Most children with a cavity won’t come and tell you, “Mumma, my tooth hurts.” Especially with milk teeth, the signs are often much quieter. Children show discomfort through small changes in how they eat, sleep and behave, and these are easy to miss in a busy day.

Here are six everyday signs that can point to a cavity, or even an infection, in a milk tooth.

1. Chewing on one side only

If your child always moves food to one side of the mouth, they may be avoiding a tooth that hurts when they bite. Watch how they eat something firm, like an apple or a roti.

2. Suddenly avoiding cold, sweet or hard foods

A child who used to love ice cream or cold drinks and now refuses them, or who won’t bite into hard foods, may have a sensitive tooth. Sensitivity to cold and sweet is often one of the first signs of a cavity.

3. Waking up at night, cranky, for no clear reason

Tooth pain often feels worse at night, when a child is lying down and has nothing to distract them. Repeated night waking without another obvious cause is worth a dental check.

4. Touching the cheek or face often

Younger children may not be able to say where it hurts, so they keep putting a hand on the cheek or jaw on the side of the painful tooth.

5. Not letting you brush one particular spot

If your child is happy to brush but pulls away every time you reach one area, that spot may be tender because of a cavity or sore gums.

6. A small pimple-like bump on the gums

A small bump or boil on the gum near a tooth, sometimes with pus, is usually a sign of infection at the root of a milk tooth. It may not hurt at all, which is why it is often ignored, but it needs to be checked soon.

“But the milk tooth will fall out anyway”

This is the most common reason parents wait. Some milk teeth, especially the back molars, stay in the mouth until 10 to 12 years of age. A cavity in a milk tooth will not go away on its own, and decay spreads quickly in milk teeth because their enamel is thin. If an infection reaches the root, it can also affect the permanent tooth developing underneath.

Treating a cavity early is usually simpler, quicker and gentler for your child. Waiting until there is pain often means a root canal treatment or an extraction instead of a small filling.

What happens when you bring your child in

Dr. Urvashi will gently examine your child’s teeth and gums, explain what she finds in simple language, and talk you through the options. For anxious children, we take time to build familiarity first, and happy gas is available when it’s appropriate. We never force treatment.

Common questions from parents

Can a cavity in a milk tooth heal by itself?

No. Very early decay, seen as chalky white spots, can sometimes be stopped with fluoride varnish or silver diamine fluoride. Once a cavity has formed, it needs treatment to stop it from growing.

My child says nothing hurts. Should I still get it checked?

Yes. Many cavities in milk teeth don’t hurt until they are quite deep. No pain doesn’t mean no problem, which is why regular check-ups every six months matter.

What does the pimple on the gum mean?

It is usually the body draining an infection from the root of a tooth. The infection won’t clear up by itself, even if the bump comes and goes, so please book a check soon.

Will my child need an X-ray?

Sometimes. Cavities between teeth or near the root can’t always be seen directly. If an X-ray is needed, we’ll explain why and the cost before taking it.

If you’ve noticed any of these signs, don’t wait for your child to complain. Get it checked.