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Your toddler’s smile can surely light up a room. However, it can also be a source of stress, especially if you think your little one might have a cavity.

Dental caries (cavities) are common in baby teeth. In fact, experts share that some 20 percent of kids ages 2 to 5 may have untreated cavities.

While your child will eventually lose their primary (baby) teeth, taking care of those teeth is important because they hold space for adult teeth.

Here’s more about the symptoms your child may experience with a cavity, what treatments are available, and how a strong dental care routine from a young age can help protect those pearly whites.

Cavities (also referred to as tooth decay) are weak points in otherwise strong tooth enamel. Throughout the day, a sticky coating of plaque forms on the teeth and traps the sugars from the foods your child eats.

If this substance isn’t properly brushed off teeth, the bacteria in the plaque will release acids that break down the enamel and form holes (cavities) in the tooth.

Causes include:

  • Brushing habits. Not brushing often enough allows sugars to sit on the teeth and turn into acid. Acids can attack teeth for up to 20 minutes after each snack or meal, no matter the size.
  • Dietary choices. Eating lots of sugary foods or eating frequently throughout the day may cause acid to build up on teeth and weaken enamel.
  • Bottle use. Toddlers who go to sleep with bottles, drink juice out of bottles, or use bottles as pacifiers may develop cavities. Decay from bottles often affects the middle two front teeth.
  • Genetics. Some kids may be more prone to cavities because they have weaker enamel or some other genetic factor, like low saliva production or tooth shape.

Your child may not have any symptoms with a cavity — especially if the decay is in the early stages. That’s why regular dentist appointments are important. Your toddler’s dentist can help spot and treat cavities before they become impossible to treat with a filling.

Early signs

Your child may not exhibit signs of having a cavity. Other times, the signs are quite subtle or your child cannot articulate them.

While brushing your toddler’s teeth, make it a habit to examine their teeth. That way, you can spot changes and bring them up to a dentist when you have concerns.

Look out for the following:

Other symptoms

As a cavity progresses, the color may change from light brown to dark brown or even black. Along with physical symptoms or pain, your child may exhibit other signs that may not always be as obvious.

  • Trouble eating. Tooth pain may make simple snacks and meals unpleasant experiences. After a while, your child may simply choose to stop eating some foods to avoid discomfort.
  • Trouble with weight gain or vitamin deficiencies. If your toddler has trouble eating a balanced diet, they may also have trouble gaining weight or getting the right balance of vitamins and minerals.
  • Fussiness. Younger toddlers may not have the language to share what’s wrong. Instead, they may cry or be cranky. Your toddler may also tug at their ear when they’re in pain.

If a cavity is not treated, the tooth can become infected. Signs of infection include fever and pain, as well as an abscess on the tooth or facial swelling. Speak with your child’s dentist or pediatrician if you have concerns about infection.

Your child can develop cavities as soon as they get their first tooth.

While it may seem early, the American Dental Association (ADA) recommends taking your baby to the dentist by the time their first tooth comes in or by their first birthday. After that first appointment, you should aim for regular checkups every 6 months, per the American Academy of Pediatric Dentistry (AAPD).

You may want to head in sooner if your child is complaining of tooth pain or you notice other symptoms. At your appointment, your toddler’s dentist will:

  • take into consideration their dental history
  • look at their teeth
  • possibly perform an X-ray to evaluate the level of decay

Once the dentist has the full picture, they can proceed with a plan for monitoring the tooth or treating it.

There are several options when it comes to treating cavities in toddlers. If the decay isn’t advanced, a dentist may suggest monitoring the tooth and following good dental hygiene to see if the decay reverses.

A professional fluoride treatment can also help reverse the early decay by restoring tooth enamel.

Restoration (filling)

A filling involves removing the decayed portion of your child’s tooth by drilling to create a hole. The hole is then filled with silver (amalgam), resin (composite), acrylic, or some other material.

This treatment involves a single office visit. However, if your child has more than one cavity, a dentist may offer to break up the visits.

Getting a filling involves an injection in the mouth to dull pain during the procedure. If you think your child may have trouble getting a filling, you can ask your dentist about sedation dentistry.

There are various types of sedation, including using nitrous oxide, or “laughing gas.” Your dentist can walk you through the type that’s best for your child.

Other treatments

For more severe cases of decay, a dentist may suggest placing a crown over the affected tooth. A crown usually takes just one visit to place in a child, because it will come in pre-formed sizes.

In cases where the crown needs to be created, it can take two or more visits to complete, according to Johns Hopkins Medicine.

Extraction (pulling) is another possibility if a tooth becomes infected or damaged. If your child’s tooth is extracted, the dentist will likely put in a spacer to ensure there’s room for adult teeth to come in later on.

Unfortunately, a cavity won’t go away on its own. If you cannot get in to see your child’s dentist immediately, you can do a few things to help ease a toothache at home.

These are temporary ways to lessen the pain from a cavity and should be followed up as soon as possible with a dental checkup.

Over-the-counter (OTC) pain relief

You can give your little one acetaminophen (Children’s Tylenol) to numb the ache. Follow all bottle instructions and dose according to your child’s weight or your doctor’s recommendation.

And be sure to brush teeth well after giving medication, as it contains sugars that can sit on the teeth.

Salt water

Swishing with salt water helps ease pain around the tooth, and the salt may provide some antibacterial protection.

Dissolve 1 teaspoon of salt into a quarter cup of boiling water. You can then add cold water to adjust the temperature (test it before having your child use it) and instruct your tot to swish it around in their mouth.

You may want to avoid this method with young toddlers who cannot follow instructions. Otherwise, they might swallow the salt water.

Cold compress

If your little one’s face is swollen, a cold compress can help reduce inflammation and dull pain. Use an ice pack (you can get soft ones that mold to your child’s face) or a bag of frozen vegetables.

Place a dry cloth between your tot’s face and the cold pack to avoid frostbite. A wet paper towel may also do the trick.

Clove oil

Clove oil contains a powerful ingredient called eugenol. It is also used for toothaches.

According to a 2015 review, studies on eugenol show that it may be more effective than OTC topical pain relievers at reducing inflammation, pain, and even infection.

Dilute a couple drops of clove oil with a teaspoon of carrier oil, like olive or coconut oil. Soak this solution up into a cotton ball and apply to the affected area.

You’ll need to be careful when using this method with young children so they do not swallow the cotton ball.

If you don’t have dental insurance, keeping up with regular visits can be a financial strain. Various options can help make dental care more affordable.

  • Contact your local health department. You may be able to find affordable or free dental care at a community health center near you. For more information, check out the Health Resources & Services Administration website or call 888-Ask-HRSA.
  • Check into federally funded programs. Medicaid and the Children’s Health Insurance Program (CHIP) may offer free or low cost dental care to children and their families. Services and eligibility may vary by state.
  • Look out for free events. The ADA runs a free program called Give Kids a Smile that provides dental screenings to children in need. Call 844-490–4527 (GKAS) for more information.
  • Call dental education programs near you. Many programs offer free or low cost cleanings and other treatments as part of their student training. Search for dental education programs or dental hygienist schools in your area and contact for more details.

Read this article to learn more about free or reduced dental care options.

Children who have cavities in their baby teeth are more likely to develop cavities in their adult teeth. You can help your child avoid tooth decay from the start by promoting good dental hygiene and tweaking lifestyle habits.

Keep these tips in mind:

  • Help your child brush their teeth twice each day with a toothpaste that contains fluoride. Toddlers generally only need a pea-sized amount of toothpaste to do the trick.
  • Practice flossing with your child at least once per day, according to the ADA. You can use standard floss or another tool, ideally sized for your child’s mouth, such as water flosser, floss pick, or pre-threaded flosser.
  • Provide your child with healthy meals and snacks that don’t contain too much added sugar. Foods like cheese, milk, and yogurt are good choices because they’re low in sugar but high in calcium. And drinking plenty of water instead of juice may help keep sugar at bay.
  • Do not allow your child to fall asleep for nighttime or naps with a bottle or sippy cup of juice or milk.
  • Keep up with your child’s dental visits. It’s good to get a professional cleaning and dental exam twice per year, according to the AAPD.
  • Ask your child’s dentist about fluoride treatments or sealants (protective coating applied to the deeper grooves on back teeth) that may help provide an additional barrier of protection on baby teeth.

Baby teeth are temporary but important. Treat your toddler’s dental visits like you would their regular health checkups.

Routine cleanings and exams help spot small issues before they turn into decay and cavities that could affect your child’s smile for a lifetime. If cost is a concern, there’s help.