Hi Dr. Ellie,
My four year old son has a very large cavity in one of his molars. Is it possible for this to remineralize with just eating the 6.5 grams of xylitol a day, brushing with Crest and using the ACT or should I have this filled? He is able to spit well and does not swallow. Should we do the Closys and Listerine too? What type of filling would you recommend if need be? I know this is just a baby tooth but he will have it for several more years. Thanks, CL
Every baby tooth is very important a vital “place holder” for the permanent tooth.
Your son is young for fluoride rinsing he definitely should only rinse under adult supervision and be encouraged to spit out several times.
Many children leave a mouthful of rinse in their mouths even after spitting out!
Maybe you can do two things:
Start with some tap water with some ACT added to it….just to make sure he can rinse and spit well.
Encourage him to have fun spitting …see if he can spit out three times in a row!
Then if this goes well, you can progress to using the ACT not diluted.
I would always encourage multiple spits ( I do this myself) just to make sure there is no excess rinse left in my mouth.
You do not want to eat or drink anything more after rinsing before going to sleep at night.
Xylitol and this kind of mouth care will remineralize your son’s tooth.
The problem is that if the tooth has already has a “very large cavity in it” food and things may get stuck in the hole and/or the tooth may fracture if the hole is so big the tooth is weakened. I would suggest starting the preventive care as soon as possible. In any case you need to strengthen his other teeth ( usually cavities are on all sides of the mouth). I expect his other molars have damage even if it does not show yet.
I would encourage you to start this program as soon as you can ( just make sure rinsing is fun and not a punishment).
As long as your son is not in any pain and as long as food is not getting stuck in the hole you can take a little time to find a nice dentist.
Ask him or her if you need a filling.
If you do, maybe you could have a filling containing fluoride put in and try to make the tooth last until the permanent tooth erupts under it.
My main concern would be to investigate WHY your son has this cavity.
Apple juice, soda, allergy medication, dry mouth or some other reason…???
Once you know what is damaging teeth you can use xylitol to remove the danger.
You don’t have to give up anything just protect teeth from damage.
For example, if apple juice is his love he can still drink it ……just eat some xylitol ( a candy, mint or gum) after the juice to take away mouth acidity.
Always look for 100 percent xylitol and try to get at least 6.5 grams a day.
Good luck and let me know if you have any more questions,
Ellie Phillips, DDS