KidsMD Health Topics

Cavities (Tooth Decay)


    Boston Children's Hospital 
    300 Longwood Avenue
    Hunnewell 4
    Boston MA 02115

     fax: 617-730-0478

  • In-Depth

    Some children may inherit from their parents "good teeth" and never develop cavities. But more importantly, what your child eats will determine the chance of developing cavities.

    Risk factors that put a person at a higher risk for tooth decay include:

    • Diets high in sweets, carbohydrates and sugars. Children's recommends limiting juice consumption to no more than four ounces daily.
    • Water supplies with limited or no fluoridation. Children's encourages parents to use fluoridated water for cooking and drinking, as most bottled water does not have adequate fluoride.
    • Age (children and senior citizens are at an increased risk for tooth decay)

    Smart snacking       

    When you are deciding on a snack, the National Institute of Dental Research, part of the National Institutes of Health (NIH), reminds you to think about the following:

    • the number of times a day you eat sugary snacks
    • how long the sugary food stays in your mouth
    • the texture of the sugary food-chewy or sticky

    According to the NIDR, damaging acids form in your mouth every time you eat a sugary snack. Consider an alternative, such as raw vegetables, fresh fruits or whole-grain crackers next time the urge to snack strikes.

    Symptoms of tooth decay and dental carries

    Each child may experience symptoms differently. Yet symptoms may include white spots on the teeth that appear first. Then, an early cavity appears that has a light brown color on the tooth. The tooth color progressively becomes darker.

    Preventing tooth decay:

    Preventing tooth decay and cavities involves five simple steps:

    • Brush your child's teeth, tongue, and gums twice a day with a fluoridated toothpaste, or supervise them brushing their teeth.
    • Floss your child's teeth daily after the age of 2.
    • Make sure your child eats a well-balanced diet and limit or eliminate sugary snacks.
      * Consult your child's physician or dentist regarding the supplemental use of fluoride and/or dental sealants to protect your child's teeth against plaque.
    • Consult your child's physician or dentist regarding the supplemental use of fluoride and/or dental sealants to protect your child's teeth against plaque.
    • Schedule routine (every six months) dental cleanings and examinations for your child.
  • Tests

    Dental caries are usually diagnosed based on a complete history and physical examination of your child. A diagnosis may be performed by your child's physician or your child's dentist.

  • Treatment, in most cases, requires removing the caries and replacing the lost substance of the tooth with a filling.

    What are fillings?

    Teeth that have been affected by tooth decay (caries or cavities) require a filling. There are many different types of fillings, including:

    • Dental Amalgams - Dental amalgams, also known as silver fillings, are comprised of a mixture of mercury (45 to 50 percent), and an alloy of silver, tin, and copper (50 to 55 percent). When combined with other materials in a dental amalgam, mercury's chemical nature changes.
    • Composite Resins - Also known as white fillings, a composite resin is a tooth-colored plastic mixture filled with glass (silicon dioxide) that is used primarily for cosmetic improvements of the smile by changing the color of the teeth or reshaping disfigured teeth.

    Other alternatives to restoring damaged or decayed teeth:

    • Porcelain veneers - a ceramic material is bonded to the front of teeth to change the tooth's color, size and/or shape
    • Crown - a cap that covers a cracked or broken tooth, unfixed by a filling, to approximate its normal size and shape
    • Cast gold restorations - this type of restoration is often more costly and may require more than one dental fitting
  • Research & Innovation

    Man Wai Ng, MD, dentist-in chief, is undertaking one of the only quality improvement initiatives for pediatric dentistry in the country: redesigning the care delivery system based on the prevention and management of cavities. Instead of "drilling and filling," Ng advocates for treating cavities as a disease that can be reduced and controlled. In addition to office-based treatments, her project includes educating parents and giving them self-management plans. She's finding a marked decrease in new cavities and a reduced need for surgical treatments-costly endeavors that often require a child to undergo anesthesia.

Request an Appointment

If this is a medical emergency, please dial 9-1-1. This form should not be used in an emergency.

Patient Information
Date of Birth:
Contact Information
Appointment Details
Send RequestIf you do not see the specialty you are looking for, please call us at: 617-355-6000.International visitors should call International Health Services at +1-617-355-5209.
Please complete all required fields

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

This department is currently not accepting appointment requests online. Please call us at: 617-355-6000. International +1-617-355-6000.

Thank you.

Your request has been successfully submitted

You will be contacted within 1 business day.

If you have questions or would like more information, please call:

617-355-6000 +1-617-355-6000
Find a Doctor
Search by Clinician's Last Name or Specialty:
Select by Location:
Search by First Letter of Clinician's Last Name: *ABCDEFGHIJKLMNOPQRSTUVWXYZ
Condition & Treatments
Search for a Condition or Treatment:
View allSearch
The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO