Early Childhood Caries

What is Early Childhood Caries

Early childhood caries is tooth decay in a child’s baby teeth (primary teeth) that is caused by bacteria.

The decay can develop as soon as a child’s baby teeth begin to come in at about 6 months of age.

It is important that any decay in your child’s teeth be found and treated as soon as possible. Decay that is not treated can:

  • Spread to other primary teeth and cause gum disease.
  • Cause holes (cavities) in your child’s permanent teeth.
  • Lead to school absences, more complicated and expensive dental care, and even hospitalization.
  • Lead to loss of primary teeth. Primary teeth hold spaces for permanent teeth. If they come out too early, primary teeth can come in crooked and crowded.

What are the causes?

The bacteria that cause early childhood caries stick to your child’s teeth and feed on sugar. Over time, acids made by the bacteria break down the covering of the tooth (enamel) and cause changes in the color of the tooth. Eventually the acids form a cavity in the tooth.

What increases the risk?

This condition is more likely to develop when the teeth are exposed to sugars in foods or liquids for long periods of time. The condition is also more likely to develop in children:

  • Who do not practice good care of the mouth and teeth (oral hygiene) at home.
  • Who are not seen by a dentist by age 1.
  • Who share eating utensils or pacifiers with others.

What are the signs or symptoms?

Symptoms of this condition include:

  • White spots or lines on the teeth near the gums.
  • Dark-colored areas on the teeth.
  • Tooth or gum pain.
  • Trouble eating.

How is this diagnosed?

This condition is diagnosed with an exam. Your child’s dentist will check for changes in tooth color and cavities.

How is this treated?

This condition may be treated with:

  • Good oral health home care. Taking good care of your child’s teeth at home:
    • Helps to prevent cavities from forming.
    • Helps to prevent the condition from coming back (recurring).
    • May help with changes in tooth color.
  • A fluoride treatment. Your child’s dentist may recommend this treatment if there are changes in tooth color. During this treatment, the teeth are coated with a fluoride solution.
  • A filling. This treatment is done to clean and fill a cavity. The way the treatment is done depends on the size, severity, and number of cavities.
    • A minor cavity may be cleaned out with a handheld tooth cleaner and restored with a tooth filling.
    • A larger cavity may be cleaned out with a dental drill and filled.
    • A child with severe cavities or many cavities may be given medicine to make him or her sleep through the treatment (general anesthesia).
  • A crown. This is a protective cap that is placed over a filling.

Follow these instructions at home:

Tooth and gum care

  • Wipe your child’s teeth and gums with a damp washcloth every day in the morning, at night, and after each feeding.

When your child’s first tooth appears, use a soft toothbrush to brush your child’s teeth 2 times every day (once in the morning and once at night). Teach your child to spit out the toothpaste after brushing. The amount of toothpaste that you should use depends on your child’s age:

  • If your child is younger than age 3, use a smear of toothpaste that is no larger than a grain of rice.
  • If your child is 3–5 years old, use a pea-sized amount of toothpaste.

Eating and drinking

  • Do notshare utensils with your child. The bacteria that cause dental caries can spread through saliva.
  • Do notuse anything other than a bottle to give your child breast milk or formula.
  • Do notput your child to bed with a bottle. Infants should finish bedtime and nap time bottles before going to bed.
  • Try to wean your child from a bottle between 12 and 18 months of age.
  • Do notdip your child’s pacifier in honey, syrup, or sugar.
  • Do notgive your child sweets in between meals.
  • Do notuse sweets as a reward.

General instructions

  • Check your child’s mouth regularly. Look for spots on the teeth.
  • Make sure your child is seen by a dentist before age 1.
  • Do notput your child’s pacifier in your mouth.

Contact a health care provider if:

  • Your child has a white, yellow, or brown spot on his or her tooth.
  • Your child is fussy and is not eating well.
  • Your child complains of tooth pain.

Get help right away if:

  • Your child’s face, neck, or jaw is swollen.
  • Your child has trouble swallowing or breathing.

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