EARLY CHILDHOOD CARIES (ECC)
WHAT IS EARLY CHILDHOD CARIES?
Early Childhood Caries goes by many other names. It has been reffered to as baby bottle decay, baby bottle caries, nursing caries and bottle rot amongst other names. It is basically caries affecting infants, toddlers and preschoolers. It is presence of one or more decayed, missing(due to decay), or filled tooth surfaces in any primary tooth in a child up to age of 6. It refers to a specific pattern of decay observed along the gum line in the baby teeth of children. The teeth most affected are usually the four upper incisors (upper front 4 teeth)
WHAT CAUSES ECC?
There are several risk factors which play key role in the progression of the early childhood caries disease, but it basically boils down to poor diet and oral hygiene.
1. The bacterial risk factor
There are 2 main bacteria identified in the progression of the disease. Streptococcus mutans and streptococcus sobrinus. These 2 bugs LOVE sugar. They consume whatever sugar is left behind on your teeth and produce lots of tooth dissolving acid as a waste product.
According to the studies, s.mutans can make upto 30%of the bacteria in the plaque scraped off teeth in children with ECC wheras it only makes up to less than 0.1% in children with negligible or no decay.
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2. The sugar risk factor
It is surely comes as no surprise that sugary foods and drinks increases your chances of tooth decay, especially if the sugar is not being removed properly or cleaned off teeth immediately after consumption of sugary items.
3. The feeding risk factor
- Inappropriate use of the baby bottle contributes significantly to the cause and severity of ecc. E.g : filling bottles with fruit juices, cordials or soft drinks, milk with sugar in it and dipping bottle or dummy teats in sweets syrups like honey.
- When a child sips from a cup , the sugar moves past the teeth quickly and does less harm , but when a bottle is sucked slowly the sugar lingers in the mouth.
- Prolonged bedtime bottle use and sleepimg with bottle , especially with sweet drinks. Has been associated with severe ecc. Although milk and formular are technically not sweet drinks ,they contain sugar lactose. The bacteria in the mouth can breakdown this sugar and release plaque acids in the process.
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HOW IS ECC TREATED ???
- Early Childhood Caries Treatment depends on the severity of the disease.
- If we catch ecc in its early stages, all that may be required is routine check ups and clean ups along with better oral hygiene practices at home.
- If its severe can require fillings and cappings.
- Sometimes partial or complete removal of the pulp may be necessary prior to restorations .
- And unfortunately if the tooth is too far gone, then removed of the remaining tooth may be our only option left.
HOW CAN WE PREVENT ECC ???
- There is no substitute for a healthy diet and good oral hygiene practices including routine dental visits .
WE WANT TO AVOID DECAY PROMOTING BEHAVIOURS…
- Children should not be put to bed with baby bottle containing anything but cool, boiled water. Even natural sugars found in milk and formula are harmful when they cling to a child’s teeth for a long period of time. The flow of saliva also decreases during sleep which usually helps to wash away sugars.
- “at will” breastfeeding should be avoided after the 1st baby tooth erupts and other dietary carbohydrates are introduced.
- Infants should be weaned off the bottle at 12 to 14 months of age, however you can begin to introduce a feeding cup from 6 months.
- Infants should be encouraged to use a cup as they approach 12 months of age.
- Constant sipping of sugary drinks or constant snacking on the sugary foods throughout the day should be avoided.
Also interesting to note is that genetic research has identified that streptococcus mutans is generally passed on from the caregivers to the infant around the time their 1st bay teeth erupt of even prior that. In most cases the infant will have the same strain as the mother , as they are primary carer. Link to vertical and horizontal transmission
Therefore , it is beneficial for expecting mothers or women planning to conceive to make sure their mouths are healthy and free of any plaque, tartar or decay.
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