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Early Childhood Tooth Decay

A recent spate of early childhood tooth decay within my increasing patient pool of children has prompted me to look deeper into this condition. Termed “Early Childhood Caries”, or E.C.C., it has also been termed “bottle decay”, because it was mostly found in children ages 1-3 who went to sleep with a bottle of milk or juice in their mouths. This would pool around the teeth and due to a lack of salivary action and neutralization throughout the night, the acids from dental plaque would cause havoc on the teeth.

Nowadays, due to the growing health and diet awareness among parents, one would expect less “bottle decay” in their children, but paradoxically ECC is more prevalent among the children of just THESE parents. They are understandably perplexed because they claim they brush and floss the teeth of their toddlers and avoid all sugars. Most of these parents mention that they nurse at night. That sparked an alarm for me to look into this issue, since nursing is always associated with positive effects on child development.

Here are my findings:

  1. Traditionally, as one would think, some resources still cite the prevalence of ECC being correlated with poverty, maternal prenatal smoking, some ethnic groups, families with low income, premature birth and infant obesity. The next points, however, apply to the MODERN educated and well-off population.
  2. Many studies show that breastfeeding longer than 12 months and nocturnal (nighttime) breastfeeding increased caries rates.
  3. A Japanese population-based study revealed that breastfeeding more than 7 months resulted in increased caries at 30 months.
  4. Microbiology was my undergraduate major. What struck me back then, and what applies even more today, taking into account the excessive antibiotics and toxins in our environments and foods, microbes are constantly mutating and adapting. This applies to the culprit of dental caries, Streptococcus mutans. As it mutates and learns to process more diverse carbohydrates, it is also more aggressive. Some resources mention that teeth of children aged 3-5 years old, colonized with S. mutans, AND S. sobrinus, will carry a higher risk for ECC.
  5. Another study showed that children who eat snacks frequently, chew out of boredom, and keep their food in their mouth too long, will also be prone to developing ECC.

The purpose of this article is not to attempt to alter or judge parental behavior, however some awareness of what increases incidence of ECC would be appropriate.

Nighttime nursing should be stopped beyond a certain age, but more importantly, I would suggest that this new trend in dental disease among the modern well-off population be countered by improved oral hygiene techniques.

Here are 5 tips to help you prevent dental disease in your babies and toddlers:

  • Use xylitol gel applied to a 2×2 gauze to rub the toddler’s teeth after nighttime nursing sessions.
  • Start flossing the toddler’s teeth (age 2 in some cases) AS SOON as you notice teeth developing contacts (i.e. they are touching each other side by side).
  • Follow a routine brushing and flossing session twice a day.
  • Reduce the frequency of carbohydrate snacks, even if they are healthy and complex carbs. Citrus fruits should be consumed promptly.
  • Chewing organic hard cheeses and fibrous vegetables are the only foods that toddlers can chew as long and as much as they want.

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The information provided in this site is intended for general informational purposes only. It is not a substitute for medical advice and is not intended to provide complete medical information. KidsMisdiagnosed, Inc does not offer personalized medical diagnosis of patient-specific treatment advice. All medical information presented should be discussed with your healthcare professional. Remember, the failure to seek timely medical advice can have serious ramifications. KidsMisdiagnosed, Inc urges you to discuss any current health related problems you or your child are experiencing with a healthcare professional immediately.