Early childhood caries (ECC) is a common and severe form of cavities found in very young children (0-4 years of age). Without treatment, decay can spread deeper into the tooth, causing pain and infection and even damage to the underlying adult tooth. The baby tooth or teeth may need to be removed. Unfortunately, because of their young age, children may require treatment under sedation or general anesthesia at a hospital.

Baby teeth hold space for adult teeth as shown in the dental X-ray. If a baby tooth is missing too early other teeth may move into its space and block the way for the permanent tooth.

Causes for Early Childhood Decay

• Diets high in sugar
• A high frequency of snacking and/or frequent meals as well as sticky and sugary snacks.
• Sustained use of the baby bottle or sippy cup (especially at bed time)
• Lack of tooth brushing and flossing
• Limited access to fluoridated water

Your child’s first dental visit should occur by age one or within six months of when you see the first tooth.

Regular dental examinations support good health. The earlier your child visits the dentist, the better the chance of preventing a problem, such as decay. This can also increase your child’s comfort with the experience. The dentist will:

• Examine your child’s mouth
• Address any problems before they become more serious
• Monitor the development of your child’s teeth
• Provide tips to care for your child’s teeth and gums

Fluoride may be applied to strengthen their teeth.

Preparing Your Child for Their Visit

To help create a positive experience for your child:

• Schedule an appointment for a time when your child will be well rested and relaxed
• Treat the appointment as routine and bring along a favourite toy or blanket

Frequency of Exams

Your dentist will recommend how often your child should visit, normally twice a year. This allows the dentist to catch any potential problems early to prevent the problems from getting much worse. Children who are at increased risk of tooth decay, have unusual growth patterns, or who have poor oral hygiene may need more frequent visits.

X-rays

X-rays are generally not taken until your child is old enough to understand how to cooperate for this procedure. X-rays show decay between teeth and also show if adult teeth are coming in properly. Under some circumstances, like an accident involving the mouth, dental X-rays may be done on children as young as a year old. The X-rays are safe for your child. Dentists are careful to limit the amount of radiation to which children are exposed.

• Keep your child’s teeth clean. This is the easiest way to keep teeth healthy.
• Limit sugar-filled foods and drinks (particularly for babies). Milk, juice and formula all contain sugar. Avoid using the bottle and sippy cup to sooth your child. Fill them with water instead.
• Visit the dentist by age one or within six months of when you see the first tooth. Through regular examinations your dentist will monitor the development of your child’s teeth and gums to catch problems early and prevent disease.
• Avoid sharing utensils. Plaque-causing bacteria in your mouth can transfer easily to your baby’s mouth, so it’s best to avoid sharing utensils. Likewise, don’t clean your baby’s soother in your mouth.

Tooth brushing tips for parents and caregivers (PDF) (Arabic) (Chinese) (Spanish) (Punjabi) (Farsi)

7 Tips for Healthy Teeth (PDF) (French)

Teething is the process where teeth appear (erupt) and it can cause pain, fussiness and drooling. To help ease the pain, many babies like to chew on a cold clean face cloth or teething ring. You can also rub your child’s gums gently with a clean finger. Do not give your child teething cookies as most contain starch and sugar which contributes to tooth decay.

• Caring for the mouth starts early. Begin by cleaning your baby’s mouth using a wet cloth and gently wiping the gums to remove any leftover milk or formula from the mouth.
• Brush your child’s teeth as soon as the first tooth appears and make sure you lift the lip to brush along the gum line. Young children cannot clean their own teeth. Brush for them when they are very young and with them as they grow older.
• Use a soft toothbrush. Choose an appropriate size for the age of the child.
• Use a small amount of fluoride toothpaste to protect the teeth from cavities. Children under the age of 3 should only use a smear (size of a grain of rice) while those over 3 can use a pea-sized amount. Encourage your child to spit out the toothpaste.
• Make brushing fun and develop a routine: brush at a specific time (after a bath or before a book); in a specific location (mom’s knee); or with specific cues (music, counting).
• Cavity-causing bacteria can transfer from your mouth to your child’s. Avoid sharing soothers, toothbrushes or other items with your child.
• Regardless of age, discourage grazing on sugary foods and drinks throughout the day or overnight. For instance, constant and slow sipping on milk-filled bottles or sippy cups with juice keeps sugars in the mouth and can lead to cavities—fill them with water instead.
• Choose healthy snacks such as cheese, fruit or nuts. What’s good for the body is good for the mouth.
• The earlier a dental problem is found, the easier it is to fix. Check your child’s mouth and visit the dentist regularly.
• Look in your child’s mouth for signs of disease such as brown or yellow spots on the teeth. Other signs that your child may be suffering from dental disease include trouble sleeping; difficulty concentrating; and, avoiding certain foods, such as cold drinks and foods.
• The first dental visit should take place by age one or within six months of when you see the first tooth. Through regular examinations, your dentist will monitor the development of your child’s teeth and gums to catch problems early and prevent disease. Starting dental visits early can also improve your child’s comfort with visiting the dentist.