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Early Childhood Caries

What Is Early Childhood Caries?

Tooth decay (also called caries or cavities) is a very common dental health problem, affecting the majority of the world’s population. In Canada, about 96% of adults will have had at least one cavity in their lifetime. Cavities are mostly preventable with proper diet, good oral hygiene, and regular professional dental care. Cavities in children also called early childhood caries or ECC can lead to some problems and can increase the risk of having cavities as an adult.

What exactly is a cavity?

Cavities are holes that form in teeth, caused by acids that are produced by certain types of bacteria. These bacteria digest the sugars and starches from what we eat or drink to produce these acids. Cavity-causing bacteria can be transferred from one person to another and is frequently passed from mother to child.

When can a child begin to get cavities?

As soon as teeth are present in the mouth, there is a risk of developing cavities. That is why the CDA (Canadian Dental Association) has recommended that children begin to visit the dentist by the age of one and then continue with regular dental visits. These first visits will be to assess the risk of decay, introduce the child to the dental office environment, and provide parents with oral care instructions. Parents play a significant role in preventing early childhood caries.

What are early childhood caries (ECC)?

Early childhood caries is defined as a child younger than six years of age developing at least one cavity in their primary teeth. In severe cases, ECC may involve many teeth and progress very quickly. In Canada, statistics show that ECC is the primary reason for day surgeries in children from ages one to five.

What can cause ECC?

One of the main causes of ECC is falling asleep with a bottle containing milk, formula or juice. Once the child is asleep, the liquid stays pooled in their mouth and in contact with their teeth for long periods of time. All milk contains sugars, including breast milk, formula and cow’s milk. Breastfeeding usually does not lead to ECC, since the milk goes more to the back of the mouth than with a bottle, which mostly bypasses the teeth. ECC risk is increased if nursing often at night in a lying down position and the milk is allowed to pool in the mouth.

Negative effects of ECC:

ECC can progress very quickly and become a serious problem if left untreated.
Cavities can cause pain, swelling, and infection.
If teeth are severely decayed and need to be removed, this can lead to problems with speech and eating.
If primary teeth are prematurely removed, the remaining teeth can shift and move into the spaces and affect the eruption of the adult teeth.

Preventing ECC:

Professional dental care starting at the age of one as recommended by the Canadian Dental Association. Fluoridated drinking water is proven to strengthen teeth and decrease the risk of cavities (although not everyone has access to it). Cavity-causing bacteria is often transferred from mother to child, so good oral hygiene is very important for both. Mothers should avoid “cleaning” a soother in their mouths as this can transfer the bacteria to the baby.

Bottles should be finished before going to bed. If a child falls asleep while drinking from a bottle, wipe the milk out of their mouth. If a bottle is used when going to bed, it should be filled with plain water.
Maintain a proper diet with limited sugary drinks and foods. Frequent and unrestricted eating and drinking of sugary or starchy products can lead to cavities.

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Parents should clean their child’s teeth as soon as they erupt. Special care should be taken after consuming anything with sugar or starches. Parents need to assist with proper brushing and flossing until the child develops correct skills. This is usually not until the child can write (not print) their name.

Monitor at home for signs of cavities. White or brown flecks on teeth, brown spots or holes on the biting surfaces or near the gum line are all signs of cavities. Children should start being taught to drink from a cup by the age of one.

Dental Considerations

Preventing decay in children helps ensure proper development and sets them up for a lifetime of good oral and overall health. Dental treatment in children can be more challenging due to their age, attention span, and cooperation. Major dental treatment may need to be done with sedation or under general anesthetic. While prevention is key, early treatment at the first signs of decay can limit the damage and prevent your child from having dental pain or infection. If you suspect your child may have a cavity, contact us right away.

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