1. What causes cavities in baby teeth, i.e. are they soley the
result of poor oral hygiene?
Cavities in baby teeth are the result of bacteria consuming carbohydrates and turning them in acid which demineralizes the tooth. Carbohydrates sitting on the teeth is what causes cavities. Poor oral hygiene results in those bacteria and carbohydrates sitting on the surface of the teeth for longer periods of time, increasing the risk of substantial acidic damage to the teeth. Minor demineralization is reversible, but if enough demineralization occurs to the point it starts to collapse the inner tooth layer (dentin), then cavitation results. This step is irreversible.
2. Why are cavities in baby teeth so common?
Cavities are common in baby teeth due to dietary choices of kids as well as their inferior oral hygiene compared to adults. To a lesser degree, there can be some anatomical differences genetically between people in teeth as well, as deep narrow grooves (too narrow for a toothbrush bristle to penetrate) can make it more difficult to remove the bacteria and carbohydrates that can break down teeth and form cavities.
3. How are cavities in baby teeth treated?
Cavities in baby teeth are usually treated the same way as adult teeth - drill and fill. Mild cavities or cavities that a child cannot tolerate to have fixed are sometimes treated with a temporary resin in some situations to make the filling more likely to last in situations where it is difficult to get a child to cooperate fully during the dental appointment. Children that can't tolerate a standard filling can also receive various forms of sedation to ease the process. There are also pediatric crowns in the case of larger cavities, or even mini-root canals called pulpotomies. Occasionally, a baby tooth can even be extracted and a space maintainer sometimes placed to hold room for the permanent tooth to come in later. Rarely, if a tooth is loose and will fall out soon naturally, the filling may not be performed.
Occasionally, if the tooth appears affected by acidic degradation but has not yet turned into a cavity, demineralization with fluoride can help. Some dentists also will use silver diamine fluoride to help arrest cavity progression in some kids as a short term, less invasion solution to help stabilize the tooth.
4. What can you do to prevent cavities?
Avoiding fermentable carbohydrates and sugars is the most important step, with proper oral hygiene as a close second. Third, use of fluoride on the surface of the teeth is also effective as remineralizing and strengthening the hardness of the teeth, making them less susceptible to acid.