Caries is a disease that causes tooth decay. Caries can be prevented if you brush your baby’s teeth regularly and do not give sweet snacks too often.

The milk teeth are extra sensitive to caries because they are thinner than the permanent teeth. Although the child will lose his milk teeth, it is important to care for them.

Symptoms of caries in children

The symptoms of caries are usually not noticeable until it has gone so far that the child has an infection of the tooth and gets sore. Then it is difficult to cook. It is good if the child comes to the checks called dental care because then caries can be detected in time.

The first visible sign of holes in the teeth is so-called chalk caries or enamel caries. In children, chalk caries is often found on the front jaws of the upper jaw as a white and sometimes rough stripe along the gum line.

The same superficial caries may exist between the teeth, but there you cannot see the change without the teeth being x-rayed. With the help of the x-rays, the dentist sees damage to dental surfaces that are not visible otherwise. The dentist also sees how far into the tooth a hole has reached.

This superficial caries injury does not cause any problems and can heal by itself if you improve the child’s eating habits, brush his teeth clean and give the child fluoride supplements through for example fluoride toothpaste and fluoride tablets.

Deeper damage can cause trouble

A caries attack can extend inside the tooth, although the entrance opening is small on the tooth’s chewing surface or just below the contact surface between the teeth. When it has spread and the child chews on something hard, the “roof” on the hole breaks. Then it may seem that the child suddenly has a large hole, although the attack has, in fact, lasted a long time without any notice.

When the caries attack has reached the tooth bone, it has generally gone so far that the dentist must repair the tooth with filling or grind away the damaged part of the tooth.

If the hole is not repaired, the baby may get sore when chewing, especially when eating something sweet or cold. Finally, the child can get real toothache with swelling and be around the tooth. Then the dental nerve has become infected and dead. The infection has spread to the jawbone and there is a risk that even the tendon of the permanent tooth will suffer damage that is visible when it appears. Such a damaged tooth cannot be repaired but must be pulled out.

An infected oral cavity affects the general condition. The pain can cause the child neither wants nor can eat and therefore the child may not gain weight properly. The child may also have difficulty sleeping.

When should we seek care?

Contact a dentist if you notice that the child appears to have a toothache, is swollen and tender around the tooth, has difficulty chewing, or if you see white spots on the teeth. The earlier the child’s teeth are examined, the easier it is to treat the teeth.

How do we reduce the risk of getting holes?

Regular toothbrushing with fluoride toothpaste and improved eating habits means that superficial holes can heal and the child does not have to get new holes. Preventing caries yourself is always the best treatment.

The most important self-treatment for caries is that:

  • Brush your teeth morning and evening with fluoride toothpaste.
  • Let your teeth rest between meals and all night.
  • Drink water between meals.
  • Pay attention to new teeth at the back as they are extra sensitive.

Start brushing when the first tooth arrives

A new tooth is extra delicate and sensitive to caries attack. When the first teeth start to come up, it is time for the child to get acquainted with the toothbrush in a soft and playful way. As soon as the first teeth have arrived, an adult should brush their teeth with fluoride toothpaste on the child twice a day, morning and evening.

The brushing should be done so carefully that the teeth are clean and the gums are kept healthy and do not bleed when brushing. Toothbrushing in the evening is most important. The toothbrush should be small and have very soft bristles.

The upper jaws of the upper jaw get light holes along the gum line. Therefore, it is important to keep your lips away so that you look good and get to brush especially there.

Clean in the mouth during the night

The risk of caries increases if the child receives something other than pure water as a night meal or in a baby bottle when the child is to fall asleep. The food stays up all night as the self-cleaning of the teeth of the saliva, lips, cheeks, and tongue stops asleep. Should the child fall asleep immediately after the meal, it is good to clean the mouth with a soft toothbrush and fluoride toothpaste even though the child sleeps.

Children under the age of three have poor self-cleaning in the mouth. It can also have children with disabilities. Then the child needs help to finish the meal with drinking water.

Pay attention to the six-year teeth

When the first cheek comes, it’s time to start brushing in a more systematic way. The new cheek teeth are usually bulky and are difficult to access so that they are difficult to brush really clean.

Of all permanent teeth, it is the six-year-old who usually gets deep caries and usually needs treatment. A good rule is, therefore, to look far back in the mouth from the age of five so that the six-year teeth are detected and thus brushed early. It is always possible to contact the dentist if a visit needs to be made earlier if you suspect holes in a tooth.

To reduce the risk of caries, the potholes and grooves of the chewing surfaces can be protected with a thin layer of plastic. This is called sealing the tooth fissure.

It is advisable to seal the six-year teeth as soon as they have broken out. Corresponding treatment also applies when the twelve-year period breaks out. Fissure sealing is a great way to protect the cheek teeth from caries in the chewing surface pits and fissures.

Bacteria and sugar form acid

Almost all children and adults have bacteria in their mouths that can cause tooth decay. The bacteria become more in the mouth if the child does not brush his teeth regularly and often eat sweet snacks.

The baby’s milk teeth are affected more quickly by bacteria, as the teeth are thinner than the permanent teeth that come later. This means that the distance to the denture and the nerve is shorter. The risk of getting an infection is greater and this makes the milk tooth more difficult to cook.

To be able to get caries, a bacterial coating is needed on the surface of the tooth and sugar. The bacteria from acid from easily soluble carbohydrates such as sugar. The acid dissolves the enamel and if it can be undisturbed, a hole is formed. If the tooth is rested, the saliva can neutralize the acid and repair the tooth surface. Brushing the tooth clean from bacterial coating also stops holes in the tooth.

When you have a hole in the tooth, other bacteria can grow inside the hole. This way bacteria and acid can work their way into the dental nerve. In the end, you get toothache because the nerves and vessels in the pulp become irritated.

Children can get caries bacteria from their parents

Children can get caries bacteria from adults in the area who have a lot of caries bacteria. The child is infected and the risk of getting holes in the teeth at an early age increases. Therefore, it is good for children’s teeth that even close-knit adults take care of their teeth.


From the age of three, but usually already from one or two years of age, all children are offered visits to the Folktandvården, and then they are called for regular dental visits. Up to the age of 23, children are entitled to free dental care, even at a private dentist. In some county councils and regions, free care is also given to older youth.

How is the investigation going?

Caries examination is usually done by a dentist or dental hygienist. A dentist can do a dental examination and if something is not right a dentist will come.

When the tooth is made dry with compressed air, it is examined with a mirror. It is done to examine changes in the color or transparency of the tooth that may reveal that the tooth is not intact. The caries attack can have a very small entrance into the tooth and then spread out inside the dental crown. The dentist or dental hygienist uses a thin and pointed instrument called a probe. With this, it is possible to feel if the tooth is healthy and the pits in the tooth’s chewing surface are hard.

The teeth are x-rayed to detect caries between the teeth early in the dental crown. The first X-rays are usually taken at about five years of age or when the milk teeth grow so that they are in contact with each other. If the child has no signs of caries, it usually takes two or three years before the next x-ray is taken.

Treatment for holes in milk teeth

When there is already a hole in the tooth, the dentist must make a repair. How it is done depends on the child’s age and ability to cooperate. Together with the child and the adult, dental care sets up a treatment plan. In the case of very young children, an attempt is often made to make a temporary repair that will prevent the hole from becoming larger.

Most children over the age of three usually manage to get their teeth fixed. It is good if the child is allowed to attend school and train at various stages before the planned treatment. There are aids such as nitrous oxide, sedative medicine, or in some cases anesthesia. It can be used if the child is very anxious or if the treatment is so acute that you cannot wait for the child to be educated.

No plastic fillings

The front teeth of the milk teeth are not usually cooked with filling, but are sanded so that the toothbrush will clean. The milk teeth farther back are usually repaired with a so-called glassy cement.

Glass ion cement can be reinforced with a little plastic. Glasiomas bind to fluorine and can thus strengthen the tooth surfaces around caries. In addition, the glassy cement copes well with the changes that occur in the child’s mouth as it grows. The material is a bit softer and worn so that it fits in the child’s bite.

The dentist selects filling material according to the size of the hole and where it is located. The experience of the filling materials used today is good and, given the relatively short life span of the milk teeth, they do well. 

Sometimes it is best to pull out the tooth

One of the tasks of the milk teeth is to hold the permanent tooth that comes after. Especially the milk teeth can be important for the bite. Sometimes it may be that a milk tooth is no longer important for the bite. If it has a large hole, the dentist may choose to remove the tooth instead of repairing it.

Milk teeth that have holes that have entered the nerve are almost always pulled out. If it has formed around the root, the tooth is always pulled out so that the infection does not spread.

Ehtisham Nadeem

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