Early Childhood Caries may initially affect the primary maxillary incisors of children who are routinely given a nursing bottle containing a fermentable carbohydrate at night or nap times, or who breast-feed (at will) after teeth begin to erupt and other dietary carbohydrates have been introduced. Frequent, non-mealtime use of sippy cups containing beverages other than water is known to have a similar affect.
As the child sleeps, pools of fermentable liquid can collect around the teeth, especially the maxillary incisors, which can initiate the decay process. Additionally, upper primary incisors are in a saliva deficient area and therefore are more susceptible to acid attack. The nipple of the baby bottle and the infant’s tongue cover the mandibular anterior teeth, which are also wet by the major salivary glands. Lower anterior teeth are rarely affected unless the decay becomes rampant. If detected early, further demineralization can be minimized and may be reversed by modifying diet, dietary habits, oral hygiene practices and introducing fluoride.