Tooth decay is the most common chronic childhood illness, with the National Institute of Dental and Craniofacial Research reporting as many as 42% of children ages two to eleven having cavities. Cavities can often be overlooked by parents, since they are usually located in areas not obviously evident, such as close to gums, between teeth, or in back molars.

When cavities are caught when they are small, treatment is much easier than if a cavity is large or a tooth is broken or decayed beyond repair. It can mean the difference between a filling, a crown, or even extraction of the tooth.

Let’s talk about why each of these treatments might be needed:


A filling is used to patch or fill in a hole left in a tooth after decay is removed. The pediatric dentist removes the decay and fills the hole with a tooth-colored composite resin, then smooths and polishes the tooth. Without repair, cavities will continue to decay, and food, plaque and bacteria will collect in the hole, causing further damage.

The pros of fillings are that they are less-expensive than crowns, and tooth-colored options are available. They are not, however, a good option for large or multiple fillings in the same tooth, or for decay that is located close to the nerve.


A crown is a tooth-shaped cap that covers and protects the entire tooth. Available in two options: stainless steel or tooth-matching porcelain, crowns are generally preferred for larger repairs, such as multiple fillings in the same tooth or broken teeth. More durable than fillings, crowns are used to help keep baby teeth healthy until the tooth is ready to fall out, and in most cases, offer a good way to protect back molars, which fall out around age 12 or so.

Crowns may be more expensive short term, but can be more cost-effective in the long run. The downside of crowns is that more of the original tooth structure must be removed to fit the crown into the existing bite. In addition, their size can be unsightly (as with stainless steel crowns) and porcelain crowns can chip.


If decay is so severe that it causes infection to surrounding gums and bone, teeth may need to be extracted (removed). This helps ensure that the health of the permanent tooth is preserved, as the adult tooth bud is growing between the roots of the baby tooth.

Consider dental sealants

Dental sealants are invisible plastic resin coatings that can be “painted” onto back teeth to smooth out the deep grooves of chewing surfaces, the place where your child is most likely to get cavities. With a sealant, a tooth is far less likely to develop a cavity.

When should you begin to visit your pediatric dentist?

You should schedule your first visit to your pediatric dentist when the first tooth appears, generally when your child is between six months and a year old. From there, schedule a twice-a-year visit to your pediatric dentist for a professional cleaning and dental exam, along with fluoride treatments to prevent problems or catch them before they become large.

In addition to regular exams, you should contact your pediatric dentist if you notice a change in your child’s teeth, like a cavity or when a trauma such as a broken tooth occurs. Children may not necessarily complain, so watch for changes in their behavior like avoiding eating or drinking, chewing on one side of their mouth only, or a different in their speech.

Contact Smile Wonders

Dr. Rishita Jaju is a board-certified pediatric dentist and recognized dental laser expert located in Reston, Virginia. Call Smile Wonders today to schedule your appointment.