Early childhood caries can occur in children as young as six to 12 months of age. In infants, the upper four front teeth (incisors) are the most commonly affected. Dental caries are holes in teeth caused by decay. Early childhood caries can be caused by the inappropriate use of bottles.
How to tell if your infant has early childhood caries
Early childhood caries can be difficult to detect. Its appearance will depend on how advanced the condition is. Early childhood caries may show up as:
- A dull white band along the gumline this is the first sign and usually remains undetected by parents. Bacteria found in plaque change sugars into acids, which dissolve minerals in the tooth’s enamel in a process known as demineralisation. If untreated, this can lead to holes (cavities or caries) in the teeth.
- A yellow, brown or black collar around the neck of the teeth this indicates that the demineralisation has progressed to cavities.
- Teeth that look like brownish-black stumps this indicates that the infant has advanced cavities. The upper four incisors (front teeth) are usually involved, while the lower incisors remain relatively unaffected. The back teeth may also be involved.
Importance of early detection
Unfortunately, in most cases, early childhood caries is not picked up until the child is about 20 months of age. By this stage, many children need significant dental treatment. This can be traumatic for both the infant and parents.
Feeding tips to prevent early childhood caries
Breastfeeding is best as it carries a reduced risk of early childhood caries. If bottle feeding is necessary:
- Take the bottle away when the child has had enough.
- Use cooled, boiled water if the child needs a bottle for comfort or extra fluids.
- Introduce the child to a feeding cup between six and eight months of age. In most cases, the bottle can be discarded when the child is 12 months old.
- Encourage children to drink water rather than fruit juices or sweet drinks when thirsty.
Toothbrushing
Toothbrushing recommendations include:
- Start as soon as the first tooth appears. Wipe the front and back of each tooth using a finger wrapped in a face washer.
- Introduce a soft toothbrush at 12 months (earlier if tolerated by the infant).
- Introduce toothpaste at about 18 months of age.
- Use a pea-size amount of toothpaste.
- Use low fluoride toothpaste for children under six years old.
Dental checks
Dental check-ups can help detect early childhood caries. The Child Health Record recommends two dental checks before the age of three and a half years. This may be done by a maternal and child health nurse or a dental professional.
Fluoride helps protect teeth against caries
Seventy-five per cent of Victorians have access to fluoride in their water. If your drinking water is not fluoridated, seek professional dental advice about the use of fluoride toothpaste for children. A dental professional may advise more frequent use of fluoride toothpaste, commencement of toothpaste at a younger age or earlier commencement of use of standard toothpaste.
Fluoride supplements in the form of drops or tablets to be chewed or swallowed should not be used as they can affect the development of your child’s second teeth and cause dental fluorosis (staining).
Dummies and medicines
Avoid dipping dummies in honey, glycerine or other foods or liquids. If your child needs medicine, ask your doctor to prescribe a sugar-free form.
Where to get help
- Your dental professional
- The Australian Dental Association (Victorian branch) Tel. (03) 9826 8318
- Dental Health Promotion Unit, Dental Health Services of Victoria Tel. (03) 9389 8888
- Your local Maternal and Child Health nurse
- Your pharmacist
Things to remember
- Early detection of early childhood caries may prevent the need for dental treatment.
- Tooth cleaning should begin as soon as your infant’s first tooth appears.
- Use a low fluoride toothpaste for children under six years of age.
You might also be interested in:
Dental care - common conditions - 0 to 5 years.
Dental care - dummies.
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