and sugar. And unfortunately, even many organic packaged foods are not ideal. Aim to eat unpackaged, whole foods as much as you can.

To encourage children’s oral health, there are also some specific nutrients you’ll want to make sure they get enough of, including vitamin D3, vitamin K2, calcium, and probiotics.  

Vitamin D is one of the nutrients responsible for delivering calcium to your teeth (along with vitamins A and K2). Many people are deficient in vitamin D, even in developed nations! Foods high in vitamin D3 are excellent for supporting tooth remineralization and protecting against cavities.

Some of my favorite vitamin D3 foods are:

  • Cod liver oil
  • Egg yolks
  • Sardines

The next lesser-known nutrient key to pediatric dental health is vitamin K2, which is vital to building tooth structure. Vitamin K2 is not the same as K1 (or just “K”), is found in very different foods, and has a dramatically different function in the body.

If you’re K2-deficient, your teeth and bones will become weaker over time. Plus, your risk of most chronic diseases goes up (not just cavities).

Foods highest in vitamin K2 include:

  • Natto
  • Cheese
  • Grass-fed butter
  • Egg yolks

Calcium is a nutrient your teeth need from the inside out. Plus, more calcium intake reduces your risk of gum disease.

Try incorporating these calcium foods into your child’s diet:

  • Chia seeds
  • Beans/lentils
  • Collard greens
  • Edamame

Next up is probiotics, which support both your oral and gut microbiome. Healthy bacteria are necessary for crowding out the bad stuff that leads to cavities and gum disease. They even keep your breath fresh! 

Start with probiotic foods like:

  • Fermented pickles
  • Kefir
  • Sauerkraut

I also recommend supplementing with an oral probiotic like Hyperbiotics Pro-Kids ENT. These mouth-friendly bacteria are great for supporting oral health.

Things like crackers, pretzels, cheese puffs, granola bars, dried cereals, and fruit snacks should be limited as best as you can. They stick in teeth and break down into sugars and acids very quickly, causing lots of dental problems.

What are some pro-dental health foods for kids? Try veggie sticks and hummus or guacamole, seeds and nuts, olives and pickles, cheese, seaweed snacks, fresh berries and fruit, or hard-boiled eggs.  

I try to meal prep on the weekends, including cutting veggies and fruits for ready-to-go snacks for the week ahead. It’s a pay-it-forward trick that I have found helps my family tremendously!

Dental Sealants

Dental sealants are thin, plastic coatings that seal over the narrow grooves found on the chewing surfaces of the back teeth.  When placed perfectly on these deep pits, sealants can prevent a significant amount of tooth decay (cavities) by protecting sensitive tooth enamel from the acid that causes cavities.

Children who benefit most from dental sealants include those:

  • With very deep grooves in their molars
  • At high risk for cavities
  • Who eat a diet high in processed foods, refined flours and sugars, and sugary drinks
  • With special needs that make dental hygiene and/or a healthy diet more challenging

Ideally, sealants should be placed immediately after the eruption of the first molars (around age 6) and second molars (around age 12). Sooner is better to ensure the grooves have not been affected by bacteria or early cavities.

Many parents are concerned about the possible negative effects of dental sealant material on their children’s overall health. Most dental sealants do contain BPA and/or bis-GMA. Both of these established endocrine disruptors should generally be avoided in developing children.

To avoid toxic sealant materials (even in very small amounts), ask your dentist what materials they are using for their sealants. Ceramic-based materials, rather than those with BPA, Bis-DMA, or bis-GMA materials, are associated with the smallest level of risk to overall health.

Should my child get fluoride treatments?

When it comes to the importance of pediatric dental care, fluoride is a controversial topic. 

Should you give your child fluoride treatments? My short answer: No. 

My long answer: Preferably not. However, if your child has special needs or can’t really eat a healthy diet and correct mouth breathing, then fluoride treatments may be a stopgap measure worth the risk.

Rather than fluoride toothpaste, I recommend hydroxyapatite toothpaste. Research demonstrates that hydroxyapatite toothpaste helps to remineralize teeth and also prevent demineralization. Additionally, it’s been shown to work just as well to prevent cavities as fluoride toothpaste.

When should my child see a pediatric dentist?

Around the time of your child’s first eruption of baby teeth is a good time to begin regular dental checkups with a pediatric dentist. Some dentists suggest waiting until their first birthday or even 2 years of age.

If you find that teaching dental hygiene to preschoolers is challenging, your pediatric dentistry of choice is likely to have some great tips. Thankfully, there are a lot of playful, yet non-toxic toothbrushes on the market today. Making dental care fun is one of the easy ways to make your child look forward to maintaining a healthy smile and mouth. It also makes your life easier, too! 

Sources

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