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Early childhood caries

Contents of this page:


Tooth anatomy
Tooth anatomy
Baby bottle tooth decay
Baby bottle tooth decay

Alternative Names    Return to top

Bottle mouth (Bottle carries); Baby bottle tooth decay

Definition    Return to top

Early childhood caries (ECC) is a dental condition in which there is significant decay in a child's teeth, particularly the upper and lower cutting teeth (incisors).

Information    Return to top

ECC used to be blamed on inappropriate bottle use, which is why it is sometimes called baby bottle tooth decay. However, it is now known that the tooth decay results from a combination of tooth strength, sugar exposure, and mouth bacteria. ECC certainly can be triggered by bottle use, but also by sippy cups and even sugary snack foods.

ECC is often triggered by frequent and prolonged exposure to liquids containing sugars. The worst types are juices, punches, soft drinks, gelatin, sugar water, or other sweetened liquids. Milk and formula can also contribute to decay, especially if the child is also getting sweets from another source.

Bacteria on the teeth uses these sugars as an energy source to form acids that attack tooth enamel. If there is an almost constant supply of sugar (such as an infant with a bottle of juice in his mouth most of the day), decay can occur on a continuous basis rather than just at feeding time.

Breast milk by itself is the healthiest food for babies’ teeth, day or night. It tends to slow bacterial growth and acid production. However, when breast milk is alternated with sugary foods or drinks, the rate of tooth decay can be faster than with sugar alone.


References    Return to top

Azevedo TD. Feeding habits and severe early childhood caries in Brazilian preschool children. Pediatr Dent. 2005;27(1): 28-33.

De Grauwe A, Aps JK, Martens LC. Early Childhood Caries (ECC): what's in a name? Eur J Paediatr Dent. 2004 Jun;5(2):62-70.

Douglass JM, Douglass AB, Silk HJ. A practical guide to infant oral health. Am Fam Physician. 2004 Dec 1;70(11):2113-20.

Nainar SM, Mohummed S. Diet counseling during the infant oral health visit. Pediatr Dent. 2004 Sep-Oct;26(5):459-62.

Ribeiro NM, Ribeiro MA. Breastfeeding and early childhood caries: a critical review. J Pediatr (Rio J). 2004 Nov;80(5 Suppl):S199-210.

Seminario AL. Early childhood caries. Acta Medica. 2003; 46(3): 91-4.

Touger-Decker RJ. Position of the American Dietetic Association: oral health and nutrition. J Am Diet Assoc. 2007 Aug;107(8):1418-28.

Update Date: 4/10/2008

Updated by: A.D.A.M. Editorial Team: David Zieve, MD, MHA, Greg Juhn, MTPW, David R. Eltz, Kelli A. Stacy, ELS. Previously reviewed by Daniel Rauch, M.D., FAAP., Director, Pediatric Hospitalist Program, New York University School of Medicine, New York, NY. Review provided by VeriMed Healthcare Network (7/26/2007).

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