Info Center Early Childhood Caries

Understanding & Preventing Early Childhood Caries

What is early childhood caries (ECC)?

Early childhood caries, also known as baby bottle tooth decay (BBTD), is a preventable, infectious disease caused by certain types of bacteria that live in your child's mouth. These bacteria stick to tooth plaque and feed on the same foods that are common among young children; namely sugars (fruit, milk, formula, juice, etc.) and cooked starches (bread, potatoes, rice, pasta, etc.). About 5 minutes after your child eats or drinks, these bacteria begin producing acids as a byproduct of their digestion of that same food. The acids damage the tooth’s outer surface, resulting in caries or cavities.

early childhood caries

How do I know if my child is at risk for ECC?

Children who snack frequently, have a high level of bacteria, or go to sleep with a bottle containing anything other than water, are at higher risk of developing ECC.

How do children get the bacteria that cause ECC?

Research shows that children are not born with the bacteria that cause decay and ECC. They are infected with it, usually at an early age, from their caregiver most often mom. If you have ever had a cavity, you carry the bacteria that cause cavities. Caregivers with untreated cavities have higher levels of bacteria in their mouth and are more likely to pass bacteria to their children.

How do I lower my child's risk of getting ECC?

If you are pregnant or caring for a baby or young child, visit your dentist for a check up and have cavities filled. Bacteria is passed through saliva and infection can occur before the child's first tooth appears. Avoid sharing spoons and forks with your child, and use water to clean a pacifier instead of cleaning it in your mouth.

Following proper feeding techniques can also help prevent ECC.

  • Hold your baby when you feed him/her.
  • Remove the bottle when baby falls asleep.
  • If you child requires a bottle at nap or bed time, use water only.
  • Stick to a feeding schedule and limit between meal snacking.

And, ensuring your child's teeth are cleaned regularly can help prevent ECC.

  • Wipe your baby’s teeth/gums with a damp washcloth at least twice per day and when baby is done eating.
  • At six months, begin brushing your baby’s teeth with a small, soft toothbrush without toothpaste.
  • Take your child to a CDA member dentist no later than age one, preferably at around the time your baby cuts his/her first tooth.
  • At age two, begin brushing your child's teeth with a pea-size dab of toothpaste.
  • Continue to help your child brush their teeth until they have mastered this skill, usually around eight years old.

Can I tell if my child is developing ECC?

Yes. Parents can play an important role in the early detection of decay, which appears as white spots on your child's teeth. Lift your child’s lip to look for early signs of decay. If you see white spots, especially on your child’s front teeth, schedule an appointment with your dentist. Your dentist may want to apply fluoride for a few months to protect your child’s teeth from further damage.

Community Poll #4

When should a child first see a dentist?

When first tooth erupts - 50%
Around first birthday - 50%
Around three years of age - 0%
When child starts kindergarten - 0%
Not sure - 0%

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