Overview

Dental decay is damage to a tooth. If it is not treated, this can cause pain, an infection, and swelling.

It can also cause damage to the adult tooth that's developing underneath it.

The damage is caused by bacteria in the mouth that turn sugars into acid. Over time, the acid makes a small hole (cavity) in the tooth.

Dental decay can be caused by:

• not brushing your teeth well
• having lots of sugar in your diet
• having developmental conditions affecting the teeth

There are different treatments for dental decay. The treatment your child has will depend on how much damage there is to their teeth.

Some children might need to have their treatment or check-up under general anaesthetic. This means they will be asleep (unconscious) during the treatment, and will not feel any pain. This can help them cope with their treatment.

Read information on looking after your child’s teeth and gums to prevent dental decay.

Dental decay

Teeth are made up of 3 layers:

• enamel (outer layer)
• dentine (middle layer)
• pulp (bottom layer)

The treatment for each tooth will depend on which layer the decay has reached.

Sometimes the decay is between teeth, where you cannot see it.

The pulp is the centre of the tooth, where the nerves are. When the decay is close to, or has reached the pulp, there is more risk of having pain and infection.

If this happens, the tooth will need to be removed.

Treatment for dental decay

Most children will have one or more treatments if they have dental decay.

Treatment plans can often change. Due to long waiting lists for treatment, the decay might get worse. This means more treatment might be needed than originally planned. 

The dentist might not be able to tell you exactly what treatment is needed until your child is under general anaesthetic. This is because they might need to check the decay when your child is asleep.

Check-up (examination)

The dentist might take X-rays during the check-up, to help them decide what treatment your child needs.

Some children find it difficult to have a check-up when they are awake. If so, the check-up can be done under general anaesthetic.

Fissure sealants

A sealant is a white coating which is put in the natural grooves on the surface of the teeth. This protects the teeth by helping to stop food and bacteria getting into the grooves and causing decay.

Fissure sealants can sometimes wear away or chip over time, and might need replacing.

Your local dentist might be able to do this treatment if your child can cope with dental treatment while they are awake.

White fillings

Teeth that have small holes (cavities) can sometimes be treated by removing the decay and putting a white filling in the tooth.

The filling protects the tooth and helps to stop more decay.

Fillings can sometimes fall out or get damaged, and need replacing.

Stainless steel crowns

These crowns are silver coloured, stainless-steel, caps. They help to protect baby teeth by stopping any food or bacteria getting to the tooth and causing decay.

They are used when the holes in the tooth are too big for a filling, or if the teeth are weak. They can also protect healthy teeth if your child is at risk of decay.

Stainless steel crowns cover the crown of the tooth, which is the white part of the tooth that sits above the gum. They are only used for baby teeth, and are different from crowns used on adult teeth.

They are only used on teeth at the back of the mouth, so are not too noticeable. They will be lost with the baby tooth when it falls out naturally.

Sometimes these crowns can wear away over time, or fall off and need to be replaced.

Read the NHS information on crowns and what happens during this treatment.

Removing the tooth (extraction)

If the decay has reached the pulp of the tooth and is causing pain or an infection, the tooth will need to be taken out.

This will stop any pain or infection in the future which could harm the developing adult teeth.

We do not offer root canal treatment for these teeth.

After having a tooth removed, your child might have some:

• pain
• bleeding
• bruising
• swelling
• infection

The dentist or nurse will give you lots of advice about how to manage these side effects.

Read information on tooth extractions, and caring for your child after this treatment.

Care after treatment

Unless the hospital team tell you otherwise, your child’s care will be transferred to their local dentist when their treatment at the hospital is complete.

It is very important that your child visits their local dentist for regular check-ups.

They can give you advice about brushing teeth, and your child’s diet, to help stop dental decay.

They can put fluoride varnish on your child's teeth to protect them from more decay.

Read information about looking after your child’s teeth and gums.