Early childhood caries or ECC is a common bacterial infection that is reaching epidemic proportions in the US. Characterized by severe decay in baby teeth, it is an infectious and transmissible disease caused by the Streptococcus mutans bacteria. Often transmitted through the mother, ECC presents a real risk to children.

The frequent consumption of liquids like juice, milk, formula, and soda increases the risk of cavities due to the interaction between the sugars in the liquids and the cariogenic bacteria in the teeth. Frequent night feedings and the use of “sippy cups” have been linked to ECC; the decay that derives from these habits is often referred to as baby bottle tooth decay which is most common in babies and toddlers.

Baby teeth are subject to decay as soon as they break the skin according to the American Dental Association. A few preventative measures put in place by the parents can keep the child’s teeth healthy and cavity-free for the life of the tooth. Decay occurs when the child drinks sweetened liquids like milk, formula, fruit juice, etc. and residue adheres to their teeth. Bacteria in the mouth feed on these sugars and produce acids that attack the teeth for up to 20 minutes after the child stops drinking—continued exposure to these acid attacks cause tooth decay.

The ADA stresses that it’s not just the contents of the bottle that causes decay, but it can also be caused by frequency of feedings and the time it takes for the infant to consume the contents. As a preventative measure, limit the number of sweetened liquid you give your child during the day and don’t put him to bed with a bottle. Cavities are caused by specific organisms that are part of a normal process called human oral flora. While this human oral flora is active in the mother, it doesn’t occur in children until they reach 6 – 30 months old. This leaves them susceptible to bacteria from their mothers, and some of these bacteria are responsible for cavities.

There has been a great deal of research on how to prevent or at least delay maternal transmission of these bacteria. They have suggested that a comprehensive program of counseling, oral hygiene instruction, fluoride treatments, and restorative care have been successful. Xylitol products also show promise.

How and Why Tooth Decay Begins

Physicians and dentists recommend that parent institute a routine of cleaning the teeth and gums of their babies and toddlers after every feeding or meal, starting as soon as the first tooth breaks through. Preventive programs for young children should begin as soon as possible. Fluoridated water can have a very positive effect on the prevention of cavities. Other chemotherapeutics found to be effective include topical fluorides (fluoride varnish), fluoridated dentifrice (toothpaste), and PVP-iodine.

If parents take the time to provide tooth care, especially if they use a small amount of fluoridated dentifrice at least once or twice a day they can forestall problems as the child grows. While studies show that fermentable carbohydrates fuel harmful bacteria, and instituting dietary interventions may seem appropriate, they are very difficult to implement in small children. A more practical course of action is to introduce the parents to counseling that provides the parents with appropriate choices.