Early childhood dental caries is one of the most common chronic infections in childhood, which, however, could be completely prevented with a little attention and proper oral hygiene.

This type of tooth decay is also called baby bottle syndrome, as sugary drinks and teas filled in baby bottles used to put children to sleep, as well as feeding breast milk to soothe a small child over the age of one, which are not followed by bedtime oral care, can be blamed for its occurrence. As a result, the erupting baby teeth can soak in this sugary liquid for hours, and the bacteria in their mouth break down the sugar and form acid, thus creating early tooth decay.

Baby bottle syndrome can appear under the age of three, during which rapid caries in the baby dentition, affecting several teeth, can be observed in the child’s mouth. The age group of one- and two-year-olds is most at risk, as the enamel development of the small baby teeth in the premolar has not yet been completed, and they are still very sensitive to the acidic effects associated with the breakdown of sugars. It shows a characteristic circular pattern: the brownish changes are visible first on the side of the palate, which spread into the spaces between the teeth and reach the outer surface of the teeth. The upper teeth are more prone to falling, as the lower teeth are slightly more protected thanks to the washing and cleaning effect of saliva, which is why the upper milk incisors are the first to be affected by caries.

Appearances of early childhood caries:

	Indelible white spots and lines appear on the labial side of the milk incisors, near the gums, and whitish-yellowish changes also develop on the surface of the palate.
	This is followed by the condition already accompanied by cavity formation, when yellowish-brown spots can be observed on the milk teeth.
	Then the process spreads more and more on the surface of the tooth, reaching deeper and deeper layers, and due to significant cavity formation, it takes on a brownish-black, circular shape.
	In this phase, the loss of tooth material can be so great that the crown of the milk teeth can break off, and the end of the process is the stumps barely protruding from the gums.

Although tooth decay primarily affects the upper milk incisors, as the process progresses, the decay can spread to the milk molars and, in extreme cases, to the milk canines that erupt later. Finally, the inflammation spreads to the area around the root through the inflammation and death of the dental lining, which can even turn into abscess formation.

Due to the rapid progress of the process, the treatment must be started as soon as possible. At the beginning of the treatment, we also discuss the rules of proper nutrition and dental care habits at home with the parents. In the case of mild lesions affecting small surfaces, we use fluoridation-in-clinic (application of solutions, varnishes, gels), and we call our little patients back for regular check-ups. In the case of advanced tooth decay, after the removal of the decayed area, a fluoride-releasing filling is placed in the cavity. In the case of an extreme degree of change, we begin the root treatment of the milk tooth. If root canal treatment is not feasible, the removal of the milk tooth(s) becomes necessary, because the inflammation around the root of the milk tooth can result in damage to the germ of the permanent tooth located below.

However, prematurely lost baby teeth can have serious consequences: crowding of permanent teeth, speech formation disorders, digestive complaints due to insufficiently chewed food, and lack of self-confidence.

Due to the rapid course of the process, prevention is the most important thing. Keeping the baby’s teeth healthy is the parent’s responsibility! We are now giving you a little crutch for this through some useful advice:

1. Drinks and teas with sugar should be to avoid, as well as breastfeeding over the age of one by reducing its frequency.
2. You should especially avoid consuming them before going to sleep. (breast milk and milky formula should also be avoided in this case)
3. It is also advisable to avoid snacking between meals.
4. After feeding (also in the case of drinks, soft drinks, tea, cocoa) you should always wash your baby’s protruding teeth (with a baby toothbrush that can be put on the parents’ fingers, a child’s toothbrush) and also wipe the gums with gauze. Under the age of 2, a thin layer of toothpaste should be applied to the toothbrush, between 2-5 years of age, a small pea-sized amount of toothpaste. When buying toothpaste, it is important to check the fluoride content of the toothpaste: 75-150 ppm up to 3 years of age; 250-500 ppm up to 3-6 years of age.
5. Rehydration should preferably be done with water. The transition from sugary soft drinks can be radical, switching immediately to water, or we can proceed gradually (diluting the soft drink and tea more and more with water each time).
6. Try to introduce drinking from a glass as soon as possible, when the toddler is already open to it (around the age of one).
7. Try not to pass your own saliva to the baby: do not lick a dropped pacifier or spoon, because you can pass the bacteria responsible for caries already present in your own mouth to the little one.

All in all, if you pay attention to your child’s proper, healthy diet, thoroughly clean their teeth and gums, and regularly participate in dental examinations, then you have already done everything for your child’s health.

Dr. Babett Toth