The medical term "early childhood caries" refers to tooth decay in children 5 and under

Baby teeth may not seem important, but, in fact, the opposite is true. Your baby’s first teeth help them learn to chew, talk, and smile properly. They also leave room for their permanent teeth to come in.

That’s why it’s important to take care of your baby’s primary teeth — and to avoid early childhood caries.

What Are Early Childhood Caries?

The medical term “early childhood caries” refers to tooth decay in children 5 and under. Early childhood caries are sometimes called nursing caries or baby bottle tooth decay.

Early childhood caries are common in the United States. The National Institute of Dental and Craniofacial Research estimates that almost 28% of children ages 2 to 5 have some form of tooth decay. It occurs most often in the upper front teeth but can happen in other teeth as well.

Parents and caregivers should not ignore tooth decay in babies and toddlers. Early childhood caries can cause developmental speech delays and difficulty eating. It can also lead to infection, pain, and needless suffering for your child.

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Causes of Early Childhood Caries

The major risk factor in early childhood caries is exposure to sugar-laden liquid. Tooth decay in babies and toddlers can begin by:

  • Passing bacteria through saliva. If you share a spoon or use your saliva to wipe off a pacifier, you can spread bacteria to your baby’s mouth.
  • Using sugary drinks as a pacifier. Using juice or another sweet drink to calm your baby leads to too much sugar on their teeth. Bacteria in the mouth turns natural or added sugars acidic. The acid starts to dissolve the enamel, or outer part of the teeth.
  • Putting baby to bed with a bottle. If you let your baby drift off while sucking on a bottle or sippy cup, you run the risk of tooth decay. Formula, juice, or milk bathes your baby’s teeth in sugar overnight.
  • Not brushing baby teeth. You should start gently brushing your baby’s teeth as soon as they appear. It’s a good idea to gently clean the gums with a washcloth even before teeth erupt. This will help your baby get used to you cleaning their mouth (and later teeth) at least twice a day.

Prevention of Early Childhood Caries

The good news is that early childhood caries are preventable. Here are some ways to give your baby the best start when it comes to dental health.

  • When your baby’s teeth start to come in, use a soft baby toothbrush and a small smear of fluoride toothpaste.
  • Brush your toddler’s teeth two times a day for two minutes at a time. Again, use just a small smear of toothpaste. Aim for brushing after breakfast and before bedtime.
  • Never share feeding spoons or lick pacifiers to clean them. And don’t let your child share a bottle or sippy cups with other children.
  • Never put your baby to bed with a bottle.
  • Don’t use a bottle as a pacifier. If your baby wants a bottle when it’s not mealtime, fill it with water.
  • Encourage your child to use a cup as soon as possible. Most toddlers can use a cup by 12 to 15 months.
  • Limit sugary snack foods.
  • Limit juice. The American Academy of Pediatrics (AAP) recommends no juice for babies under 12 months. They recommend a maximum of four ounces per day between ages one and three.
  • See a dentist before your child’s first birthday. Your child’s dentist may recommend regular applications of fluoride to help strengthen their tooth enamel.

Treatment of Early Childhood Caries

If the decay is just beginning, your child’s dentist may suggest that you clean their teeth more often. A fluoride treatment may help stave off decay in the beginning stages.

If the decay is further along, the dentist may want to fill the cavity or pull the decayed tooth. They will likely give your child an injection in the mouth to dull the pain. Some pediatric dentists offer sedation.

It’s important to establish a relationship with a dentist early on. Your baby’s dental health will be an important factor in their overall health for years to come.

Contact the UPMC Children’s Hospital of Pittsburgh Division of Pediatric Dentistry

UPMC Children’s Hospital of Pittsburgh Division of Pediatric Dentistry has services at the main hospital in Lawrenceville, Children’s Pediatric Dental – Hampton, Children’s South, and Children’s North. To schedule at the main hospital or Children’s Pediatric Dental – Hampton, please call 412-692-5440. To schedule at Children’s South or Children’s North, please call 412-692-7337.

Sources

National Library of Medicine, Early Childhood Caries: Prevalence, Risk Factors, and Prevention, Link

National Institute of Dental and Craniofacial Research, Dental Caries (Tooth Decay) in Children Age 2 to 11, Link

American Dental Association, Baby Bottle Tooth Decay, Link

American Dental Association, Caries Risk Assessment and Management, Link

American Academy of Pediatric Dentistry, Policy on early childhood caries (ECC): Consequences and preventive strategies, Link

American Academy of Pediatrics, How to Prevent Tooth Decay in Your Baby, Link

About Pediatrics

From nutrition to illnesses, from athletics to school, children will face many challenges growing up. Parents often will make important health care decisions for them. We hope to help guide both of you in that journey. UPMC Children’s Hospital of Pittsburgh is a national leader in pediatric care, ranking consistently on U.S. News & World Report’s Best Children’s Hospitals Honor Roll. We provide expert treatment for pediatric diseases, along well-child visits, urgent care, and more. With locations across Pennsylvania, Maryland, and West Virginia, you can find world-class care close to home. We also work closely with UPMC Magee-Womens Hospital, a national leader in care for newborns and their mothers. Our goal is to provide the best care for your children, from birth to adulthood and beyond. Visit our website to find a doctor near you.