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Tooth decay, the breakdown of tooth enamel, can lead to carries, and this is caused by bacteria.^1,3

All children have bacteria in their mouth. So, all children are at risk for tooth decay. But some factors may raise risk for it: ^2,3

1. Tooth location: carries often occurs in the back teeth (molars and premolars) who have lots of grooves which can collect food particles and are harder to clean
2. Bedtime infant feeding such as bottles of milk, juices or other liquids that contains sugar that remains on their teeth while sleeping feed the bacteria that causes decay
3. Inadequate brushing can accelerate the first step of decay caused by plaque
4. Not getting adequate water and fluorides: fluorides prevent cavities and it is present in many toothpaste
5. Heartburn or reflux: stomach acid coming back into the mouth damages the enamel of the teeth and leading it to the attack of bacteria and create tooth carry
6. Lack of saliva and dry mouth as saliva help counter the acid produced by bacteria
7. Dental devices: they can stop fitting well which allow decay to begin
8. Some food and drinks that cling to the teeth for a long time (milk, soda, candy, cake, cookies, chips) 

Dr. Massoud Abou Zeid

Pediatric, Neonatologist 

¹https://www.hopkinsmedicine.org/health/conditions-and-diseases/tooth-decay-caries-or-cavities-in-children

²https://www.mayoclinic.org/diseases-conditions/cavities/symptoms-causes/syc-20352892

³https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=90&ContentID=P01848