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Modules

Module 2: Dental Caries Process

2.1 Dental Caries

Early Childhood Caries

The presence of one or more decayed (i.e., with cavitated or non-cavitated lesions), missing, or filled tooth surfaces occurring in children under age 6 is called early childhood caries (ECC). In children younger than age 3, any sign of smooth-surface caries is severe ECC (S-ECC).6 ECC initially affects the teeth that erupt first and are least protected by saliva (i.e., cheek side of the upper front teeth). Parents of children with S-ECC often describe their child’s teeth as melting or chipping away.

Chipping teeth Melting teeth
Chipping Teeth   Melting Teeth
Used with permission from Norman Tinanoff, D.D.S., M.S., University of Maryland Dental School.

If ECC or S-ECC are left untreated and other contributing factors remain unchanged, the bacteria that cause dental caries can spread to adjacent teeth and create new decay.7 Treatment is expensive, often requiring extensive restorations under general anesthesia in a hospital operating room. Other possible consequences of untreated ECC and S-ECC are:8

  • Severe pain
  • Spread of infection, sometimes with cellulitis
  • Difficulty chewing and poor weight gain
  • High risk for developing dental caries in permanent teeth
  • Malocclusion
  • Missed school days
  • Impaired language development
  • Inability to concentrate
  • Low self-esteem
  • Systemic illness
18 month 36 months
18 Months   36 Months
Used with permission from Norman Tinanoff, D.D.S., M.S., University of Maryland Dental School.