Tooth Decay in Children: Symptoms, Causes, Prevention

According to the American Academy of Pediatric Dentistry, tooth decay is the most prevalent chronic disease in children. Here’s what you should know about childhood tooth decay, along with some tips on keeping your child’s teeth clean and healthy. 


The signs and symptoms of cavities in children vary, depending on their location and severity. When a cavity is in its early stages, your child may exhibit no symptoms. As the decay grows, however, it will likely cause a variety of signs and symptoms, including: 

  • Tooth sensitivity
  • A toothache or spontaneous oral discomfort that occurs without an obvious cause
  • Sharp or mild pain when drinking or eating something cold, hot or sweet
  • Visible pits or holes in teeth
  • Visible discoloration on any surface of a tooth
  • Pain when biting down


Cavities are a result of tooth decay which develops in the following way:

Plaque develops.

When starches and sugars aren’t regularly cleaned from your child’s teeth, bacteria quickly start feeding on them and form into plaque, a clear sticky film that coats the surface of teeth.

Acid attacks the teeth.

As bacteria feed on starches and sugar, they release acids that remove minerals in your child’s outer tooth enamel. This erosion creates tiny holes in the enamel, allowing acid and bacteria to access the dentin within teeth. 

Decay worsens.

Without treatment, acid and bacteria move into the inner tooth material (pulp) that contains blood vessels and nerves. As the pulp becomes irritated and swollen, your child will experience severe pain. Discomfort and decay can even extend outside of the tooth root to the underlying bone.

Risk Factors

All children are at risk of developing cavities; however, certain factors can increase the risk. These include: 

  • Tooth location: Decay most often occurs in a child’s rear teeth (premolars and molars). 
  • Eating certain drinks and foods: Some foods cling to teeth; this includes juice, honey, soda, sugar, cake, cookies, dried fruit, candy and chips.
  • Frequent snacking: When kids snack between meals, they give bacteria a steady stream of fuel which helps the organisms proliferate. 
  • Lack of fluoride: If a child’s water supply doesn’t contain fluoride, the risk of tooth decay increases.
  • Bedtime infant feeding: When babies are given bottles filled with juice, formula or milk, this increases the risk of cavities. The risk is also higher for toddlers who wander around drinking from a sippy cup filled with problematic beverages.


According to the Centers for Disease Control and Prevention, tooth decay is an epidemic among children. The CDC reports that one in five kids aged 5 to 11 years has at least one untreated cavity. With this in mind, it’s clear that parents should take steps to proactively keep their kids’ teeth clean and healthy.

You can reduce your child’s risk of tooth decay by making sure they regularly brush and floss their teeth. You should also make sure they eat a healthy diet with plenty of fruits and vegetables. Limit problematic foods and snacking in between meals. You should also take your child to the dentist for regular checkups to make sure they are developing normally and check for minor cavities before they develop into serious tooth decay.