Early Childhood Caries (ECC), also referred to as Baby Bottle Tooth Decay (BBTD), is a disease that causes severe and swift decay of baby teeth. It usually begins with the upper front teeth, then moves on to the molars. Unfortunately, by the time most parents notice the decay, it may be too late to do anything about it. That's why it's important to understand the causes of ECC and learn how to prevent it before it even starts.

WHAT CAUSES ECC?

The main culprit of ECC is -- surprise -- your baby’s bottle or sippy cup. More specifically, it’s what's in that bottle or cup and how long your baby is exposed to it that is a big part of the problem. Every time you feed your baby sugary or sweet liquids such as milk, formula, fruit juices, even breast milk, they team up with the bacteria in the sticky film called plaque that constantly forms on teeth. Together, they produce acids that attack and dissolve the tooth enamel, causing tooth decay. Obviously, you can't stop feeding nutritious things to your baby - the trick is to regulate when, how and how often you feed them.

For instance, don't use a bottle filled with sweet liquids to pacify your baby at nap time, bedtime or for long periods during the day. While this may provide short-term comfort, these liquids end up pooling around your baby's teeth and gums. The longer they linger in your baby's mouth, the greater the likelihood of tooth decay. A good rule of thumb is to always hold your baby during feedings, remove the bottle when your baby falls asleep and remember to wipe off your baby’s teeth or gums with a damp washcloth when feeding is finished. A bottle or sippy cup left with a baby for any period of time should contain only water.

Additionally, it is now recognized that mothers, or main caregivers, are the most common source of transmission of decay causing bacteria to their infants. Babies are not born with the bacteria that cause decay. Instead they are “infected” sometime in their early life. Avoid behaviors that “share” with your baby, such as using his or her spoon to taste food or cleaning a pacifier by placing it in your mouth first.

HOW CAN ECC BE PREVENTED?

If the mother or caregiver has active decay, there is a much higher risk that the baby will become infected early and experience decay as well. It is important to visit your dentist, so he or she can treat the decay in your mouth. She may also recommend other strategies to reduce decay causing bacteria, such as rinsing with a prescription strength antibacterial mouthwash or chewing gum containing bacteria-reducing xylitol. We now know that mothers with healthy mouths, free of active dental decay, are much more likely to have babies that are healthy and free from early decay.

It's also important to keep your baby's mouth clean between feedings. Use a damp washcloth or gauze pad to wipe plaque off your baby's teeth and gums after feedings and snack time. You can begin brushing your baby's teeth with a small soft toothbrush, without toothpaste, as soon as the first tooth appears. When your child is a toddler and you do begin to use toothpaste, only a pea sized amount is necessary. Your child's first dental appointment should be scheduled soon after his or her teeth begin to erupt and can be as simple as holding your baby on your lap in the chair while your dentist takes a quick look inside your baby's mouth. This will help your child get used to the whole dental office experience early.

Additionally, parents play an important role in catching decay in the earliest stages. To inspect for early decay, parents should “lift the lip” to check for white spots on the teeth. These white spots are the signs of early decay and, if seen on your child’s teeth, are indications that your child should be seen by a dentist. The dentist may want to apply a fluoride coating to your baby’s teeth every few months to provide extra protection to these “damaged” areas of tooth enamel.

FLUORIDE IS IMPORTANT

If your community water supply is not fluoridated, your CDA member dentist may recommend fluoride supplements for your baby. This helps your baby’s teeth develop strong, hard enamel that better resists decay. As your child grows older, using dental products that contain fluoride to provide additional daily protection to the tooth surface is also recommended. At dental visits, professional strength fluoride products, such as gels or varnishes, are usually applied.

Proper nutrition and feeding your baby in an appropriate manner, along with regular dental visits, is the best way to protect your baby’s oral health.