• Dr. David Alfaro

Tooth Decay in Kids

***NSFW warning: There are some potentially disturbing images in this article***


Part of my role as a dentist is to promote oral health wellness, which is the reason I take the time to put up articles on our website. One big aspect of this is caries prevention. Tooth decay is a lifelong battle and good habits need to be implemented early. Along with a healthy diet, good homecare, and regular professional dental cleanings and checkups, the use of a fluoride toothpaste starting in childhood is recommended because it is the best medication available to help fight this disease process.


Again with the fluoride?


The amount of misinformation about fluoride (and many other wellness related topics) being promoted online is really disappointing from a health professional’s standpoint. When adults come to the office with strong viewpoints that fluoride is a toxin and that other products work as well, I really do not spend too much energy trying to convince them. If they have tooth decay and they are not using fluoride, I make my recommendation, they object, and I don’t push any further, unless they are open to a non-confrontational, evidence-based discussion. They are adults and have the right to control their medical choices and I do not want to create a feeling of hostility, but I am available to provide scientific support if they want.


The tough part is with parents. I get it. I am a new dad. I want the best for my daughter and don’t want anything to harm her. So I understand why people would be avoiding fluoride if they thought it was hurting their child. But people are not getting good advice about fluoride and the risks of tooth decay are being downplayed.


But baby teeth fall out anyways!


Kids get tooth decay. They get it quickly and it is a serious health concern. Too many children are suffering from aggressive tooth decay, and avoiding fluoride only increases the risk of cavities. This is not an opinion. It is proven by hundreds and hundreds of scientific articles and is a reality in my own dental practice.


Tooth decay in children is not harmless; it is painful, they can get dangerous abscesses quickly from it, and even though their baby teeth do fall out, missing and tooth decay damaged teeth can have long term impacts on their smiles, their bites, their adult teeth, and even their airways, although that last one is a hot, debatable topic in dentistry.


Many parents do not realize how serious tooth decay is until it is too late, and often the teeth can look healthy from the outside, so I want to show you some real images, from real kids, from all over the country and the US. Kids from all sorts of backgrounds.


Even a couple of big cavities can cause problems


Even just one tooth with severe decay can have a big impact for the rest of that child's life. This is a 15 year old with great homecare and diet, but who’s mother refused to use fluoride because of fears of calcification of the pineal gland (which will get it’s own entire article btw). This tooth looked ok from the outside, but we took an x-ray and saw a huge area of tooth decay, approximating the nerve. We were able to fix this with a filling, but for sure they are going to need a root canal and crown at some point early in their lives because no dental treatment lasts forever, especially in someone with dental caries. She had 3 teeth like this, so she is looking at thousands of dollars of dental care over her lifetime.


Would fluoride have stopped this? Maybe not. Would it have lessened the chances of such extensive decay? Yes!


Aggressive tooth decay is very common


That was someone with just a couple of areas of tooth decay, but what I really want to show you is the heartbreaking stuff. Now please understand that the following images are graphic and bothersome. But you need to see what pediatric specialists and hospital dentists see EVERY DAY. This is not extreme outlier dentistry. It is what we see all of the time, in people from all backgrounds. Every dentist has seen too many children in this situation.


This is what tooth decay in kids looks like:





This is not a scare tactic. This is reality. Here in Nelson over 100 children a year have to be seen at the hospital for their dental care under sedation, and sometimes under general anaesthesia. And things are only getting busier.


When a little one has tooth decay, we try our best to provide as much of the dental treatments in our office, but sometimes the work requires multiple difficult appointments or the child just cannot be managed in a private office. Providing dental care to a frightened child is one of the most stressful things that dentists do. If we fail, we could set up a scenario where that person has dental phobia for the rest of their lives.



The challenging thing is that, even after being provided this type of information, some parents continue to put up objections. They refuse fluoride, they refuse to take x-rays, they refuse to believe that it is a big problem……. and some just get up and leave. It breaks my heart seeing kids that are in pain, with visible holes in their teeth, and their parents still think we are trying to poison them or are just recommending unnecessary care. We are really trying to help your kids.


I hope that the next time someone tells you that fluoride is poison and that it is just part of some scheme to sell products, and that kids teeth fall out anyways, that you think back at these photos and realize what tooth decay in kids actually looks like. It is a battle that we are losing. Please do not be part of the spread of bad information. These risks are real, and many kids out there are suffering.


Thanks for reading,

Dr. Dave


***Thanks to all of my colleagues that sent me photos. I did not put credit up there to help preserve patient confidentiality, but you know who you are!***

Nelson Avenue Dental

623 Nelson Avenue

Nelson, BC V1L 2N4

Tel: 250-354-4244

Email: info@nelsonavedental.com

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Office Hours

Monday: 7:00 am-3:00 pm

Tuesday: 7:00 am-3:00 pm

Wednesday: 7:00 am-3:00 pm

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