Early childhood caries, also referred to as baby bottle tooth decay or nursing caries, is a rapid form of tooth decay in babies and young children. High-sugar baby formula and sugary drinks are the main causes, but it can also be caused by transmission through saliva or eating utensils.
According to the National Library of Medicine, the prevalence of early child caries in Australia is that 8% of children aged 18 months experience decay. 23% of children aged 36 months develop caries, with rapid lesion progression being observed as they get older.
As a parent or caregiver, your concern is how to recognize early childhood caries, how to stop it from progressing, and how to treat it if diagnosed. Read this guide by Brisbane Paediatric Dentist to get the answers you need.
Key Takeaways
- Early Childhood Caries affects children under 6 years old and can spread quickly from the upper front teeth.
- The main causes of ECC are sugary drinks, night-time feeding without brushing, poor cleaning habits, and sharing utensils that pass on harmful germs.
- You can prevent ECC by brushing your child’s teeth twice daily with fluoride toothpaste, avoiding bottles at bedtime, and taking your child to the dentist from age 1.
- Treatment options include fillings, crowns, or removing teeth based on how bad the decay is.
What is Early Childhood Caries (ECC)?
Early Childhood Caries (ECC) is tooth decay that affects children under the age of 6. ECC damages the upper front teeth first and then spreads rapidly to the rest of the affected tooth. You might notice white spots or brown areas on your child’s teeth as early warning signs.
Rampant caries and early childhood caries are quite common in Australia. Generally speaking, about 34% of children aged 5 to 6 experience decay in their baby teeth. This condition happens when bacteria in the mouth convert sugars from food and drinks into acids that attack tooth enamel. Fortunately, ECC is preventable.
What are the Main Causes of ECC in Babies?
ECC in babies is mainly caused by frequent exposure of the teeth to sugar, as well as a lack of oral hygiene after feeding. Bacterial transmission from the caregiver to the baby is also a common cause, and this comes from sharing utensils or chewed food.
To give you an overall look at the causes of severe early childhood caries in babies, here’s a list of things to take note of.
| Main Cause | Description | Common Sources |
|---|---|---|
| Frequent Sugar Exposure | Regular contact with sugary drinks or foods | Bottles with juice milk sweetened formula |
| Night-Time Feeding | Feeding without brushing after | Bedtime bottles or breastfeeding |
| Poor Oral Hygiene | Inadequate cleaning of teeth and gums | Skipped brushing or wiping after feeds |
| Bacterial Transmission | Passing cavity-causing bacteria to the baby | Sharing spoons cleaning pacifiers by mouth |
| Lack of Fluoride | Insufficient exposure to tooth-strengthening minerals | Non-fluoridated water or toothpastes |
| Frequent Snacking | Continuous food intake increases acid exposure | Sugary snacks biscuits sweetened cereals |
How Can You Spot ECC in a Child’s Teeth?
You can spot ECC in a child’s teeth by looking for white chalky spots along the gumline that may turn yellow or brown. Look out for dull or discoloured front teeth and any complaints from your child about tooth sensitivity when eating hot, cold, or sweet foods.
But don’t wait for your child to mention pain. Check their teeth regularly by lifting their lip gently and looking for changes in colour or texture. Early detection is important for preventing further damage.
ECC often starts on the upper front teeth and can spread quickly. The decay might look like “bottle rot” when sweet drinks pool around teeth during sleep. Bad breath that persists despite brushing can also signal decay.
Regular dental check-ups starting from your child’s first birthday are very important. Dentists can identify early signs of ECC before they become visible to parents and recommend preventive measures.
Can Early Childhood Caries Be Prevented?
Yes, you can prevent Early Childhood Caries by brushing your child’s teeth twice a day with fluoride toothpaste, limiting sweet drinks and snacks, and never letting your child sleep with a bottle. Regular dental visits starting from age 1 also help catch problems early.
Water is the best drink for your child’s teeth. If you give them juice, serve it only at meals in an open cup, not a cup with a lid or bottle that keeps teeth in sugar for longer. Don’t share spoons or clean dummies with your mouth, as this can pass on teeth harming germs. Think about getting dental sealants once your child’s back teeth come in, for extra protection.
For babies, wipe their gums with a clean, wet cloth after feeding. Once teeth show, use a tiny bit of low fluoride toothpaste on a soft brush. You should help brush your child’s teeth until they’re about 7 or 8 years old.
What Dental Treatments are Available for ECC?
You can treat Early Childhood Caries with fillings, crowns, or extractions depending on how bad the decay is. For mild cases, your dentist might use fluoride to make teeth stronger. Severe cases may need root canal treatment or removal of the affected teeth.
Management of early childhood caries depends on your child’s age, how many teeth are damaged, and if they can sit still during treatment. Young children might need sleep dentistry, a service offered by Brisbane Paediatric Dentistry, to fix many teeth at once. Prevention after treatment is also important. Your dentist will help you create a plan to stop new decay. This often includes using more fluoride products at home and changing what your child eats and drinks.
Regular check ups every 3 to 6 months are needed after ECC has been treated. These visits let your dentist catch any new decay early and help your child stay cavity free until their adult teeth come in.
Early Childhood Caries FAQs
Why are baby teeth important if they fall out?
Baby teeth are important even though they fall out, because they help your child eat and speak properly, save space for adult teeth, and shape your child’s face. Losing them too early can cause adult teeth to come in crooked or crowded.
What role does fluoride play in preventing ECC?
Fluoride plays an important role in preventing ECC by making tooth enamel stronger and more resistant to acid. It helps repair tiny areas of decay before they become cavities, and reduces the ability of bacteria to make acid. You should use age-appropriate fluoride toothpaste twice a day for your child.
Does breastfeeding cause cavities?
No, breastfeeding alone does not necessarily cause cavities. However, breast milk does contain natural sugars that can contribute to decay if your child’s teeth aren’t cleaned afterwards. Keep this in mind, especially during night feeds when there’s less saliva to wash away sugars off the teeth.
Can ECC be reversed in early stages?
Yes, ECC can be reversed in very early stages when decay is just beginning. You can stop and heal early tooth damage by using fluoride toothpaste twice daily, reducing sugary foods and drinks, and getting professional fluoride treatment from your dentist. When ECC is caught early, you might notice white chalky spots on your child’s teeth.
What are the long-term consequences of untreated ECC?
Untreated ECC can lead to pain, infections, eating problems, speech issues, and poor sleep. Your child may miss school, struggle to focus, and develop low self-esteem. The bacteria from infected teeth can spread to other parts of the body, causing serious health problems. Children with tooth decay often need more complex and costly treatments like crowns, root canals or extractions.
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