Early Childhood Dental Caries

Early childhood dental caries (ECC) are one of the really painful memories of childhood. These are the incidents of decay of one or more primary tooth in children below five years of age. The severe toothache due to abscesses may even require anesthesia in some cases. Mutans streptococci (MS) are the bacteria responsible for these ECC. Though these bacteria colonize the infant's mouth soon after birth but the eruption of primary teeth makes the child most vulnerable to MS infection.

How do MS form ECC?

MS form pellicles (films) in presence of sucrose (table sugar). These films or pellicle help these bacteria to attach to dental surfaces. The bacteria also produce acids and can tolerate high acid concentration. This ability arm MS to fight off other microbes in young child's mouth which are otherwise harmless to him. Besides, high acid deteriorates enamel making establishment of MS bacteria easier.

The most common source, from which infants acquire MS, is their mother (vertical transmission). The MS could also be acquired by transmission from other family members and from children of unrelated families as in nursery schools (horizontal transmission). MS is acquired by infants between 7-36 months of age. It is called the 'window of infectivity period'. It is also the time of eruption of primary teeth. Children who acquire MS in early infancy are likely to develop more caries in later years. Children colonized later in childhood had fewer caries experiences.

Prolonged feeding with sweetened milk bottle and night feeding with it induces caries in young children. Sucrose forms plaque that harbors MS bacteria. Most foods, juices of young children are sweetened with sugar and so provide opportunity for MS to grow . The breast milk cause minimal caries experiences.Sharing of food and drinks between mother and infant transmits MS to child. Besides, the low socio-economic children and those from less educated parents show more caries incidents. The reason is, these families are not aware of oral hygiene well. It was also found that xylitol chewingums helped mothers reduce transmission of MS to their infants.

Source:

V Law, WK Seow, G Townsend (2007). Factors influencing oral colonization of mutans streptococci in young children. Australian Dental Journal 2007; 52 :( 2):93-100