Early Childhood Caries (ECC)

Early Childhood Caries

Early Childhood Caries, (which used to be known as Baby Bottle Tooth Decay, or Baby Bottle Syndrome, or Nursing Bottle Mouth) is a dental condition that involves the rapid decay of many or all the baby teeth of an infant or child. For the baby it causes intense PAIN, and suffering and waiting lists for the procedures can be months.

The teeth most likely to be damaged are the upper front teeth. They are some of the first teeth to erupt and have the longest exposure time to the sugars in the bottle.⁷ The lower front teeth tend to be protected by the tongue as the child sucks on the nipple of the bottle or the breast.

ECC is a pandemic, affecting the lower socio-economic communities around the world.^3,4,5,6 It has been an intense problem in Manitoba. Clinical studies have shown that in some Manitoba communities 54% of children are afflicted with this disease.⁶

Early Childhood Caries is caused by frequent exposure of a child’s teeth for long periods of time to liquid containing sugars.

• a bottle or sippy cup containing formula, milk or juice that your child can drink out of several times a day.
• a pacifier dipped in honey
• leaving a bottle in bed with your baby. That last sip of juice will contain sugar that will help eat away at your baby’s teeth all night without interruption⁸

The liquid pools around the front teeth. During sleep, the bacteria living in every baby’s mouth, turns the milk sugar or other sugars to acid that causes the decay.

It can also be caused by the transmission of bacteria from an adult to a child. If an adult has active gingivitis or periodontitis, the bacteria that is causing that disease can be passed on by kissing the child or sharing drinks.⁷

Severe Early Childhood Caries

Parents may not know there is a problem until serious damage has been done:

• teeth and gum checks should be performed by parents to detect early signs of the disease. ⁷
• Make it a regular habit to look in your child’s mouth for anything irregular. ⁷
• Brown spots along the gumline on your child’s teeth are signs that should alert you.
• If your child prefers soft foods, frowns or cries when eating cold, sweet, or hard foods, they should be checked for tooth decay. ⁷

Once tooth decay is visible it may be too late and crowns, pulp therapy, or even extraction of the decayed teeth may be necessary. As a result, your child may suffer from long term disorders that include speech impediments, possible psychological damage, crooked or crowded teeth, and poor oral health.

You can prevent this from happening to your child’s teeth by learning how to protect them.

• clean your child’s teeth daily⁸
• never allow your child to fall asleep with a bottle filled with juice, milk, or formula⁸
• Never let your child sip on juice or formula for long periods of time, “grazing”
• start bottle weaning by at least a year⁸
• give your child plain water for thirst
• have regular dental visits for your child beginning when their first tooth erupts
• wean your child towards a cup by 12 months. The best root is straight from bottle to cup without sippy cup.
• Have your child know that drink time is at the table and comes with meal time
• Never “clean off” a child’s utensils or pacifiers with your own saliva, it can contain bacteria⁸
• Have your child visit a dentist by their first birthday. There you can discuss with the dental professionals on how your child can get the fluoride needed to help prevent cavities and ECC.

TIP: Cut back on sugary bottles by gradually watering them down until they are only water.

Most children begin life with strong, healthy teeth. Help your child’s teeth stay that way. Your newborn is totally dependent upon you as a parent. The decisions you make will have a vital effect on your child’s dental future and smile.

Your dental hygienist can give you more information that can improve the care of your child’s teeth and ensure their best oral health.

References:

1. Loesche WJ. Roles of S. Mutans in human dental decay. Microbial Rev. 1986, 50(4), 353-80.

2. Berkowitz RJ. Causes, treatment and prevention of early childhood caries: a microbiologic perspective. J Can Dent Assoc. 2003 May;69(5):304-7.

3. Schroth RJ, Smith PJ, Whalen JC, Lekic C, Moffatt ME. Prevalence of caries among preschool-aged children in a northern Manitoba community. J Can Dent Assoc. 2005 Jan;71(1):27.

4. Bray KK, Branson BG, Williams K. Early childhood caries in an urban health department: an exploratory study. J Dent Hyg. 2003 Fall;77(4):225-32.

5. Schroth RJ, Moore P, Brothwell DJ. Prevalence of early childhood caries in 4 Manitoba communities. J Can Dent Assoc. 2005 Sep;71(8):567.

6. Piwat et al. A longitudinal study of early childhood caries in 9- to 18-month-old Thai infants. Comm Dent and Oral Epid 34 (6): 429-436

7. CDHA, Oral Health Matters for you and your baby,

8. Darby, Walsh, Dental hygiene, theory and practice 2^nd edition.2003, Elsevier

Pictures from:

www.ada.org.au/_Backgrnd.asp

http://www.cdafoundation.org/journal/jour0203/denbesten.htm