Understanding dental decay in young children (Early Childhood Caries)

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If parents are not careful, tooth decay in children can begin very early. A large number of children in Singapore suffer from Early Childhood Caries (ECC). Read on to find out more about its causes and prevention.

A significant number of Singaporean children, aged six years and below, suffer from Early Childhood Caries (ECC) or tooth decay, which causes a huge amount of discomfort.

Many parents struggle with maintaining good dental hygiene for their children, and a number of parents are not well informed about ECC.

We spoke with Dr Toh Siew Luan, Paediatric Dentist at Thomson Specialist Dentistry, Novena Specialist Center to help parents better understand the causes, symptoms and impact of ECC.

Below she answers some of the most frequently asked questions by parents.

What is the most common dental problem seen in children?

Early Childhood Caries (ECC) or tooth decay is the most common dental problem seen in children. 40% of pre-schoolers in Singapore aged 3-6 have ECC.

How does the decay look like? What are the signs and symptoms?

Early decay appears as chalky white areas on the teeth, especially near the gum line.

As the decay progresses, minerals are lost from the teeth to form yellow or brown cavities (holes). The upper incisors (front teeth) are the most likely teeth to have caries.

Advanced decay appears as ‘broken teeth’ or cavities which are deeper and larger in area. When the bacteria advances to the pulp of the tooth, a dental abscess or ‘gum boil’ will appear. The child may complain of toothache and gum swelling. In severe cases, it may result in fever and a swollen face.

teeth decay in children

Sweets are not the only culprits of tooth decay in children.

How does the decay happen? Is it due to malnutrition / lack of calcium? My child does not eat sweets, why does he/she have decay?

Most of the time, ECC is not a result of malnutrition or calcium deficiency. In fact, it is often seen in children who are put to bed with a milk bottle containing milk or sweetened drinks. It is also seen in children who are on-demand feeding (breast/bottle) through the night after they have turned one.

Children who snack frequently, hold food in the mouth or have poor oral hygiene are also at risk of ECC.

Sweets are not the only culprit that causes tooth decay in children. Sugars are often hidden in a child’s diet, in foods such as biscuits, jam, sugar-coated cereals, juices, etc.

My older child eats the same food and is fed the same way as my younger one. Then why is it that my younger child has ECC but not his older sibling?

The bacteria that causes ECC can be transmitted from parents, caregiver or siblings to the child via saliva. The older child may not have had anyone transmit the bacteria to him when he was young.

However, as the older child develops decay later in life, he will pass his bacteria to the younger sibling resulting in decay of a greater severity and at an earlier age for the younger one. It is also harder for the caregivers to pay attention to a child’s teeth as the number of children in the family increases.

Now that you know the causes of tooth decay in children, or ECC, click on the next page to find out how to treat it.

Teething and Tooth Care Health