How early can a person have tooth decay? The answer is, as
soon as a person has teeth erupted.
This means an infant under the age of 1 can start having tooth
decay. Tooth decay that happens in infants is called Early
Childhood Caries. ECC is a severe problem that causes
debilitating tooth destruction in infants and young children.
The prevalence of ECC is estimated to be as high as 90 percent
in some Head Start populations. However, by following the
guidelines developed by the American Academy of Pediatric
Dentistry and by visiting a dentist for the first check-up by
the child's first birthday, ECC can easily be prevented.
ECC is a specific form of severe decay found in the teeth of
infants and toddlers who fall asleep with bottles of milk,
juice or any sweetened liquid in their mouths. ECC is also
known as baby-bottle tooth decay, nursing-bottle caries and
milk-bottle syndrome. It is the only severe dental disease
common in children under 3 years of age.
Bacteria, which are found in the mouth, convert sugar into
acids. These acids destroy the enamel and dentin of the tooth.
The flow of saliva in the mouth helps to wash acids from the
tooth surface during the daytime. However, when an infant is
asleep, the flow of saliva is significantly reduced, and this
allows acids to pool on the tooth. This, coupled with the
sugars found in juices, milk or other soft drinks, will lead
to early cavities.
The top four front teeth are most affected by ECC, which
appears as white chalky marks on the teeth due to
decalcification by the acids. If these teeth are left
untreated, unsightly and often painful cavities will develop.
Baby teeth are important to a child for chewing and biting
food, making a good smile, and speaking. However, the most
important function of baby teeth is that they are holding
space in the mouth for upcoming permanent teeth.
The first baby tooth erupts around 6 to 8 months of age, and
usually all 20 baby teeth are erupted by the age of 2 or
2-and-a-half. Early loss of baby teeth can cause blocked
eruption, drifting, crooking and crowding of the permanent
A child who prematurely loses baby teeth will have a very high
chance of needing braces in the future. If an abscess or
infection occurs around baby teeth with ECC, it may affect the
development of the underlying permanent teeth.
The best treatment for ECC is prevention. But teeth affected
by ECC can still be treated if intervention is early and the
underlying causes are stopped.
The following are guidelines, developed by the American
Academy of Pediatric Dentistry, for preventing baby-bottle
Don't allow a child to fall asleep with a bottle containing
milk, formula, fruit juices or other sweet liquids.
Comfort a child who wants a bottle between regular feedings
or during naps with a bottle filled with cool water.
Always make sure a child's pacifier is clean, and never dip
a pacifier in a sweet liquid.
Introduce children to a cup as they approach 1 year of age.
Children should stop drinking from bottles soon after their
See the dentist if any unusual red or swollen areas appear
in a child's mouth, or any dark spot on a child's tooth.
Healthy adult teeth begin with healthy baby teeth. Knowing and
following the AAPD guidelines, and visiting a dentist for the
first check-up around the age of 1, are very important for
preventing young children from getting ECC.