What Is Early Childhood Caries?

Early childhood caries (ECC), sometimes called bottle rot or baby bottle tooth decay, is an infectious oral disease found in young children. Bacteria present in the mouth eat sugars that are left behind after liquids like milk, juice or formula are consumed, producing acids that attack tooth enamel and cause cavities. ECC is highly preventable by limiting bedtime beverages and snacks and proper dental care with regular dentist visits for caregivers and children.

ECC happens most when parents put children to bed with a bottle or "sippy cup" full of milk, soda or formula, or when children are given carbohydrate-loaded snacks before they go to sleep. Natural sugars in even healthy drinks are attacked by bacteria and the by-products of their digestion eat away at tooth enamel. These bacteria are passed to the child by the caregiver and are not naturally occurring at birth. White spots on the teeth are often the first sign of decay.

Risk factors for early childhood caries include poverty and very young mothers, who may not have the education or maturity to properly care for their children's teeth or good healthcare resources. Maternal smoking during pregnancy and longer periods between dental visits have also been found to contribute. As children grow older, their incidence of early childhood caries increases. Solid foods that stick to the teeth and more frequent snacking set up a situation ideal for cavity-causing bacteria.

A 2007 US study showed no evidence that breastfeeding is a risk factor for early childhood caries. Although an animal study during a similar time period found that human milk is more prone to cause cancer than cow's milk, in the US most children do not breastfeed past the weaning stage, as in other cultures. A 2011 study showed a new pathogen, Scardovia wiggsiae, present in severe cases of early childhood caries. Streptococcus mutans is one bacteria primarily known for causing ECC, but the new pathogen showed up where the Streptococcus was not present. This knowledge may help healthcare professionals devise treatment and cures.

To prevent this disease from taking hold, parents can wipe baby's mouth with a clean damp cloth after eating and at least twice daily. The baby should not fall asleep with a bottle that contains anything other than water. Snacking can certainly be limited. Dental visits should start around age one. At six months, brush with a soft brush and no paste, and regular brushing with help can begin around age two until child can do it alone. Many future health issues can be prevented by eliminating severe infectious ECC.