Protecting Little Smiles: Understanding and Preventing Childhood Tooth Decay

Lacey St. Clair, RDH

Dental decay—also known as caries or cavities—is one of the most common preventable chronic diseases affecting children in the United States. When left untreated, tooth decay can cause pain and serious infections and may interfere with a child’s ability to eat, play, communicate, and learn. During the 2024–25 school year, Missouri’s Preventive Services Program identified that 1 in 4 children had untreated dental decay. Understanding how tooth decay develops is essential for parents and caregivers. 

Cavities form due to a combination of oral bacteria, sugary or starchy foods, and poor oral hygiene/homecare. Bacteria in the mouth feast on sugars and starches from food ingested (milk, juice, crackers, bread, soda, fruit snacks), producing acids that weaken and break down tooth enamel over time.  To put it simply sugar + bacteria = acid.  Each acid attack can last 20 minutes.

Now, let's talk about prevention. Diet plays a huge role in tooth decay—not just the types of foods consumed, but also how frequently they are eaten. Constantly sipping drinks (milk, juice, sweet tea) throughout the day can lead to significant damage. The acidic environment created by the first drink barely has time to neutralize before the second drink creates another.  Limiting sugary items such as fruit snacks, juice, candy, soda, and sweet tea can help reduce dental decay.

Consistent daily home care can also reduce dental decay.  Brushing twice a day for two minutes and flossing every night before bed is recommended. Using fluoride toothpaste is ideal, though brushing without toothpaste is still beneficial. The most important factor is the manual removal of plaque. It only takes about five minutes a day to help prevent cavities. In addition, Children should visit the dentist at least twice a year. Identifying and treating small areas of decay early is critical to maintaining healthy smiles.