Early Childhood Caries (ECC) is a particularly aggressive form of cavity formation in young children. It is characterized by rapid development of cavities beginning on the upper front teeth, usually on the back side where it is not noticed by parents until late. The cavity pattern progresses to the first baby molars. ECC typically is diagnosable before 16 months of age, though due to its location in hidden areas of the teeth it may not be noticed by parents until the cavities are severe. The combination of events necessary for ECC to develop include a dietary component and existing chemistry in the mouth. Therefore, a child with ECC may have a sibling with a similar diet pattern but different mouth chemistry who does not have ECC.
ECC is preventable. It is the most important driving reason to have a dental visit before the child's first birthday. Learn how to avoid this devastating disease.
Due to the aggressive nature of the cavity formation these young children often end up needing their dental work done under general anesthesia, often in a hospital operating room, at the age of 18 to 24 months. If, however, we diagnose the problem early, it is possible to stop the cavity process and avoid the impending dental work. Stopping the cavity process, which is critically important whether we have to do fillings or not, requires diligent attention to the home care routine for the teeth. We have outlined the steps below.
- Step 1 Identify the cause of the early caries and stop whatever that is. Without excellent cooperation with this step at home all the rest of our efforts will be in vain. We will loose a lot of time, spend a lot of money, and still need to do immediate conventional treatment on a worsened condition.
- Step 2 Remineralizing with topical fluoride, silver diamine fluoride, and calcium/phosphate applications at the office and at home. All the fluoride research the last 40 years demonstrates (first) that the beneficial effect of fluoride is topical. We don’t need to swallow it to get the benefit. And (second) that the fluoride can actually trap calcium and remineralize areas where the cavity has started. It is healing the cavity.
- Step 3 Monitor carefully! We recommend follow-up visits monthly until we are comfortable the cavity process is arrested, followed by check-ups at a 3-month interval.
A. If caries is progressing we want to identify it quickly while as many options for treatment as possible are still available.
B. If we need to modify the program, or add to the program, we want to identify the need and reasons at the earliest interval possible.
I want to emphasize: If this program is followed correctly, it is highly successful. If the program is not followed adequately it is not successful and leads to a delay in treatment and a worsening of the problem. If at any time in the process you feel you cannot fulfill what is being requested in your home care activities, let us know so we can adjust the program appropriately and/or discuss the alternative decisions you will want to make before the problem gets worse.