What is ECC?

Early Childhood Caries (ECC) is a chronic disease that destroys tooth structure leading to loss of chewing function, pain, and infection in children through five years of age. Defined as > 1 decayed, missing, or filled primary tooth surface in children under the age of 6.

  • ECC was once called "nursing caries" or "baby bottle tooth decay."
  • Now the disease is called ECC as a variety of feeding habits are implicated.
  • Other known variables include socioeconomic status, access to dental care, fluoride exposure, and family caries experience.

Caries Prevalence

  • 21% of primary teeth ages 2-5
  • 51% of permanent teeth ages 6-11
  • 54% adolescents ages 12-19

Progression

  • Upper front teeth that are least protected by saliva are affected first
  • Disease moves posteriorly as teeth emerge

Severe Early Childhood Caries

Joanna Douglass, BDS, DDS
Joanna Douglass, BDS, DDS
Joanna Douglass, BDS, DDS

References

Centers for Disease Control and Prevention. Oral Health Surveillance Report: Trends in Dental Caries and Sealants, Tooth Retention, and Edentulism, United States, 1999–2004 to 2011–2016. Atlanta, GA: Centers for Disease Control and Prevention, US Dept of Health and Human Services; 2019. www.cdc.gov/oralhealth/publications/OHSR-2019-dental-caries-permanent-teeth.html

American Academy of Pediatric Dentistry. Policy on early childhood caries (ECC): Consequences and preventive strategies. The Reference Manual of Pediatric Dentistry. Chicago, Ill.: American Academy of Pediatric Dentistry; 2023: 88-91. 

Dye BA, Xianfen L, Beltrán-Aguilar ED. Selected Oral Health Indicators in the United States 2005–2008. NCHS Data Brief, no. 96. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention; 2012.

Fleming E, Afful J. Prevalence of total and untreated dental caries among youth: United States, 2015–2016. NCHS Data Brief, no 307. Hyattsville, MD: National Center for Health Statistics. 2018.

Wright JT. The Burden and Management of Dental Caries in Older Children. Pediatr Clin North Am. 2018; 65(5): 955-963.Â