Decay in baby teeth progresses much faster than in adult ones. Paediatric dentist Audrey Camilleri argues that a child’s rotten teeth should be filled rather than extracted even though they will eventually fall off.

Fillings should be done under local anaesthetic to ensure that all decay is removed and that the procedure is completely painless for the child.

Baby teeth are as prone to develop cavities as adult teeth but decay progresses much faster.

“Since they are smaller, the caries reaches the nerve area much faster with consequent pain and infection,” says paediatric dentist Audrey Camilleri.

The fact that sugary foods can harm our teeth is well known by now, but some mothers may still be unaware that some food may contain hidden sugars.

“Besides the usual sweets, juices and soft drink, sugar is present in foods such as tomato ketchup, most cereals and also in natural products, such as honey,” she points out.

Asked whether natural-occurring glucose is as harmful to our teeth as refined sugar, Camilleri quickly replies: “Any foodstuff which has an ingredient ending in ‘ose’ has sugar in it.”

Babies that are exclusively breast- or bottle-fed are also at risk of cavities, but only when:

• a child is bottle fed formula milk beyond one to one-and-a-half years of age;

•a child is put to sleep with a bottle in their mouth;

•bottle feeding continues beyond two years of age;

•breastfeeding continues beyond the age of one year.

If a child has cavities in his teeth, it is important that these are filled.

“They can and should be filled,” maintains Camilleri. “They should only be extracted if there is severe infection and pain. If these teeth are not filled, the child will experience pain while eating and the caries will spread, resulting in more pain, a swollen face and the need for an extraction.

“An early extraction of a baby tooth can cause space loss for the permanent tooth which will erupt later on.”

Camilleri says that most, if not all, fillings should be done under local anaesthetic to ensure that all decay is removed and that the procedure is completely painless for the child.

“Ideally a topical anaesthetic gel is placed before giving the injection and also, ideally, the child does not see the syringe being used.”

As always, prevention is better than cure and it should start at a very early age. Parents can start brushing their baby’s teeth as soon as they come through. The brush size should be age appropriate and due consideration should be given to the amount of toothpaste and fluoride used.

“There is still a lack of awareness of the importance of fluoride in a child’s toothpaste which should be used as soon as the first tooth erupts,” the dentist recommends.

She suggests that children up to three years of age should use a smear of toothpaste with a fluoride level of at least 1,000ppm (parts per million), while children older than three use a pea-sized amount of toothpaste with a fluoride level of 1,350-1,500ppm.

And the first dental check-up should take place when children are three years old and reviewed on a six-monthly basis.