Mitchell S, Ruby J, Moser S, Momeni S, Smith A, Osgood R, Litaker M, Childers N. 2009. Maternal transmission of mutans treptococci in severe-early childhood caries. Pediatric Dentistry 31(3):193-201. Abstract available.

This study utilized multiple genetic analyses to detect evidence of maternal MS acquisition in children with S-ECC. MS genotypes that did not match maternal strains were identified in the majority of children (74%) within this S-ECC population. Evidence of maternal transmission was detected in 41% of mother/child pairs.

Sheller B, Churchill SS, Williams BJ, Davidson B. 2009. Body mass index of children with severe early childhood caries. Pediatric Dentistry 31(3):216-221. Abstract available.

This study was designed to clarify the association between severe early childhood caries (S-ECC) and body weight in healthy children undergoing dental rehabilitation for S-ECC. The authors found that (1) children with S-ECC did not have a typical weight distribution; (2) a significant number of children with S-ECC were underweight; and (3) age- and gender-specific body mass index percentile was not correlated with decayed, missing, or filled teeth or with the number of pulp-involved teeth.

Ismail AI, Lim S, Sohn W, Willem JM. 2008. Determinants of early childhood caries in low-income African American young children. Pediatric Dentistry 30(4):289-296. Abstract available.

This article describes the prevalence, incidence, and determinants of early childhood caries (ECC) in African-American children from families with low incomes who reside in Detroit, Michigan. The authors found a high prevalence and incidence of ECC. The ages of the child and caregiver, the child's gender, and the caregiver's fatalistic belief and religiosity were significant predictors of ECC and severe early childhood caries (S-ECC). Consumption of soft drinks was also associated with development of S-ECC.

Southward LH, Robertson A, Edelstein BL, Hanna H, Wells-Parker E, Baggett DH, Eklund NP, Crall JJ, Silberman SL, Parrish DR. 2008. Oral health of young children in Mississippi Delta child care centers: A second look at early childhood caries risk assessment. Journal of Public Health Dentistry 68(4):188-195. Abstract available.

This study identified risk predictors of early childhood caries and treatment urgency beyond minority and socioeconomic status for the purpose of more easily identifying children within this population who are most in need of referral to a dentist. Children ages 3-5 attending licensed child care centers in the Delta region of Mississippi were evaluated on a number of risk indicators, some new and some derived from the American Academy of Pediatric Dentistry's Caries-risk Assessment Tool and a previous study of oral health risk predictors. The authors identified several potentially useful oral health risk indicators for children already known to be of high-risk status. The findings include levels of mutans streptococci, presence of plaque, oral-health-related quality-of-life measures, and history of parental abscess.

Kopycka-Kedzierawski DT, Billings RJ, McConnochie KM. 2007. Dental screening of preschool children using teledentistry: A feasibility study. Pediatric Dentistry 29(3):209-213. Abstract available.

This study assessed the feasibility and reliability of using intraoral cameras and telehealth communication technology to screen preschool-age children for oral disease, in particular early childhood caries (ECC). The authors found that there was no statistically significant difference between a visual examination and an examination using an intraoral camera, thus suggesting that the intraoral camera is a feasible and potentially cost-effective alternative to a visual oral examination for dental caries screening, especially ECC screening, in preschool-age children attending childcare centers.

Clarke M, Locker D, Berall G, Pencharz P, Kenny DJ, Judd P. 2006. Malnourishment in a population of young children with severe early childhood caries. Pediatric Dentistry 28(3):254-259. Abstract available.

This articles presents findings from a study to describe the nutritional status of young children (ages 2-6) with severe early childhood caries (S-ECC) and to assess the ability of several measurements of nutritional status to detect malnutrition in these children. All the nutrition tests detected malnourishment in children with S-ECC. The findings further imply that S-ECC may be a risk marker for the development of otherwise unexplained iron deficiency anemia in young children.

Foster T, Perinpanayagam H, Pfaffenbach A, Certo M. 2006. Recurrence of early childhood caries after comprehensive treatment with general anesthesia and follow-up. Journal of Dentistry for Children 73(1):25-30. Abstract available.

This study determined (1) the likelihood of new caries among children diagnosed with early childhood caries (ECC) after comprehensive treatment using general anesthesia and (2) whether attendance at immediate follow-up can prevent relapse. Despite the aggressive treatment of ECC, more than half the children had new caries lesions within 2 years. The children who missed their immediate follow-up appointment were more likely to experience a relapse.

Arizona Department of Health Services, Office of Oral Health. 2005. Social marketing research: Early childhood caries. Phoenix, AZ: Arizona Department of Health Services, Office of Oral Health.

This report presents results of the first two phases of a pediatric social marketing research project on oral health awareness targeted at parents of young children. The report provides information on the methods and results of social marketing research, identifies three important target audiences for information on early childhood caries, identifies potential areas of influence to impact knowledge and behavioral changes in the target population, and discusses next steps for the implementation of the social marketing campaign.

Brown A, Lowe B, Zimmerman B. 2005. Promising approaches and lessons learned for preventing or reducing early childhood caries: Summary of a workshop convened by the Maternal and Child Health Bureau. Washington, DC: Health Systems Research.

This report summarizes a national forum on early childhood caries (ECC) held on May 16–17, 2005, in Washington, DC, to identify common program elements using the Association of State and Territorial Dental Directors’ Best Practices for Oral Health Programs criteria as a framework and to develop a knowledge base of promising program approaches, practices, challenges, and lessons aimed at reducing and preventing the incidence of ECC.

Children's Dental Health Project. 2005. Early childhood caries trends upward. Washington, DC: Children's Dental Health Project.

This fact sheet discusses trends in dental caries among children. The fact sheet focuses on disparities in dental caries among young children, children from families with low incomes, and children of color. Implications of oral health disparities are also presented.

South Dakota Department of Health. 2005. Prevent cavities: Infant and toddler tooth decay or "early childhood caries" (ECC). Pierre, SD: South Dakota Department of Health

This brochure for parents describes early childhood caries and how to prevent tooth decay in infants and young children. Topics include the importance of healthy primary teeth and gums, oral hygiene, avoiding putting an infant or young child to bed with a bottle or “sippy” cup, avoiding drinks high in sugar, when to teach an infant or young child to drink from a cup, and when to schedule the first dental visit.

UCLID Center at the University of Pittsburgh and University of Pittsburgh School of Dentistry. 2005. An oral health tutorial providing a brief overview of early childhood caries for non-dental professionals. Pittsburgh, PA: UCLID Center at the University of Pittsburgh and University of Pittsburgh School of Dentistry.

This tutorial for non-oral health professionals who work with infants and young children and children with special health care needs is designed to help non-oral health professionals identify early signs of early childhood caries (ECC), differentiate between ECC and other oral heath problems, counsel families about prevention, and refer children with dental caries to a dentist.

American Academy of Pediatric Dentistry
• Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies
• Early Childhood Caries (ECC): Unique Challenges and Treatment Option
• First Visit by First Birthday: The Dental Home Resource Center
• Parent Resource Center
• Use of a Caries-Risk Assessment Tool (CAT) for Infants, Children, and Adolescents

American Dental Association
• ADA Statement on Early Childhood Caries
• Early Childhood Tooth Decay (Baby Bottle Tooth Decay)