Early Childhood Caries

Early childhood caries (ECC) is a specific form of tooth decay which occurs all over the world in young children. It affects the primary dentition of patients and appears disproportionately in populations which suffer from economic and educational stress. As in other forms of dental caries, ECC is associated with a reduction of pH in the mouth and the resultant demineralization of tooth enamel and dentin, but unlike tooth disease that typically appears later in life, ECC affects the smooth surfaces of teeth not commonly affected by dental caries. Early childhood caries has long been associated with bottle feeding as well as prolonged breastfeeding and feeding at night, and while these practices are important factors in the initiation and

It is thought that the most prevalent source of such microorganisms is from the mother, although the exact mechanism of transmission is not well understood. Once acquired, a source of carbohydrates such as sucrose or fructose feeds the bacteria, which reduce the pH in the mouth as they proliferate, leading to demineralization of the enamel and dentin. The disease typically manifests in areas that are not commonly associated with later onset caries, most notably the smooth surfaces of the maxillary incisors. As the condition progresses, it spreads to the canines and molars, propagating to the mandibular teeth, with the mandibular incisors typically the last and least affected, due to their proximity to the primary salivary glands and protection from the substrate provided by the nipple of the bottle or the spout of the sippy

The primary role of the dental hygienist is to inhibit the progression of the disease once it has presented or, preferably, to prevent the occurrence of the disease at all. In either case, the areas of focus for the dental hygienist are regular dental hygiene interventions, dietary modification, feeding habits, daily dental hygiene improvements in the home and parental education. By intervening in these areas, the dental hygienist can minimize the risk of ECC where the disease has not yet appeared, and facilitate treatment by mediating the environmental factors influencing the progression of existing