Do cavities in baby teeth need to be filled?

That first trip to the dentist can be scary. But explaining what's going to happen can help relieve anxiety for some kids.
That first trip to the dentist can be scary. But explaining what's going to happen can help relieve anxiety for some kids.

Some babies leave the womb and enter the world with teeth already in place. In about 1 in every 2,000 to 3,000 births, these natal teeth, or fetal teeth, make an appearance [source: MedlinePlus]. They're often removed to spare a nursing mother from discomfort and to prevent the baby choking on them should they fall out.

But that isn't the usual progression, of course. Primary teeth, the dentist's name for baby teeth, begin to erupt as early as 3 months along. It's usually the bottom two teeth that crop up first, no surprise to any of us who have seen Facebook photos of babies with gummy smiles.

Teething can be rough for both infant and parent. While some families get away with little to no squalling during the teething period, others have a considerably bumpier ride, which is why so many home remedies exist for teething pain, from a cold spoon to chew on, to a chilled washcloth. (Steer away from whiskey on the gums, folks. That's why they make numbing gels for babies nowadays.)

Many people seem to think that dental care before the eruption of permanent teeth is a piece of sugar-free cake. That's not the case. As soon as those little chompers appear, they should be cleaned with a baby toothbrush and water. The first visit to the dentist should occur by the first birthday, at the latest, and brushing with toothpaste starts around age 2.

Plaque, that lovely bacterial film that develops on our teeth, comes from the sugar and starches in foods. Sugary substances like sodas and candy contain them, of course, but many people don't realize that nutritious foods, such as milk and fruit, have naturally occurring sugars in them as well. That means that even a baby who is exclusively breast- or bottle-fed is at risk for cavities, or caries. Acids in plaque attack the tooth's enamel, burning holes in it that make perfect homes for bacteria. When left untreated, those holes simply grow larger until the whole tooth rots.

Baby bottle tooth decay came into the public consciousness in the 1970s, when the media began reporting on research that babies who slept with milk bottles got more cavities than babies who didn't. Since then, the term has been revised to early childhood caries, or ECC. And ECC is an infectious disease.