1.
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.
2.
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.
3.
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.
4.
How can ECC be prevented?
a)
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.
b)
Parents
should also minimise saliva sharing activities such as cleaning pacifiers with
the mouth and sharing utensils.
c)
Parents
should bring their children to visit a paediatric dentist by age one to
establish a dental home for their child.
d)
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.
e)
Children
at risk of getting early childhood caries should visit their paediatric dentist
for professionally applied fluoride.
f)
Minimising
consumption of sugar overall and also sweet snacks and drinks between meals.
g)
Minimising
the consumption of processed foods that have high amounts of hidden sugars will
also prevent tooth decay.
h)
Prevent
putting children to bed with milk in a bottle and/or wipe teeth with a wet
cloth after night-time milk feeding.
i)
Avoid
putting juices and other sweet drinks in baby bottles and sippy cups.
j)
As
children approach their first birthday, they should be encouraged to drink from
a regular cup.