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Statement on Early Childhood Caries

(Trans. 2000:454)

1. Early Childhood Caries is defined as the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a preschool-age child between birth and 71 months of age. The term "Severe Early Childhood Caries" refers to "atypical" or "progressive" or "acute" or "rampant" patterns of dental caries.

2. The Association recognizes that early childhood caries is a significant public health problem in selected populations and is also found throughout the general population.

3. The Association urges health professionals and the public to recognize that a child's teeth are susceptible to decay as soon as they begin to erupt. Early childhood caries is an infectious disease. There are many aspects of early childhood caries; baby bottle tooth decay is recognized as one of the more severe manifestations of this syndrome.

4. The Association urges parents and guardians, as a child's first tooth erupts, to consult with their dentist regarding:

  • Scheduling the child's first dental visit. It is advantageous for the first visit to occur within six months of eruption of the first tooth and no later than 12 months of age, and
  • Receiving oral health education based on the child's developmental needs (also known as anticipatory guidance).

5. The Association urges its members to educate parents (including expectant parents) and caregivers about reducing the risk for early childhood caries:

Role of Bacteria

  • Because cariogenic bacteria (especially mutans streptococci) are transmitted soon after the first teeth erupt, decreasing the mother's mutans levels may decrease the child's risk of developing ECC. The Association recommends that parents, including expectant parents, be encouraged to visit a dentist to ensure their own oral health.

Nutrition

  • Infants and young children should be provided with a balanced diet in accordance with the Dietary Guidelines for Americans published by the U.S. Department of Agriculture and the U.S. Department of Health and Human Services.
  • Unrestricted, at-will consumption of liquids, beverages and foods containing fermentable carbohydrates (e.g. juice drinks, soft drinks, milk, and starches) can contribute to decay after eruption of the first tooth.

Bottle Feeding

  • Unrestricted and at-will intake of sugary liquids during the day or while in bed should be discouraged.
  • Infants should finish their bedtime and naptime bottle before going to bed.

Breast Feeding

  • Unrestricted, at-will nocturnal breastfeeding after eruption of the child's first tooth can lead to an increased risk of caries.

Use of a Cup

  • Children should be encouraged to drink from a cup by their first birthday.
  • At will, frequent use of a training cup should be discouraged.

Home Care

  • Proper oral hygiene practices, such as cleaning an infant's teeth following consumption of foods, liquids, or medication containing fermentable carbohydrates, should be implemented by the time of the eruption of the first tooth.
  • A child's teeth should be periodically checked at home according to the directions of the dentist.

6. The Association urges state and local dental societies to be a resource for the medical community and public health programs (e.g. Women, Infants and Children [WIC] and Head Start). Dentistry can be instrumental in educating professionals and the public about risk factors for ECC.

7. The Association recognizes that the unique characteristics of ECC should be considered in selecting treatment protocols.

8. The Association, recognizing that the science surrounding early childhood caries continues to evolve, encourages research activities to study risk factors and preventive practices and should continue to seek a cure for early childhood caries.

and be it further
Resolved, that Resolution 6H-1997 (Trans.1997:675), Statement on Early Childhood Caries, be rescinded.