Counseling caretakers regarding feeding practices and daily tooth cleaning for infants should include information on Early Childhood Caries (ECC). ECC is a particularly virulent form of caries that can develop when an infant is provided a bottle of formula, milk, or sugared liquids for at-will feedings and/or at sleep times. Sugared liquids remain in the mouth for hours creating an acid environment that enhances enamel demineralization.
The maxillary incisors are the first teeth affected, usually by 18 to 20 months of age. Because children who experience ECC have a greater probability of subsequent caries development in both the primary and permanent dentitions, aggressive preventive and therapeutic measures often are necessary. Interim therapeutic restoration (ITR) and stainless steel crowns (SSC) should be considered as treatment options. Without early caries detection and therapeutic intervention, extractions may be indicated. Sedation or general anesthesia are often necessary adjuncts in guiding the behaviors of young children who require dental treatment.