Early childhood caries affects many children

Early childhood caries affects many children

Donya Betancourt, Pediatrician, Sanur, Bali, drdonya@hotmail.com

Early childhood caries, or ECC, is a disease which afflicts
many children. This new term includes baby bottle tooth decay and
nursing caries.

These are the four factors required for carious lesions:
A susceptible tooth; Acid producing bacteria (mutans
streptococci); Fermentable carbohydrates (sucrose); Time
(repeated exposures to sugar).

Since there is almost no saliva flow during sleep, any food or
drink, which is in a baby's mouth at this time stays there many
hours and promotes the caries disease process. That is why it is
absolutely essential to give the baby ONLY water in its bottle
when it is sleeping or taking a nap.

Do NOT put fruit juice, soft drinks, sweet tea, formula, or
milk in your baby's bottle or sipper cup during bedtime or nap
time. Do NOT dip pacifiers in sweet liquids.

Another insidious cause of early childhood caries is the sugar
in the medications that are prescribed for infants and toddlers.

Many oral medications and prescriptions contain up to 50
percent sucrose. Oral antibiotic formulations for children are
big offenders. The caries disease can be prevented by cleansing
your child's teeth after every administration of oral medication.
Using ordinary water on a toothbrush works fine.

Soft drinks are very destructive to children's teeth. Many of
them contain not only processed sugar, but also carbonic acid,
citric acid, and phosphoric acid. The acid in sodas slowly
dissolves the enamel of children's teeth. The sugar provides food
for the bacteria which cause early childhood caries.

Mutans Streptococcus is the most important bacterium
responsible for early childhood caries. This bacterium thrives on
the acids contained in soft drinks. To make matters worse, such
an acidic environment actually kills off the "good" oral
bacteria. Under the right circumstances, an adolescent's
mouth may eventually harbor more than 400 species of microbes.

One important warning sign of the caries disease are "white
spot lesions". These are white, chalky areas on the front teeth,
close to the gum line.

These decalcifications directly precede irreversible loss of
tooth structure (a cavity). Be sure to get these areas examined
by a pediatric dentist as soon as possible so that treatment can
be initiated, if necessary. When your baby is twelve or eighteen
months old, it will be time for its first dental checkup. A
pediatric dentist is trained to perform dental exams on infants
and to advise parents on preventive measures which are essential
for maintaining healthy teeth and gums. Do NOT wait until you
child is four years old to have this done.

You can help prevent early childhood caries. Begin by NOT
sharing your eating utensils with your infant and vice versa
because your mouth contains millions of bacteria, including the
infectious mutans streptococci. These bacteria are the initiators
of the caries disease process as discussed above.

When a parent puts the baby's feeding spoon into his or her
mouth, the mutans streptococci bacteria from the parent's mouth
will be transferred back to the baby's mouth and infect the
baby's teeth. This process can take place as early as eleven
months of age. The danger of infecting an infant's teeth is
actually increased when the mother already has the caries disease
herself.

As soon as the first baby teeth erupt, which occurs between
six and twelve months of age, parents need to clean the new teeth
with a new, damp cloth twice a day. It is better to use a baby
tooth cleanser, NOT tooth paste, until your baby is about
eighteen months old.

Using a baby tooth cleanser will prevent excessive fluoride
ingestion during infancy. At eighteen months of age, the first
primary molars begin to erupt. Then it will be time to brush all
of the teeth with an infant toothbrush and a pea-sized drop of
children's toothpaste, twice a day.

The good news is that many oral infections, including caries,
are preventable. By minimizing the intake of sweets, cleaning
your child's teeth daily, providing early dental examinations,
and minimizing the sharing of objects that harbor viruses and
bacteria, your baby will have a happy, healthy smile.

Next week we will discuss how to take care of dental injuries.