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StatPearls Publishing 2019-01

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Baby bottle syndrome, now known as early childhood caries (ECC), is defined as the presence of 1 or more decayed teeth or missing teeth (resulting from dental caries) or filled tooth surfaces in any primary tooth between birth and 71 months of age. Tooth decay or dental caries is the single most common chronic childhood disease worldwide, 5 times more common than asthma, 7 times more common than hay fever, 4 times commoner than childhood obesity, and 20 times commoner than juvenile diabetes. According to the American Academy of Pediatric Dentistry, it is today an international public hazard in both developing and developed nations. It is an infectious disease that can begin as early as the teeth erupt, usually around 6 months, and can progress rapidly causing immense pain and discomfort to the child.[1][2][3] The multifactorial nature of ECC encompasses but is not restricted to certain other terminologies such as "nursing caries," "comforter caries," and "baby bottle tooth decay," as improper nursing is not the only causative factor as they would suggest.[4][5][6] Presently, the term "early childhood caries" is used as the best description.[5][7] This term was coined at a workshop sponsored by The Center for Disease Control and Prevention 1994. The goal to comprehend the causative factors behind the genesis of this malady. Attention was drawn to various psychosocial, economic, ethnic, and cultural factors that contribute to the widespread increase in the incidence of this disease worldwide.[8] In infants, ECC often follows a characteristic pattern of development. It affects maxillary incisors first, followed by the maxillary and then the mandibular molars, and because of the protective nature of the tongue, the mandibular incisors are often spared. Progression in infants depends on the chronology in which the dentition erupts and the dietary habits. Actual causation is the interaction of microbes like Streptococcus mutans on sugary foodstuffs or fermentable carbohydrates producing lactic acid which erodes the tooth enamel causing demineralization.[9] Left untreated, the repercussions on the child’s health and quality of life, and can create serious social and economic consequences.

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