Tooth decay in children as young as four is on the rise and it's rising at an alarming rate.
More dentists in the Valley are having to put kids under anesthesia just to operate.
"It's an astounding amount of decay," said Dr. Joseph Greene, a pediatric dentist in Harrisonburg.
That decay is evident in preschool aged children across the U.S. Some dentists are treating kids as young as two with several cavities.
"Early childhood carries is almost of epidemic proportion," said Dr. Greene.
Childhood carries is an infectious disease that can begin as early as the teeth begin to emerge.
Greene says the disease is partly a sugar -driven disease, but every case is different.
"It's not ever one simple cause. Sometimes it's he the amount of saliva or the quality of your enamel. That's what makes it such a tough disease," said Dr. Greene.
It's also been tough for 12-year old McKinsey Estes of Waynesboro.
"Last year she started complaining of pain on the left side of her face. Within a couple of hours her face started swelling. When I looked I could tell there was a huge abscess there," said Stephanie Estes, mcKinsey's mother.
McKinsey was in the operating room for three and a half hours getting that tooth surgically removed.
She has cerebral palsy and sensory processing disorder.
"Just the simple task of brushing hair and brushing teeth is very hard and the back teeth are very hard to get to," said Stephanie Estes.
MdKinsey is using a prescription gel and a prescription toothpaste.
"Dentists say to use the toothbrush with the spin brushes on it. They hope the feeling of that, the stimulation will help her take regular brushing.
Dr. Greene says parents can start brushing that first tooth that comes into their child's mouth.
"That's almost unthinkable to parents because they ask, 'How do you brush a young child's teeth?' They can learn how to hold the child, what to expect from the child and let the child get used to that brush," said Dr. Greene.
Other things parents can do?
"To be off the bottle by 12-months of age, and not putting a child to bed with a bottle," said Dr. Greene.
Greene says sugar is another thing parents can cut back on.
"Sipping on a sippy cup all day long will just destroy the teeth," said Dr. Greene.
McKinsey and her brothers, Brayden and Garyett, all know the importance of brushing their teeth.
"It's better for your hygiene and it keeps you healthy," said Garyett Estes.
Stephanie Estes agrees that parents can cut down on a child's sugar intake, but says tooth decay is not all about sugar.
"Don't judge because every case is different. I have a child that we try very hard, twice a day, every day, brushing her teeth. The amount of children having issues with their hygiene, you can't blame every situation on Kool-aid and candy. There's genetic reasons. There's disability reasons just like in our case," said Stephanie Estes.