Caries in children

Bacteria and the biofilm – how caries develops in a child's mouth

Perhaps you know that furry feeling when you run your tongue over your teeth. Every day a deposit builds up on the surface of our teeth that has it in it: dental deposits, plaque, or biofilm. This deposit consists of remains of our food, components of the saliva and – take note – living, tiny organisms. Bacteria, equipped with the ability to enter into a lasting relationship with our teeth, settle within a very short time. Further bacteria and germs join them and a soft deposit forms, which at this stage can still be removed with the right brushing technique. Without regular cleaning of the tooth surfaces and the spaces between the teeth, the critical phase for the enamel begins after 48 hours at the latest. The soft deposit becomes a hard substance – tartar, which can only be removed thoroughly at the dental practice

What is decisive for the development of caries is the interplay of plaque bacteria and the food available, that is, carbohydrates and sugar above all

Caries-causing bacteria are marked by two decisive properties. They produce substances that allow them to attach themselves particularly well to tooth surfaces, which is why they are also an essential component of the deposits. And they use many carbohydrates for energy, producing acids as metabolic products as they break them down. These acids dissolve calcium and phosphate out of the enamel. Particularly large amounts of acid are formed when the bacteria can use easily fermentable carbohydrates such as sucrose (table sugar), glucose and fructose for their metabolism

Do you know Streptococcus mutans?

The bacterium Streptococcus mutans plays a leading role in caries. It can break simple sugars down into acids. It can also build more complex carbohydrate compounds out of sugar, which serve the germs themselves as a food reserve for times when little sugar is available. In those phases it falls back on them and breaks them down into acids. Streptococcus mutans is not part of the original oral flora. Like many other pathogens it is passed from mouth to mouth. The source of infection may be the mother, the father or the grandparents. When they lick the dummy or the child's spoon, the germs are transferred to the infant or toddler. Because of the close contact between parents and child, transmission cannot be entirely ruled out here. It therefore makes sense to begin fighting the germs with expectant mothers and fathers. Ideally all teeth would be either healthy or fully treated by the start of the pregnancy. At the very least, a dentist should be consulted once the pregnancy has been confirmed. The dentist can establish any need for treatment and carry out the most urgent work straight away. During pregnancy, two dental appointments with professional tooth cleaning should be obligatory