Dental Hygiene: Cavities in Early Childhood/Early Childhood ‘Caries’

What causes childhood cavities and how can you prevent them?

Dr. Tina Rokadia, Prosthodontist at North Carolina Dental Practice in Dubai and a Breastfeeding supportive dentist tells us how to best care for our kids teeth and avoid ‘Early Childhood Caries’. 

Most parents are unaware of the harmful effects of nighttime feeding (breast or bottle) in children who have erupted (visible) teeth. The resulting condition called “Early Childhood Caries (ECC)” or more commonly “Nursing bottle caries” causes severe harm to the child’s teeth and requires time consuming, painful and expensive treatment.

This is typically caused due to night time feeding of a baby with Formula, Cows milk or other sweetened liquids like fruit juice. However, the most recent guidelines by the American Academy of Paediatrics states that breastfeeding, while not causative, is associated with a greater risk of ECC. There are other risk factors, such as the oral health of the mother or other caregivers, oral hygiene of the child and amount and type of carbohydrate consumption in the form of solids.

It must be noted that breastmilk in a bottle is not the same as breastmilk directly and the associated problems are more similar to those with formula. This is a result of the milk pooling in the mouth vs being swallowed. This pooling might even result during phases of inactive sucking during breastfeeding.

Breastmilk and breastfeeding are a vital component to nutrition and comfort and as a mother of two children myself I would not ask a mother to stop breastfeeding her children without an established risk.

However, I do make the following recommendations.

a) perform excellent oral hygiene. This includes brushing twice a day. Even if they have to be pinned down and brushed while they wail, this is paramount.

b) If you have high caries risk or active caries, please avoid spoon sharing with your child once their teeth have erupted. Get yourself treated immediately to avoid sharing “bad bacteria”.

c) If your child continues to breast/bottle feed multiple times during the night, please be under the care of a breastfeeding-friendly dentist. This dentist can monitor the oral hygiene, recommend fluoride treatment to strengthen teeth and can advise if decay starts. Early diagnosis can be helpful and hence visits every 3-6 months are essential.

d) Fluoride toothpastes and water in fluoride is GOOD for teeth. (Yes, its true!) The required levels are age and area dependent, hence each child might need an individual assessment.

I completely understand the struggles that young mums face, especially in the face of conflicting data. Creating awareness of these potential problems and giving the correct support to mothers is of massive importance to me.