Toddler Cavities: How to Treat Cavities in Children

Cavities in children are not uncommon, but toddler cavities may be more surprising to many parents. So, are baby teeth more prone to cavities? Yes, but thankfully, there’s a lot you can do to prevent cavities in young children. Read on to learn how to take great care of your kids’ baby teeth and how to instill excellent oral care habits from an early age

What Causes Cavities in Children?

Why are baby teeth more prone to cavities? Cavities in kids occur the same way they occur in adults. Generally, it begins with diet and oral care and hygiene habits, though family history can also play a role. However, baby teeth have a thinner layer of enamel than adult teeth, making them more susceptible to decay and cavities. 

Think cavities in kids are rare? Unfortunately, they’re not. The National Health and Nutrition Examination Survey found that nearly 28% of children between ages 2 and 5 had cavities in their baby teeth. Among kids aged 6 to 11? Over 51%. Similarly, our recent survey showed that 45.4% of kindergartners surveyed had more than 7 cavities. 


So why is that? Let’s take a look at what has the greatest impact on tooth decay in kids and what might cause early childhood and toddler cavities in your children.

Brushing habits

How well and how frequently your child brushes their teeth can have a significant impact on their oral health. Everyone’s mouth is full of bacteria. Some of it is helpful, and some of it is responsible for creating plaque, which eats away at our tooth enamel. Brushing teeth helps to brush away that plaque and harmful bacteria to help preserve and protect teeth. What happens when kids don’t brush their teeth properly or often enough is that bacteria and plaque builds up. This breaks down the enamel, causing tooth decay and cavities. 

Dietary choices

Your child’s diet is incredibly important when it comes to tooth decay. Diets high in sugar, starch, and acid feed the harmful bacteria that cause plaque and eat away at your child’s teeth. The more they consume foods and beverages high in these things, the more likely they are to develop cavities (especially without excellent oral hygiene). 

Bottle use

Sometimes, constant bottle use can lead to tooth decay, which is why early childhood cavities are sometimes called baby bottle tooth decay. This type of decay typically happens when babies and toddlers are put to bed with a bottle, or when a bottle or sippy cup is allowed to be used as a pacifier. In both of these cases, the child’s teeth get prolonged, frequent exposure to the sugar in any drink other than water in the bottle or cup. It’s a particular problem when young children are given juice, soft drinks, or other sugary drinks. 


There’s been a lot of talk recently about whether or not genetics play a role in toddler cavities. A recent study was unable to find evidence of a genetic contribution to cavities in kids. However, other studies have supported the idea that genes can impact a child’s susceptibility to tooth decay and cavities. Genetics can clearly play a role, however, if low saliva runs in the family. Without adequate saliva flow, your child is at a higher risk for cavities.

Shared bacteria

Sharing your oral microbes with your baby could lead to tooth decay. Each person has their own unique oral microbiome, but we can pass bacteria from person to person. If you share a spoon with your toddler or clean your baby’s pacifier in your mouth, you’ll pass your oral bacteria to your child. This can change your child’s oral microbiome, introducing more harmful acid-producing bacteria and increasing the risk of tooth decay. 

Toddler Cavities: Symptoms and Early Signs

Tooth decay may look different on each child. However, there are some early signs and symptoms to look out for that indicate cavities. Help younger children with their daily oral hygiene, which will give you the opportunity to look out for signs of decay. Here’s how to catch cavities in kids.

Visual signs of cavities

As the tooth enamel breaks down and decay sets in, you’ll see changes in the teeth. Look for the following:

  • Early on, white spots may begin to form on the teeth or along the gumline where the enamel is beginning to break down. 
  • Once a cavity has developed, you might notice a light brown color on the tooth.
  • If the cavity progresses untreated, it will turn a darker shade of brown or black. 

Sensations indicating tooth decay

In addition to visual signs of cavities, you might also notice your child complains of new sensations that could indicate decay. These can include:

  • Increased sensitivity to hot or cold food and drinks.
  • Sensitivity to particular foods and beverages—especially anything sweet or acidic.
  • Pain on the tooth or around the tooth with the cavity.

How to Diagnose Cavities in a Child

While you might see signs of tooth decay in your child, you also might miss them so it’s extremely important that you see your child’s dentist regularly. Regular dental visits help ensure that your child’s dentist has a thorough history of your child’s oral health, so they’ll know what to look out for and when. 

During routine cleanings and check-ups, the dentist will check for signs of tooth decay and cavities in children. They’ll also get any necessary X-rays if they think cavities might be setting in. If they find a cavity, they’ll determine how advanced it is and then decide how to proceed. 

Are Cavities in Toddlers Treatable?

My 5-year-old has cavities. Now what? The great news is that cavities are treatable—even in young kids and toddlers. Treatment will depend on a number of different factors, but in most cases cavities require fillings. 

Restoration (filling)

To stop decay from progressing, most cavities require restoration, which involves removing the decayed portion of the tooth and replacing that with a filling. Fillings can be made of composite, silver, resin, acrylic acids, or even fine glass powders, and often look just like the natural tooth. Composite fillings are most common. 

Home Remedies for Cavities in Toddlers

There are no home remedies to reverse cavities once they’ve moved past your enamel. Fluoride products and sugar-free gum containing xylitol can periodically remineralize enamel, so they might help a 7-year-old with cavities. However, these really aren’t an option for toddlers.

It’s important that toddlers not ingest fluoride, so the amount of fluoride toothpaste that’s recommended for toddlers is just the size of a grain of rice. Toddlers also can’t be trusted to chew gum without swallowing or choking on it, so sugar-free gum shouldn’t be given to them.

The home remedies below may prevent cavities or help stop them from getting worse, but won’t fix them. Don’t attempt to treat cavities at home. Bring your child to the dentist if you suspect cavities so that you can get the necessary treatment recommendations as soon as possible.

Over-the-counter pain relief

If your child is experiencing pain because of a cavity, over-the-counter pain medication like acetaminophen or ibuprofen can be used until the dentist can see you. Use only the recommended dosage for your child’s age and weight and don’t use it for longer than a couple of days. 

Salt water

Salt water helps treat the pain associated with cavities and may help slow the decay until you can get it treated. Just know that salt water won’t reverse the decay. To use salt water to help fight the buildup of harmful bacteria and re-balance the oral microbiome, mix:

  • 1 teaspoon table salt
  • Warm water

Add the salt to a glass of warm water and mix until dissolved. Your child should swish the salt water and spit twice per day. If your child can’t spit toothpaste properly, don’t attempt a salt water rinse. Swallowing salt water could make your child sick to their stomach.

Cold compress

An ice pack can be a miraculously effective treatment for all kinds of bumps and bruises, and it can help if your child has a toothache from a cavity, too. Apply a cold compress or ice pack, wrapped in a clean towel, to the outside of the check near where the pain has occurred. Hold the cold compress on the area for about 15-20 minutes. This will reduce inflammation and constrict blood vessels, which can help with pain. Most importantly, don’t put ice directly on the skin as it could cause frostbite.

Clove oil

Clove oil can also be used for the pain associated with cavities, but it won’t improve the tooth decay that’s already present. Proponents say clove oil could provide both analgesic and antimicrobial benefits. To try this, put a small amount of clove oil on your finger or a cotton swab, then massage into the affected tooth and area. This can be done up to 2-3 times daily, but pure essential oils can also be irritating when used too heavily, so be cautious. Never apply the oil directly to the mouth from the bottle to avoid aspiration. 

Affordable Dental Care for Children

Finding affordable dental care for children can be a challenge, but there are options available to you. If you have dental insurance, routine cleanings, checkups, and fillings are typically covered. If you don’t have dental insurance, you have several options. 

First, talk to your dentist about whether they have any available discounts or promotional offers available to you and your family. Also, find out whether they provide payment plans to spread the cost of treatment into smaller payments over a period of months. Many dental offices will work with you to find a way to make the cost of treatment work for you. 

Second, look into programs that may be available through your city, state, or nationally. Give Kids A Smile, for example, is a national program with volunteer dental professionals providing oral screenings, preventative care, and treatment to children who may not otherwise have access to dental care. Additionally, many dentists participate in State Children’s Health Insurance Programs (SCHIP) and Medicaid to provide dental care to kids at low or no cost.

Preventing Cavities in Toddlers

The best thing you can do to prevent cavities in kids is to start oral care early and keep it up. Start by wiping your baby’s gums with a clean, damp cloth after feedings, and begin brushing as soon as the first tooth appears. Continue brushing twice per day with an age-appropriate amount of toothpaste. Also, avoid serving sugary drinks—particularly in a bottle or sippy cup—and limit sticky, sugary foods. Give your child water to drink to rinse their mouth after eating. 

Fluoride is a powerful tool for preventing tooth decay and can sometimes remineralize enamel, so some parents wonder, “Can children use adult mouthwash or can kids use adult toothpaste?” Generally speaking, kids can use adult toothpaste, but they will use a smaller amount than adults. A 7-year-old with cavities will use a pea-sized dollop of fluoride toothpaste, while a 2-year-old should use just a small smear the size of a grain of rice. This ensures kids don’t swallow fluoride products as that can cause health issues and streaking on the teeth. Children shouldn’t use adult mouthwash because of this, and should be watched closely anytime they use any fluoride products.

Finally, make sure you bring your child to the dentist by their first birthday and every six months after that. Preventing cavities is key, but so is early intervention. A pediatric dentist can help you set your kids up for a lifetime of great oral health. 

Protect Your Kids’ Teeth to Give Them a Healthier Life

Protecting your kids’ teeth and gums is essential to preserving their oral health for as long as possible. If you can avoid cavities in your kids, you’ll help them prevent further decay in the future. However, if your kids do experience cavities, treating them quickly also helps protect their mouths from future damage. 

Additionally, ensuring your kids’ oral health benefits their overall health. The mouth is the gateway to the body, so when the mouth is healthy, it helps keep the rest of the body healthier, too. To learn more about how focusing on dental health can help your kids maintain whole body health, pre-order your copy of If Your Mouth Could Talk. You’ll get expert insights into the mouth-body connection and discover how to ensure your kids have healthier, happier lives with great oral care. 

Key Points About Cavities in Children

  • Baby teeth are more susceptible to decay because they have a thinner layer of enamel.
  • Poor oral hygiene habits, diet, bottle use, genetics, and shared oral bacteria can all cause tooth decay in children.
  • Look for signs of decay while helping kids brush or floss, and bring them to the dentist regularly for checkups and cleaning.
  • Signs of cavities can include discoloration—moving from white marks to light brown to dark brown or black—and sensitivity, discomfort, or pain.
  • Cavities are treatable with fillings, and some early decay may be reversed with fluoride or sugar-free gum in older kids.
  • Home remedies can be used to treat tooth pain and help reduce the growth of harmful bacteria, which could slow (but probably won’t stop) decay.
  • Find affordable dental care by combining insurance benefits, options provided by your dentist, and city, state, or national programs.
  • Preventing cavities requires a healthy diet, the right amount of fluoride, and  early healthy oral hygiene habits and dental care.
  • Oral health is connected to overall health, so taking care of your kids’ mouths helps take care of their entire bodies.

Cavities in Kids: FAQs

How to tell if my toddler has a cavity 

To check for cavities, do a quick oral exam on your toddler after brushing and flossing, and look for discoloration on any teeth. Ask if they’ve had any pain or if hot or cold things hurt their teeth. If you suspect a cavity, see your child’s dentist.

What to do if my toddler has cavities 

If your toddler has cavities, ask their dentist about the next steps. Get any cavities that need restoration filled and ask about improving your oral hygiene at home for prevention.

Is it necessary to fill baby tooth cavities? 

If the cavity has gone through the enamel and it’s in a tooth that isn’t close to coming out naturally, it will require a filling. Ask your dentist about baby tooth fillings.

How to prevent tooth decay in children 

To prevent tooth decay in kids, make sure they brush twice per day with your help, using a deantist-recommended toothpaste. Help them floss once per day and make sure they’re eating well and limiting sugary, acidic, or sticky foods and drinks. Bring them to the dentist every six months.



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About the Author

About Dr. Kami Hoss

Dr. Kami Hoss is a nationally sought-after expert with a master’s in craniofacial biology from USC, a doctorate in dental surgery from UCLA, and a post-doctorate in orthodontics and dentofacial orthopedics. With over 25 years of experience in the dental field, Dr. Hoss is a #1 National Best Seller author frequently featured on NBC, ABC, FOX, NPR, and CBS affiliates, and founder of The Super Dentists, one of the leading multi-specialty dental practices in the country.

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