Early Childhood Caries

1.What is Early Childhood Caries(ECC)/ Baby Bottle tooth Decay & Severe Early Childhood Caries( S-ECC)?

ECC is the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in a child under the age of six years. In children younger than three years of age, any sign of smooth surface caries is indicative of severe early childhood caries

It is a  serious form of decay among young children is baby bottle tooth decay. This condition is caused by frequent and long exposures of an infant’s teeth to liquids that contain sugar. Among these liquids are milk (including breast milk), formula, fruit juice, sodas and other sweetened drinks.

Putting a baby to bed for a nap or at night with a bottle other than water can cause serious and rapid tooth decay. Sweet liquid pools around the child’s teeth giving plaque bacteria an opportunity to produce acids that attack tooth enamel. If you must give the baby a bottle as a comforter at bedtime, it should contain only water. If your child won’t fall asleep without the bottle and its usual beverage, gradually dilute the bottle’s contents with water over a period of two to three weeks.

After each feeding, wipe the baby’s gums and teeth with a damp washcloth or gauze pad to remove plaque. The easiest way to do this is to sit down, place the child’s head in your lap or lay the child on a dressing table or the floor. Whatever position you use, be sure you can see into the child’s mouth easily.

In younger children avoid exposure to food containing high amount of sugar like biscuits, cookies, jams, caramel which can add to the already damaged tooth

2. How does Dental Caries occur? What is difference between Dental Caries & Cavitation

       Dental caries is caused by the action of acids on the enamel surface. The acid is produced when sugars (mainly sucrose) in foods or drinks react with bacteria present in the dental biofilm (plaque) on the tooth surface. The acid produced leads to a loss of calcium and phosphate from the enamel; this process is called demineralisation. Dental Caries is an microbial infectious disease which is mainly caused by Streptococcus Mutans (MS) bacteria.
Dental caries occurs when Microbes(MS) Agent produces Acid from the Substrate( Food) in a Susceptible Host i.e Tooth for an adequate time. Each of these three factors are again governed by multiple factors.
So when there is demineralization of the tooth the tooth weakens and gets cavitated (surface defect). Conservative management of initial caries is advised with help of oral prophylaxis and other remineralizing agents like Fluoride, Xylitol, Cpp- Acp etc.

How to prevent Early Childhood Caries / Baby Bottle Tooth Decay?

♦Help your child start learning to drink from a regular cup by their first birthday.
♦ If your child “grazes,” only allow water in any bottles or sipper cups used.
♦ Clean your baby’s gums with a fresh gauze pad after each feeding.
♦ Begin brushing as soon as you see the first tooth.
♦ Never give your child a pacifier coated in sugar or dipped in honey.
♦ The bacteria that causes caries is transmissible, avoid sharing drinks or kissing your baby close to the mouth, especially if you have not seen your dentist for regular appointments.

How do the child acquire Germs of Dental Caries?

Dental Caries is not like any other air born or water born disease but it occurs by direct transmission of germs of Dental Caries(MS) through saliva from closed relatives (anyone who is physically closed to child-mother, father, child care providers, etc) Transmission of germs occur during sharing of utensils- spoons, kissing etc during eruption of child’s milk teeth. This period is called as Window of Infectivity. So sharing of saliva should be prevented especially from closed ones who are suffering from dental caries

How much of added sugar is recommended?

The AHA ( American Heart Association) have made three recommendations:

♦Children over age 2 years should consume no more than 6 teaspoons (25 grams) of added sugar each day.

♦Children should not drink more than one 8-ounce sugar-sweetened beverage per week.

♦Children under 2 years should avoid consuming any added sugar since they need nutrient-rich diets and are developing taste preferences.