Early Childhood Caries

What are the symptoms of ECC?

Tooth decay does not happen overnight. It begins as White Spot Lesions (WSL) which appear as chalky areas on the tooth surface, often found under plaque. The acids in plaque remove tooth minerals, so WSL indicate demineralisation of the tooth surface. They are painless and still reversible at this stage. However, as demineralisation progresses, the tooth surface breaks down to form a cavity.

Tooth decay varies in severity. Overtime, bacteria and acids wear away the enamel (outermost layer of tooth) to reach the dentine (inner layer of tooth). Dentine has tiny tubules that communicate directly with the dental pulp, the innermost part of the tooth which contains nerve and blood vessels. Bacteria can irritate the pulp and cause pain and/or swelling.

Untreated cavities can lead to

• pain
• swelling
• difficulty eating and sleeping
• damage to the developing permanent teeth, or in severe cases, systemic infection

Early signs of tooth decay in a 2-year-old child. The white chalky areas on the teeth indicate areas of enamel demineralisation.

Severe early childhood caries in a 2-year-old-child. The gum swelling above the upper primary central incisors is called an "abscess" and it contains pus, a sign of infection.