Nursing Bottle Caries

Early childhood caries, also known as "nursing bottle caries," is a type of early-onset severe tooth decay that affects young children, specifically those under the age of five. The most common area for this disease to occur is on the primary upper anterior teeth (the upper front teeth). Typically, the lower front teeth are spared from this condition because of the natural protection provided by the pooling of saliva and the positioning of the child's tongue.

The development of ECC occurs as follows. When free sugars (e.g., milk, juice, honey) come into contact with cariogenic bacteria (specifically Streptococcus mutans) in the oral environment, they produce acidic compounds which demineralize hydroxyapatite crystals in the enamel. If left untreated, these acid-produced areas will quickly erode through the thin enamel covering of a primary tooth and penetrate to the soft dentin layer underneath, and then continue their progression toward the delicate pulp chamber. Once in the pulp chamber, the destruction of the tissue can be extremely painful and very destructive.