Early Childhood Caries

Early childhood caries (ECC), also known as baby bottle tooth decay (BBTD) is a preventable, infectious disease caused by certain types of bacteria (bugs) that live in your mouth. Bacteria stick to the film on your teeth called plaque. The bacteria feed on what you eat, especially sugars (including fruit sugars) and cooked starch (bread, potatoes, rice, pasta, etc.). About 5 minutes after you eat, or drink, the bacteria begin making acids as they digest your food. These acids can break down the tooth’s outer surface and dissolve valuable minerals. The result is cavities. Children who snack frequently, have a high level of bacteria, or go to sleep with a bottle containing anything other than water, are more likely to have ECC.

How to prevent ECC?

Many parents do not realize that nutritious food and drinks such as milk, formula, breast milk, and fruit juice have naturally occurring sugars that contribute to the decay process. When children go to bed with a bottle containing milk for example, liquid sits in the child’s mouth for an extended period creating a perfect environment for bacteria. You can’t stop feeding your child nutritious food, but you can regulate when and how often your child is exposed to “sugar hits.” Limit between meal snacking and if a bottle is needed, use only water at nap/bed time. Research shows that children are not born with the bacteria that cause decay, but are infected with it, usually at an early age, from their caregiver – primarily mom. If you have ever had a cavity, you carry the bacteria that cause cavities. Caregivers with untreated cavities have higher levels of bacteria in their mouth and are more likely to pass bacteria to their children. Visit your CDA member dentist for a check up and have cavities filled. Your dentist may recommend an antibacterial mouthwash or chewing gum containing xylitol to help reduce the amount of bacteria in your mouth. Bacteria is passed through saliva and can occur before the first tooth appears.

• Avoid sharing spoons and forks with your child

• Use water to clean a pacifier instead of cleaning it in your mouth

• Proper feeding techniques and cleaning your child’s mouth will also help prevent ECC.

• Hold your baby when you feed him/her

• Remove the bottle when baby falls asleep

• Wipe off baby’s teeth/gums with a damp washcloth at least twice per day and when baby is done eating

Parents play an important role in the early detection of decay. Lift your child’s lip to look for early signs of decay – white spots. If you see white spots, especially on your child’s front teeth, schedule an appointment with your CDA member dentist. Your dentist may want to apply fluoride for a few months to protect your child’s teeth from further damage. When your baby‘s first tooth erupts, begin cleaning baby’s teeth with a soft washcloth or small, soft toothbrush with a tiny smear of toothpaste with fluoride. At this age, your dentist or pediatrician may also want to prescribe fluoride supplements. Fluoride helps strengthen developing teeth making them more resistant to decay. Children that drink fluoridated community water should not receive fluoride supplements.

Begin brushing your child’s teeth with a pea-size dab of toothpaste at age two. Instruct your child to spit out the toothpaste after brushing. Continue to help your child brush their teeth until they have mastered this skill – usually around eight years old.

Remember:

• Avoid passing your saliva to your child

• Put water in baby’s bottle or sippy cup at nap/bed time

• Lift your child’s lip to look for signs of decay

• Offer healthy foods and limit sugary food and drinks

• Keep baby’s mouth clean

• Take baby to a CDA member dentist when his or her first tooth erupts or by age one, whichever is earlier. Schedule your exam with a CDA member dentist for optimal oral health.