I am going to tell you the story of a child with Early childhood caries. It was a sunny day. A 3-year-old boy has entered into my room with his mother. When I enquired about the complaint, she (mother) replied in a soft voice saying ”Doctor! My son has teeth decay. He doesn’t eat chocolates. But still, he has many teeth with caries”.
After a thorough examination, I found all his upper teeth missing due to caries. The boy doesn’t have any teeth to bite. This condition is called “Early childhood caries”, a devastating disease seen in many children below three years.
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WHAT IS EARLY CHILDHOOD CARIES [ECC]?
Early childhood caries is a peculiar condition where the upper front teeth are mostly involved. They selectively affect the neck region of teeth and destroy its entire crown portion. Finally, it results in complete loss of upper front teeth. In severe condition, the patient comes with multiple abscess and pain.
HOW DOES EARLY CHILDHOOD CARIES [ECC] OCCUR?
Malnutrition and bad oral health habits play a catalytic role in ECC.
Prolonged and nocturnal breastfeeding in kids below one year can increase the risk of ECC.
Prolonged bedtime use of milk bottles containing rich content of sugar and especially lactose can aggravate ECC. This condition is called “Nursing bottle caries or Baby bottle tooth decay”.
HOW DOES TOOTH DECAY IN TODDLERS APPEAR?
Early Childhood Caries mainly start with upper central incisor teeth. Initially, a soft decay will appear along the neck region of teeth, just above the gum line. Slowly it involves the entire circumference of the crown resulting in loss of tooth structure. Finally, the root stumps are left.
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Later the condition expands to other teeth, resulting in multiple root stumps. As a result, the child will have no teeth left in the upper arch. It appears in children between 3 to 5 years of age.
HOW CAN I PREVENT ECC?
As a dentist, I advise every parent to consider this issue as an emergency, as the global statistics of ECC is increasing day by day. Here are a few tips to reduce the prevalence of ECC.
Mother is the prime source for caries producing bacteria. Yes! Caries producing bacteria like S.mutans enter into kid’s mouth through mother. It usually occurs through kissing the newborn or sharing food between the mother and child. Regular brushing and mouth rinsing with mouthwashes should be encouraged in mothers.
MINIMIZE SALIVA SHARING ACTIVITIES.
Parents become overprotective during their initial journey with their kids. They check everything before giving it to his or her kid. It is a good practice but with limitations.
Avoid sharing food between parents and children, where there is a scope of salivary contamination from parents. Avoid activities like putting kid’s hands into the parent’s mouth.
Do not check the food with the same spoon that you are using to feed the baby. Usually, mothers have a habit of tasting the baby’s diet before they give the same to their babies.
It is a good practice until and unless you are going to use different spoons for yourself and the baby.
STOP PROLONGED FEEDING OF BABIES DURING NIGHTS.
Infants tend to cry for milk during nights. Many parents feed them with breast milk or bottle milk when they do so.
But during this process, they [parents] fail to stop feeding immediately after the child has gone to sleep.
It makes the kid expose to high lactose content for the whole night resulting in activation of caries-producing bacteria leading to ECC.
AMERICAN ACADEMY OF PEDIATRIC DENTISTRY HAS GIVEN SOME RECOMMENDATIONS TO PREVENT ECC.
HOW CAN I PREVENT TOOTH DECAY IN TODDLERS?
- Avoid milk bottles or breastfeeding during sleep.
- Stop Ad libitum breastfeeding after the first primary tooth begins to erupt. Stop bottle feeding by the age of 12-14 months.
- Parents should encourage their kids to have milk or infants drink from a cup, by the time they approach their first birthday.
- Avoid prolonged exposure to high carbohydrate food [excessive use of chocolates and sugar beverages].
Any kid who doesn’t follow the above guidelines would come under high risk for ECC. In such condition, early and effective treatment with fluoride varnish can reduce the risk of ECC.
Daily tooth brushing with a fluoride-containing toothpaste is an effective and economical way to prevent ECC. But most children tend to swallow toothpaste during brushing. Hence we recommend restricting the amount of toothpaste to the size of grain in children below 6-12 months.
In case, if parents have seen any decay in their kid’s mouth, they should consult the dentist immediately. Early intervention of such tooth decay can have a profound effect on reducing ECC in children.
Regular periodic checkup of your kid with a dentist is an excellent preventive practice for ECC.
There are many treatment options for tooth decay in toddlers. Early diagnosis and treatment can help you in saving your kid’s teeth.
For more information on the use of toothpaste in your children [CLICK HERE]
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