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Early Childhood Caries

Early Childhood Caries: Symptoms, Causes, Prevention | National Dental Centre Singapore

Early Childhood Caries - What it is

Tooth decay in children under the age of 6 is termed as Early Childhood Caries (ECC). In Singapore, 40% of preschool children are affected by ECC. Whether caries occurs in adults or children, it is 100% preventable.​

Early Childhood Caries - Symptoms

The process of tooth decay takes time and does not happen overnight. It usually begins with early signs of Early Childhood Caries (ECC), which present as White Spot Lesions (WSL) on tooth surfaces. These white spots appear as chalky areas on the enamel surface. They are often found under plaque.

WSL are signs of enamel demineralisation. The WSL is the precursor to the cavity. As demineralisation progresses, parents often complain that their child’s teeth keep breaking off, or they can scrape bits of tooth off. WSL can turn yellow/brown and the tooth surfaces will start to break off to form cavities. 

Untreated cavities can lead to pain, swelling, loss of appetite and sleep, damage to the developing permanent teeth, or in severe cases, systemic infection. WSL are not obvious to caregivers unless you look for them. They do not cause pain. It is only at this stage that decay can be reversed. Once the WSL has progressed to become a cavity, reversal is not possible.

Early Childhood Caries - How to prevent?

​Here are ways which you can prevent Early Childhood Caries (ECC).

  • Children are recommended to have their first dental visit by age one or when their first teeth erupts.
  • Keep good oral health if you are pregnant and/or have a young child.
  • Avoid filling your child’s nursing bottle with liquids such as sugar, water, honey or soft drinks.
  • Do not allow your child to fall asleep with a bottle containing milk, formula, fruit juices or sweetened liquids.
  • If your child needs a comforter between regular feedings at night or during the day, give him/her a bottle of cool water instead.
  • Wean your child off the milk bottle by age one.
  • Fluoridated toothpaste should be used. The type of toothpaste will be recommended by the dentist depending on your child’s caries risk.

Early preventive dental visits enable the dentist to assess the child’s risk of getting ECC, catch the early signs and recommend appropriate preventive measures to prevent the progression of the disease.

Early Childhood Caries - Causes and Risk Factors

​Prevention is the best option in the management of Early Childhood Caries (ECC). In order to reverse White Spot Lesions (WSL), you have to understand the factors that cause it. These causes include (but are not limited to):

  • Poor oral hygiene resulting in accumulation of plaque.
  • Prolonged use of milk bottle filled with milk or sweetened liquids as a comforter to soothe the child to sleep.
  • On-demand breastfeeding throughout the night without considering oral care measures.
  • Streptococcus Mutans is a caries-causing bacteria which is transmittable from caregiver to infant through acts like sharing of food and eating utensils.

If you find a white spot lesion or lesions on your child’s teeth, you should bring your child to the dentist as soon as possible. You have a small window period whereby prevention and early treatment can be done.

Early Childhood Caries - Diagnosis

Early Childhood Caries - Treatments

Early Childhood Caries - Preparing for surgery

Early Childhood Caries - Post-surgery care

Early Childhood Caries - Other Information

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