By Dr. Erica Coe Hollander, DMD
When parents ask me what causes cavities in children, they are often surprised by the answer.
Cavities are not caused directly by sugar. They are caused by bacteria that naturally live in our mouths. When we eat sugar or processed carbohydrates, these bacteria feed on them and produce acid. That acid attacks the teeth, causing them to lose minerals and begin to dissolve.
Fortunately, our bodies have a built-in repair system. After we eat, saliva gradually neutralizes the acid and delivers important minerals, such as calcium, back to the teeth. This process, called remineralization, helps repair early damage before it becomes a cavity.
Throughout the day, our teeth are constantly cycling between periods of acid attack and repair.
The problem occurs when children are eating or drinking frequently throughout the day. If a child is constantly grazing, snacking, or sipping on sweet drinks, their teeth may never get enough time to recover. Instead of alternating between damage and repair, the teeth remain under a near-constant acid attack, increasing the risk of cavities.
One of the best things parents can do is create structure around eating. Children who have defined meal and snack times give their teeth a chance to rest and rebuild between eating episodes. Drinking water after snacks can also help wash away food particles and neutralize acids.
Certain foods are especially cavity-causing because they stick to the teeth for long periods of time. Common culprits include gummies, dried fruit, Goldfish crackers, cookies, and other processed foods. These foods can lodge between teeth and in the grooves of molars, allowing bacteria to feed on them for hours.
Parents often ask what my own children eat for snacks. Some of our family favorites include string cheese, Nori (dried seaweed), chomp sticks, bell peppers, pistachios, edamame, blueberries, and spam musubi.
These foods are filling, nutritious, and generally do not stick to the teeth the way many processed snack foods do.
I am less focused on avoiding treats altogether and more focused on enjoying them wisely. For example, popsicles, ice cream, and dark chocolate are often better choices than sticky candies because they are eaten in one sitting and do not remain on the teeth for hours. The same principle applies to juice. An occasional serving with a meal is far better than sipping on juice throughout the day.
The goal isn’t to eliminate every treat. It’s to create healthy eating patterns that give growing teeth time to recover. A few simple changes, like structured snack times, drinking water after eating, and choosing less sticky foods, can make a big difference in your child’s oral health.
Dr. Erica Hollander is a board-certified pediatric dentist with Just Keiki Pediatric Dentistry in Kahului. Learn more at justkeiki.com.
