Early childhood caries is the term dentists use for decay in a child’s “baby” teeth. It’s a rapid form of tooth decay caused by infectious bacteria. The number of children getting early childhood caries is on the rise, particularly in low-income families. In fact, it’s now the most common chronic early childhood disease in the US—outranking ear infections, allergies and asthma. It’s often called a “silent epidemic” because this type of decay goes undiagnosed and untreated in many children. In Texas, about 1 in 5 young students has untreated tooth decay, according to data from the Centers for Disease Control and Prevention.

The American Academy of Pediatric Dentistry (AAPD) cautions that early childhood caries can cause lasting harm due to pain, damage to permanent teeth and crooked teeth. The disease makes children more likely to have tooth decay and dental problems in the future and can affect a child’s general health. Problems can include sinus and ear infections, trouble chewing (which impacts nutrition and growth) and life-threatening infections. School attendance and academic performance also are impacted.

The good news is that early childhood caries can be prevented. The AAPD and American Academy of Pediatrics (AAP) recommend that children have their first visit to the dentist before their first birthday. Most babies visit a pediatrician several times before their first birthday, but very few go to the dentist. In an AAPD survey, only 60 percent of parents thought their child should see a dentist before the first birthday, and only 25 percent actually took their child to the dentist.

To help address the early childhood caries epidemic, pediatricians and other healthcare providers can now be certified to perform a limited oral health evaluation and apply fluoride varnish. Fluoride varnish is high-concentrated fluoride solution that is painted directly onto the teeth. It helps make tooth enamel more resistant to the development of caries. It also helps stop the growth of bacteria. Introduced in Europe in 1964, fluoride varnish has been proven to be very effective and safe. In a recent Cochrane Oral Health Review, data from 10 clinical trials showed a 37 percent reduction in baby tooth caries in children who had applications of fluoride varnish.

To be most effective, applications of fluoride varnish should begin before caries develops. The US Prevention Services Task Force recommends that healthcare providers apply fluoride varnish to the baby teeth starting after the first tooth erupts. If caries has already developed, two applications of fluoride varnish given within a period of four months can be effective in reversing the decay.

Fluoride varnish is safer than other topical fluorides because the amount placed in the mouth contains one-tenth of what is contained in other applied products.

Brenda Schoolfield is a freelance medical writer who splits her time between Austin and Seattle.

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