# Tooth decay in baby teeth

- Category: chronic
- Review status: reviewed (every claim checked against a document named on this page)
- Sources: Dental Caries - StatPearls (NCBI Bookshelf NBK551699) - https://www.ncbi.nlm.nih.gov/books/NBK551699/ · ICPC-3 (WONCA International Classification of Primary Care, 3rd edition) class DD65.02 - condition scope only, no dose · No dose - referral pathway, no medicine given in primary care
- Verified date: 2026-08

## Verified against

- No dose - referral pathway, no medicine given in primary care

## Treatment metadata

- No drug therapy in primary care (Referral & Advice)

## Complete treatment card

```text
TOOTH DECAY IN BABY TEETH
Sources: Dental Caries - StatPearls (NCBI Bookshelf NBK551699) -
         https://www.ncbi.nlm.nih.gov/books/NBK551699/ · ICPC-3 (WONCA International Classification
         of Primary Care, 3rd edition) class DD65.02 - condition scope only, no dose · No dose -
         referral pathway, no medicine given in primary care
Review status: REVIEWED against the source listed above  (2026-08)

IS IT THIS? - reference only, to read alongside your own examination
  SYMPTOMS - what the patient reports (2)
    - The child usually has toothache and struggles to eat  [toothache]
    - Chewing and speech suffer, so eating, drinking, talking and mixing with other children can all
      be affected
  SIGNS - what you find (6)
    - It picks off the four upper front baby teeth while the lower ones stay sound
    - Other teeth may be involved, but less badly
    - Earliest sign is a white chalky band along the gum edge of the upper front teeth, which
      parents miss
    - That band deepens into cavities ringing the tooth neck as a brown-black collar
    - The lower front teeth stay healthy or show only slight decay
    - In severe disease the upper front crowns are destroyed and only root stumps remain
  TESTS (4)
    - Examine the child fully, since poor dental health rarely stops at the mouth
    - A full dental examination with periapical films inside the mouth, or a panoramic x-ray
    - Establish the state of the pulp before planning treatment
    - A blood count is sometimes needed as well
  IF NOT THIS - what else fits (3)
    - Developmental enamel defects: dental fluorosis, amelogenesis imperfecta, dentinogenesis
      imperfecta
    - Medical, background and dietary history sorts those out
    - Decay and a developmental defect can coexist, the defect making decay likelier
  Source  StatPearls "Early Childhood Caries" - disease-level clinical article
  Status  traced to the source above

1. NO DRUG THERAPY IN PRIMARY CARE (REFERRAL & ADVICE)    [1st line]
   Adult    Cavities in primary teeth; GP gives analgesia for pain, dietary and fluoride advice, and
            refers to a dentist for restorative treatment or extraction. - Refer, with advice
   Peds     Children follow the same pathway: recognise and refer. No primary-care medicine is
            implied.
   Source   No dose - referral pathway, no medicine given in primary care
   Why      Cavities in primary teeth; GP gives analgesia for pain, dietary and fluoride advice, and
            refers to a dentist for restorative treatment or extraction.
   Caution  No medicine is prescribed for this in primary care - this entry is for recognition and
            referral. Anything given is decided by the service it is referred to.
            RED FLAG - Facial swelling or cellulitis from a spreading dental abscess, fever, or
            difficulty swallowing or breathing (Ludwig's angina): refer urgently.

Prices are indicative (dataset snapshot 2026-06); verify with the pharmacy.
```

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Dawaa Reference is a reference for prescribers, not a medical device, and does not replace clinical judgement.

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