Milk tooth decay is a lesion involving the loss of hard tissue of milk tooth due to the demineralization process caused by bacteria in dental plaque. This is a common pathology in children; if not treated promptly, it will affect oral health and the child’s development.

Causes and Pathogenesis

According to the Ministry of Health’s guidelines, the cause of milk tooth decay is bacteria active on dental plaque that ferment carbohydrates to create acid. This acid lowers the pH on the tooth surface, causing demineralization of enamel and dentin. When the demineralization process occurs continuously and dominates the remineralization process, cavities will form.

Definitive diagnosis

The diagnosis of milk tooth decay is based on clinical and paraclinical symptoms:

Clinically, functional symptoms vary by stage. In the early stage, the child usually feels no pain. When the lesion progresses deeper into the dentin, the child may feel sensitivity upon stimulation (hot, cold, sour, sweet); this pain stops immediately after the stimulation ceases.

Upon physical examination, the doctor can detect hard tissue loss lesions on the enamel or dentin. The cavity base can be hard or soft (soft dentin), with color changing from yellow to dark black.

Regarding paraclinical aspects, X-ray images are effective support tools. On X-rays, radiolucent images of the enamel and dentin areas help doctors determine the extent and scope of the decay lesion.

Treatment guidelines

The treatment principle is to stop demineralization, enhance remineralization (in the early stage), and restore lost tooth tissue (in the stage where cavities have formed).

For early-stage tooth decay (no actual cavity formed yet): The main measure is remineralization of the damaged enamel. Doctors will use Fluoride therapies (such as applying fluoride varnish, fluoride gel, etc.) to enhance the hardness of the enamel and prevent decay progression.

For cases where cavities have formed, the technical process involves cleaning the cavity and removing all infected soft dentin tissues. Then, the doctor will shape the cavity according to standards and perform sealing to restore hard tissue using suitable materials (such as GIC, Composite, or Amalgam…). Sealing helps protect the dental pulp and restores the shape and chewing function for the child.

Prevention

To prevent milk tooth decay, parents need to pay attention to proper oral hygiene for children (brushing teeth with Fluoride-containing toothpaste), controlling diet by limiting sugar, and taking children for periodic dental check-ups to detect lesions early.

MSc. Dr. Cao Thanh Hoa – Deputy Director of the Center for Support & Continuing Education