What are Early Childhood Caries? | Dental Treatment Guide


Early childhood caries is commonly abbreviated as ECC although you may also have heard it being referred to as nursing caries, nursing bottle syndrome or baby bottle decay. This condition is defined as the development of severe cavities in the teeth of children, which can rapidly lead to premature destruction.

Normally, ECC happens if your young child's teeth are frequently exposed to food or drink that contain high levels of sugar. This can be an issue when using baby bottles or cups with a tip to drink from if the liquid being consumed is milk or fruit juice. Drinks such as these are high in sugar and when consumed over a period of time, oral bacteria break down these sugars. This produces certain acids, which attack the teeth and cause them to decay.

Events that can lead to ECC

There are a number of possibilities that may lead to your child developing ECC, each involve the exposure of your child's teeth to sugar for a significant amount of time. Firstly, your child may develop ECC if you allow them to fall asleep whilst drinking from a bottle containing a liquid that is not plain, simple water. Alternatively, the ECC can occur if you supply your child with sugary drinks and/or milk as the day progresses. Finally, it is possible that ECC will happen if you dip your baby's dummy (or pacifier) in sugary products to make it more appealing; these products are often sweet liquid stuffs such as honey.

Can breast milk cause ECC?

At present there is no evidence that breastfeeding results in cavities in your baby's mouth. However, it is possible that breastfeeding for a significant amount of time may increase the risk of ECC occurring.

The benefits of breastfeeding your child are great and if you have any questions about the safety of your child's teeth then you should approach a dental professional. It is important that you are aware of all the facts when deciding how to feed your child. For example, babies require milk for growth and development and so you should consider whether breast is best in terms of the milk's source.

What increases the chances of ECC?

The chances of ECC developing in the teeth of your child can depend on numerous factors. As mentioned, ECC occurs due to exposure to sugary products. However, you should consider not just the products being given to your child but also how long they are given for. The longer the food or drink is consumed, the higher the probability of ECC developing. For this reason, it is recommended that you do not allow your child to sleep with their bottle unless it only contains water.

Another contributing factor to ECC risk increase is the number of bacteria that inhabit your child's mouth. A bacteria that should be particularly looked out for is one known as Streptococcus mutans, which generally composes fewer that 1% of all the bacteria typically residing in a healthy mouth. However, if ECC is present then these bacteria can grow and multiply to account for over 50% of the mouth's bacteria. To prevent this situation from taking place, you should keep your child's mouth clean, healthy and cavity free. Not only this but you must do the same as it has been noted that between 6 and 31 months old, your child can obtain Streptococcus mutans from you.

Which teeth are affected by ECC?

It is usually noted that the first teeth affected by early childhood caries are the front top teeth. The ECC can then progress further back through the mouth. The teeth in the lower jaw can also be subject to ECC, however it is less common as they are protected by the tongue and nearby salivary glands. The saliva produced here works by removing the excess sugar that can be used by bacteria to make harmful acid.

What happens once ECC has occurred?

If the teeth have been impacted by early childhood caries are not properly cared for and the problem is not resolved, then infection can occur as well as significant pain. If the tooth begins to seriously decay as a result of ECC then it is likely that the tooth will have to be extracted.

ECC is a type of tooth decay and tooth decay itself is an infection caused by bacteria. This means that once it has occurred, it can spread from tooth to tooth if it is not nipped in the bud. This tooth-to-tooth exchange can even occur between the milk teeth and permanent teeth that have not yet protruded from the gums.

Tips to prevent ECC occurring

Below is a list of pieces of advice that you may wish to consider to ensure your child's teeth are not affected by early childhood caries. Each point is simple to follow and may have a significant benefit on the oral health of your young one.

  • Avoid allowing your child to go to bed with their drinking bottle if it contains milk or juice. If they do wish to sleep with a drink, fill the bottle with plain water.
  • Once your child reaches 12 months old, you should approach your doctor for advice about weaning your child away from baby bottles.
  • If you are using a baby bottle throughout the day as a method of comforting your child, fill the bottle with water as opposed to milk or juice.
  • Avoid putting any sugary products onto your baby's dummy/pacifier.
  • Try and avoid adding any extra sugar to the food you feed your child. It is likely that the food will already contain natural sugars and so adding more could be harmful to their teeth.
  • Clean your child's teeth and gums with a soft bristled toothbrush at least twice each day, if not after each meal.
  • When the first tooth comes through your baby's gum, visit the dentist to ensure it is healthy.
  • Ensure that the teeth are being exposed to a sufficient amount of fluoride but not too much. For further advice on toothpastes etc. that should be used to achieve this, approach your dentist.

Further Information about Childens Mouth & Teeth