What Is It?
Early Childhood Caries (ECC), or the destruction of tooth enamel in children under 6 years of age, is one of the most prevalent infectious diseases amongst North American children. While its causes are many and multifactorial, ECC always results from a combination of sugar, bacteria and time. Bacteria naturally living in the mouth survive by feeding off sugars in the diet, such as from milk, pop, juice, cakes or candy. These bacteria accumulate to form plaque, and produce enamel-destroying acid as a result. As the time between cleanings lengthens and the number of bacteria multiplies, so does the amount of acid on the teeth. More acid means more wearing of the enamel, and, eventually, tooth decay. It is important to note that plaque may grow in your child’s mouth even before the eruption of the first tooth.
There is good news! Early childhood caries are 100% preventable. As a parent and role model, you can make all the difference in your child’s dental health by promoting good oral hygiene habits even before any teeth are visible and maintaining these habits throughout the child’s youth. We urge you to take the following steps of action to prevent ECC in your child:
Wrap a soft, damp cloth around your index finger to gently wipe the child’s gums from back to front, and take away any leftover milk or formula. Repeat this step after each feeding.
Ensure that your child’s teeth are brushed with fluoride-containing toothpaste at least 2 times per day (after breakfast and before bedtime). Ideally, brushing takes place after each meal.
Ensure that tight contacts between your child’s teeth are flossed every day.
For more information on how to care for your and your child’s teeth, please see our ‘Oral Self-Care’ leaflet.
Is your child ready to brush his or her own teeth? Your child is ready to brush without assistance when he or she is able to handwrite (not print) his or her name, and no sooner. It is difficult for your child to hold and move a toothbrush well enough to reach all areas of his or her teeth. We, therefore, recommend that you assist your child with brushing until he or she is able to do so alone.
Ensure that your child receives a nutritious, balanced, low-sugar diet; limit your child’s snacking; sweetened foods and beverages should only be consumed at meal times;
Bring your child in for a dental check-up as soon as the first tooth appears or by his or her first birthday (whichever comes sooner);
Continue to bring your child to the dentist for regular check-ups and cleanings (every 6 months);
Ensure that you and the child's primary caregiver maintain good oral hygiene, as the bacteria which cause dental decay can easily be transmitted to the child through kissing and sharing cutlery.
Allow your child to fall asleep with a bottle, containing milk, juice or other sweetened drinks; if you must give your child a bottle at night, it should be filled with WATER ONLY;
Give your child a pacifier dipped in sugar or honey;
Scare your child by telling dentist horror stories; instead, instill a sense of trust in the dental team from a young age.
Pain and Serious Infection Allowing tooth decay to progress will cause substantial damage to the structure of the tooth. Decay may spread to the root of the tooth, causing it also to become infected and potentially abscess (develop a pus-filled pocket). Inevitably, such damage is accompanied by significant pain and suffering.
Life-Long Oral Health Problems Although every child’s primary teeth eventually fall out, it is important to note that infants and children afflicted with ECC have a high likelihood of suffering from oral health problems even when permanent teeth have replaced the primary teeth. Since a child's baby teeth serve as an eruption guide for the permanent teeth, loss of a baby tooth can cause the permanent teeth to be misaligned or crowded. A severe infection can spread to the bone tissue, containing unerupted permanent teeth, and damage these teeth even before they are directly exposed to food in the mouth.
Cost The longer tooth decay is left untreated, the more extensive and costly the required restorative procedures are.
For the sake of your child’s oral health and general well-being, we urge you to not dismiss early signs of caries (i.e., white spot lesions) in very young children. These initial lesions generally progress over a short period of time into larger cavities that can only be managed with fillings or extraction.
Once your child’s teeth are weakened by decay, there is no way to reverse the damage. Early and professional dental intervention is the key to managing ECC. At Horizon Dental, we offer different levels of patient management to accommodate various degrees of ECC severity and patient anxiety, as outlined below.
In-Office: No Anaesthesia
Patients who have built a trusting relationship with our dental team, and whose dental work is minor, often do not require any anaesthesia. Children often do very well with the treatment, but decay must be identified early on. Procedures normally performed without anaesthesia include the application of sealants, dental cleanings and treatment of early decay.
In-Office: Dental Anaesthesia (Freezing)
Our dentists usually recommend the administration of local anaesthetic (freezing) around a more severely affected tooth, prior to performing treatment. The administration of local anaesthetic is independent of your child's anxiety level, and serves solely to eliminate any physical discomfort associated with treatment.
In-Office: Dental Anaesthesia With Nitrous Oxide (N2O)
Some of our pediatric patients express overwhelming apprehension towards dental treatment. To help such patients feel more at ease during their treatment, we typically offer the calming agent, nitrous oxide, also known as laughing gas, in conjunction with freezing for more extensive treatment.
Hospital Operating Room: General Anaesthesia
At times when one or more teeth must be extracted, dental treatment is usually performed under General Anaesthesia (GA) in the hospital's operating room. The effects of GA, induced and monitored by an anaesthetist, include unconsciousness and unresponsiveness to pain throughout the duration of treatment. Our dentists schedule hospital days in Terrace as they are allotted. At times, our hospital wait lists are long as our OR days are limited, and it could be months before your child can be seen – please call us to make an appointment as soon as you notice changes in the appearance of your child's teeth.
Contrary to popular belief, having a parent hold the child’s hand during treatment rarely makes the procedure easier. Often it causes the procedure to take longer than necessary, and may also compromise the quality of results. Two of our treatment operatories are designed with an observation area behind the treatment area. From here, parents may see and hear their child's treatment but remain unobserved by the child. This allows the dental team to focus on the child, and the child to focus on the dental team throughout treatment. We urge parents to instill in their children a sense of trust in the dental team from a young age.