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
- 22% for children ages 2-5 years
- 48% for children ages 6-11 years
- 56% for adolescents ages 12-19 years
Progression
- Upper front teeth that are least protected by saliva are affected first
- Disease moves posteriorly as teeth emerge
Severe Early Childhood Caries
References
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.
Khan SY, Schroth RJ, Cruz de Jesus V, Lee VHK, Rothney J, Dong CS, Javed F, Yerex K, Bertone M, El Azrak M, Menon A. A systematic review of caries risk in children <6 years of age. Int J Paediatr Dent. 2024 Jul;34(4):410-431. doi: 10.1111/ipd.13140. Epub 2023 Dec 9. PMID: 38071403.
Stierman B, Afful J, Carroll MD, Chen TC, Davy O, Fink S, et al. National Health and Nutrition Examination Survey 2017–March 2020 prepandemic data files—Development of files and prevalence estimates for selected health outcomes. National Health Statistics Reports; no 158. Hyattsville, MD: National Center for Health Statistics. 2021. DOI: https://dx.doi. org/10.15620/cdc:106273
Wright JT. The Burden and Management of Dental Caries in Older Children. Pediatr Clin North Am. 2018; 65(5): 955-963.
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