What is Early Childhood Caries (ECC)?
Dental caries is a chronic infectious disease caused by bacteria that breaks down sugar into acids which erode teeth over time.
If a child under the age of six years old has at least one cavity, missing tooth due to dental caries or a filling on any baby tooth, then they are considered to have early childhood caries.
If they are younger than three years old, and have a cavity on any tooth surface, then this is severe early childhood caries.
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What are the risk factors of early childhood caries?
Apart from poor oral hygiene, there are several risk factors that increase chances of getting ECC. Young children are at risk of early childhood caries if their caregiver has high levels of the bacteria causing decay. The disease can be transferred to the child through saliva for instance, when sharing utensils or cleaning a pacifier with the mouth.
Other risk factors include a high consumption of sugar particularly between meals. The most obvious foods that cause decay are chocolates, sweets, cookies, juice, sodas and so on. However, sticky sweet foods such as raisins, dates and some dried fruit also increase the risk of tooth decay. Some medicines given to children are flavoured with high amounts of sugar and this too may increase the risk of early childhood caries.
Putting sweet drinks in sippy cups and milk bottles and/or allowing children to go to sleep with milk in a bottle increases the risk of developing ECC as well.
What are the consequences of ECC?
The health of children’s teeth should not be minimised just because they are “baby teeth.” When children have ECC, the resulting pain and infection can cause several major problems. Most children are not very good at describing pain and parents may become aware of the severity only as a result of restless nights or poor sleep, poor eating habits and lack of concentration in school; all of which are very important for proper growth and development of the child.
In addition, if ECC is left untreated for a while, the infection can become serious leading to high fever, admission into the hospital, emergency room visits and a much higher cost of treatment. Children who have ECC are also more likely to develop caries in their permanent teeth if changes are not made early on.
How can ECC be prevented?
- Mothers should make sure that they have a dental check-up and complete any necessary treatment to avoid passing on decay-causing bacteria to their children.
- Parents should also minimise saliva sharing activities such as cleaning pacifiers with the mouth and sharing utensils.
- Parents should bring their children to visit a paediatric dentist by age one to establish a dental home for their child.
- Oral hygiene is very important. Parents should brush their children’s teeth at least twice daily with an age-appropriate toothbrush and fluoride toothpaste. For children under age 3, a smear amount of fluoride toothpaste is sufficient while a pea-size amount should be used for children between 3 and 8 years old.
- Children at risk of getting early childhood caries should visit their paediatric dentist for professionally applied fluoride.
- Minimising consumption of sugar overall and also sweet snacks and drinks between meals.
- Minimising the consumption of processed foods that have high amounts of hidden sugars will also prevent tooth decay.
- Prevent putting children to bed with milk in a bottle and/or wipe teeth with a wet cloth after night-time milk feeding.
- Avoid putting juices and other sweet drinks in baby bottles and sippy cups.
- As children approach their first birthday, they should be encouraged to drink from a regular cup.