Good oral health results in a healthy smile, teeth, and gums. Poor dental hygiene however, can cause tooth decay in children, also known as early caries. Baby teeth help children to eat and speak.


They also guide the permanent adult teeth into position, so it is important to take care of your child’s teeth right from the start, said Manish, a foremost dentist and smile design expert in Kenya.

“The oral cavity is important,” he said. “It is the entry point for food and nutrients into the body.”

“If dental health is compromised, it will cause a breakdown of health in the entire body.”


Every child faces the risk of tooth decay. The enamel (hard outer layer) is much thinner and softer on baby teeth, making them more vulnerable to decay. The good news is that tooth decay is largely preventable.


It is the same as tooth decay in adults. Manish explains tooth decay as a disease that occurs when sugary foods stay on the teeth for long periods. Bacteria that live in the mouth change these foods into acids. The combination of bacteria, food, acid, and saliva form a substance called plaque that sticks to the teeth. Saliva helps to repair this damage, but if there is more damage than repair over time, it leaves a cavity or hole in the tooth.


Tooth decay in children is also called ‘nursing bottle caries’, ‘infant feeding caries’ and ‘baby bottle decay’. This is because the evidence suggests that early childhood caries occurs when babies and infants are settled to sleep with a bottle of milk or formula (or other sweet drinks). Milk can pool in the mouth and the lactose sugar in milk feeds the bacteria that cause decay as the baby sleeps. Saliva flow is low during sleep, and so does not protect against damage.

Early childhood caries might also occur if toddlers drink sweet drinks, such as fruit juices, cordials or soft drinks. You’ll need to avoid sugary foods and drinks, especially between meals.


Tooth decay may initially appear as white spots on the gum line of your child’s upper front teeth. These spots are hard to see at first—even for a child’s doctor or dentist—without proper equipment. According to Manish, “a child with tooth decay needs to be examined and treated early to stop the decay from spreading and to prevent further damage.”


Apart from a hole, other signs of a rotten tooth include:

  • toothache
  • sensitivity to hot or cold
  • brown, black, or white spots on the tooth
  • bad breath
  • unpleasant taste in the mouth
  • swelling
  • irritability
  • fever


  • Form healthy eating habits. Don’t put your children to sleep with a bottle, and watch their sugar intake. Many times children want sweets and chocolate, and giving in all the time is tempting. But you’re not doing your child any good that way. According to Manish, “fizzy drinks and juices are high in sugar and citric (ascorbic) acid, which contributes to tooth decay”.
  • Let your child gargle with water after every meal and after eating sweets. If they are too young to gargle, have them drink  water after eating, and no snacking between meals.
  • Clean your baby’s gums daily with a washcloth. Once the first tooth, comes out, begin brushing his teeth with a soft baby toothbrush. Use a toothpaste that contains mild fluoride, until he’s about 2. Then you can use a baby toothpaste that contains fluoride. Fluoride is important for protecting the teeth from infection and decay.
  • Children learn by example. Teach your children to enjoy brushing their teeth, by example. Manish suggests making brushing a family activity. He recommends brushing twice daily – in the morning and just before bed. He explains that “your body doesn’t produce saliva at night. So bacterial activity is three times higher during the night.” Thus brushing your teeth at night is very important, for both adults and children.
  • Scheduling routine dental appointments twice a year. Manish explains that while not many parents see the need for routine dental checks, the importance cannot be overemphasized. “Some infections are not obvious to the naked eye,” he says. “Also, the toothbrush is unable to remove all the plaque in teeth. But a visit to the dentist will solve that.”


In the early stages of tooth rot (small cavity), your dentist may perform a fluoride treatment to strengthen or remineralize the tooth, which may reverse a cavity. This method, however, only works for smaller cavities.


When a fluoride treatment isn’t an option, your dentist can remove decayed parts of the tooth and perform either a dental filling or a dental crown to fill holes in the tooth.

When a tooth can’t be saved due to severe rot, your dentist may extract the tooth and replace it with a denture, bridge, or an implant. If the tooth were to fall out early due to decay, this could cause misalignment of their permanent teeth.


  1. Smear a pea-sized amount of low-flouride toothpaste onto a soft children’s toothbrush.
  2. Sit the child in your lap, facing away from you, or stand behind taller children.  Tilt the child’s head back against your body so you can see all the surfaces of the teeth.
  3. Angle the bristles of the toothbrush towards the gum. Aim for the gums at a 45 degree angle down from and up into the gums. Move the brush in gentle circles to clean the outer sides of the teeth and gums.
  4. Brush in gentle circles on the inside of the teeth and gums.
  5. Brush back and forward on the chewing surface of the teeth.
  6. After brushing all the surfaces, encourage your child to spit out the toothpaste.
  7. The entire process should last 3 minutes and not longer.
  8. Replace toothbrush every 3-4 months, or when the bristles get worn or frayed.

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