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Early Childhood Caries

Early Childhood Caries: Symptoms, Causes, Prevention, Treatment | National Dental Centre Singapore

Early Childhood Caries - What it is

What is ECC?

Tooth decay in children under the age of 6 is termed as Early Childhood Caries (ECC). In Singapore, 40% of preschool children are affected by ECC.

Early Childhood Caries - Symptoms

What are the symptoms of ECC?

Tooth decay does not happen overnight. It begins as White Spot Lesions (WSL) which appear as chalky areas on the tooth surface, often found under plaque. The acids in plaque remove tooth minerals, so WSL indicate demineralisation of the tooth surface. They are painless and still reversible at this stage. However, as demineralisation progresses, the tooth surface breaks down to form a cavity.

Cavity Formation in Early Childhood Caries

Tooth decay varies in severity. Overtime, bacteria and acids wear away the enamel (outermost layer of tooth) to reach the dentine (inner layer of tooth). Dentine has tiny tubules that communicate directly with the dental pulp, the innermost part of the tooth which contains nerve and blood vessels. Bacteria can irritate the pulp and cause pain and/or swelling.

Untreated cavities can lead to pain, swelling, difficulty eating and sleeping, damage to the developing permanent teeth, or in severe cases, systemic infection.

Early signs of tooth decay in a 2-year-old child. The white chalky areas on the teeth indicate areas of enamel demineralisation.Severe early childhood caries in a 2-year-old child.
Early signs of tooth decay in a 2-year-old child. The white chalky areas on the teeth indicate areas of enamel demineralisation.Severe early childhood caries in a 2-year-old-child. The gum swelling above the upper primary central incisors is called an "abscess" and it contains pus, a sign of infection.
Complications of Early Childhood Caries

Early Childhood Caries - How to prevent?

How can I prevent ECC in my child?

Please see page on prevention.

Early Childhood Caries - Causes and Risk Factors

What are the symptoms of ECC?

Risk factors for early childhood caries include poor oral hygiene, insufficient fluoride and decay-causing bacteria

Risk factors for early childhood caries include sugary foods or drinks, bedtime feeding and frequent snacking

Early Childhood Caries - Diagnosis

Early Childhood Caries - Treatments

How is ECC treated?

ECC should be treated because severely decayed teeth can cause pain, swelling and infection; affecting your child's diet, growth and development of teeth and jaws.

Treatment depends on multiple factors such as the severity of ECC, and the child's behaviour and ability to cope with treatment. NDCS offers a range of treatment options incuding fluoride treatment, minimally invasive procedures (e.g. hall technique, siver diamine fluoride) and treatment under local anaesthesia or general anaesthesia. Sedation is currently unavailable in NDCS.

Early Childhood Caries - Preparing for surgery

Early Childhood Caries - Post-surgery care

Early Childhood Caries - Other Information

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