Pediatric Dentistry – Rick Buchanan, DDS

Early Childhood Caries
(Written and published by the American Dental Association)

A Healthy Start is Smart!
Did you know that tooth decay is the single most common chronic childhood disease? It is five times more common than asthma. The good news is that tooth decay be prevented!

What causes tooth decay?
Bacteria in the mouth convert the sugar in foods and drinks into acid that attacks the teeth. Each time you eat or drink, acid can attack the teeth for 20 minutes or longer. After many attacks, tooth decay can develop.

What is Early Childhood Caries?
Early Childhood Caries is tooth decay that occurs in the primary (baby) teeth of young children. It occurs when the child’s teeth are frequently exposed to sugary liquids for long periods of time. Such liquids include fruit juice, soda and other sweetened liquids, milk, breast milk and formula.

Tooth decay can begin as soon as a baby’s teeth come in, usually by age six months or so. Decay in baby teeth can cause pain. Left untreated, it can destroy the teeth of an infant or young child. Tooth decay can also have an effect on a child’s general health. He or she may have difficulty eating, resulting in poor nutrition.

Why are baby teeth important?
Baby teeth hold space in the jaw for the permanent teeth. If a baby tooth is lost too early, the teeth beside it may drift into the empty space. When it’s time for the permanent teeth to come in, there may not be enough room for them to come in properly. This may lead to adult teeth that are crooked, making them difficult to keep clean. Teeth that are not kept clean are more likely to decay. In addition, crooked teeth can affect your child’s self-esteem. Your child may grow up feeling bad about his or her smile and hide behind clenched lips and shielding hands. A nice-looking smile can help your child’s social life during the formative school years. Also, children who have decay in baby teeth are more likely to have decay in their adult teeth.

How to keep your child’s teeth healthy
Babies and young children rely on parents and caregivers for good health. Take an active role in caring for your child’s teeth by cleaning them at home, providing a balanced diet and scheduling regular dental visits. It’s important that parents and caregivers teach and practice healthy habits that children will continue into adulthood.

Start oral care early at home

  • Wipe the baby’s gums with a clean, wet gauze pad or washcloth after each feeding. This removes food particles that can harm teeth. It also helps the child get used to having his or her mouth cleaned.
  • Begin gently brushing your baby’s teeth with water as soon as the first tooth appears. Use a soft-bristled, child-sized toothbrush. If you are thinking about using fluoride toothpaste before the child’s second birthday, ask your dentist or physician first. When toothpaste is used, the ADA recommends that you place only a pea-sized amount of paste on the child’s toothbrush.
  • Young children should be watched while brushing and taught to spit out, not swallow, the toothpaste.

Bottles and breastfeeding

  • Infants should finish their bedtime or naptime bottle before going to bed.
  • After your child’s first tooth comes in, he or she should not be allowed to breastfeed constantly or fall asleep while breastfeeding.
  • Infants should not be put to bed or allowed to fall asleep with a bottle that contains milk, formula, fruit juices, sweetened liquids or a pacifier dipped in sugar or honey. Even watered-down drinks can be damaging.
  • A bottle should not be used as a pacifier. Offering a bottle containing sugary liquid as a pacifier many times a day increases the number of acid attacks and speeds tooth decay.

Training cups

  • To reduce the risk of tooth decay, children should be encouraged to drink from a cup by their first birthday.
  • Do not let your baby constantly sip on liquids containing sugar (including milk and juice drinks). Frequent sips of sugary liquids encourage tooth decay. Offer these liquids only at controlled times, and keep the cup out of reach while riding in a car or stroller. If your child is thirsty between snacks or meals, offer water in the cup.
  • Do not let your child carry the training cup around. Falling while drinking from a cup can injure the mouth.
  • Training cups should be used temporarily. Once your child has learned how to sip, the training cup has served its purpose. It should be set aside when no longer needed.


  • Infants and young children should have a healthy diet. Helpful information can be found on the U.S. Department of Agriculture’s website:
  • Limit between-meal snacks.
  • Avoid using sweet foods and drinks to reward your child.
  • If your child eats sweets, make sure it is with a meal. (Saliva increases during meals and helps rinse food particles from the mouth.)
First dental visit

  • Talk to your dentist about scheduling the child’s first dental visit. It’s helpful for the first visit to occur within six months after the first tooth appears, and no later than the baby’s first birthday. Consider this first visit as a “healthy baby checkup” for your child’s teeth.
  • During the visit, the dentist can check for decay and other conditions and show you how to properly clean your child’s teeth. Also, the dentist may offer advice on your child’s diet, pacifier use, oral care products for your family, and tell you how to prevent injuries.
  • Children should receive the ideal level of fluoride to help prevent tooth decay. Whether or not you live in a community that has fluoridated water, ask your child’s dentist about how your child can get the right amount of fluoride.

If you have any dental related question, you may reach me at my office at 686-1700 or visit my website at

Rick Buchanan, DDS