“Thirty two white horses standing on a hill, they champ and chomp and then they stand still”. The answer to this children’s riddle is Teeth. A smile, the universal gesture of friendliness would be incomplete without teeth, as would the fact of ingesting any morsel. They are the grindstones without which our digestive system would not be able to function. Tooth decay sounds the death knell for them. If this decay starts in early life then it leads to insurmountable problems for the individual in later life, going to levels of self image.

Early Childhood Caries can be defined as the occurrence of sign of tooth decay during the first three years of life. Caries is a devastating disease for infants who are dependant for the every need on their parents and caregivers. This disease is often termed as Baby Bottle Tooth Decay. Infants fed through the bottle at ,as guessed, at greatest risk. The origin of this type of tooth decay is the fact that the mouth of the infant is frequently awash with milk, or formula or sweetened fruit mixes. This leaves a residue of sugar in the mouth which provides sustenance for the bacteria to thrive. The bacteria produce acid which attacks the enamel of the teeth. The fist signs are chalky white stains on the teeth.

The dentist has to assess the damage to ascertain the mode of treatment. The upper front teeth are the first to face the brunt of the attack. If the degree of damage is less factors like maintaining better oral hygiene, changes in the patter of nutrition and fluoride cleansing might help. Primary teeth with further decay may require to be fitted with small stainless crowns. Extraction may have to be performed if the tooth is beyond repair. Fillings are not preferred as the patient is small and the infection repetition risks are great. Extraction is the last resort as the removal of teeth may lead to impediments in speech and eating. This may have a detrimental effect on the self esteem of the child. This also may have an obverse effect on the spacing of adult teeth when they emerge.

Caution is the watch word for parents and caregivers as attention to details can help in preventing problems.Avoidance of the nursing bottle can go a long way in helping the child. If a bottle need to be given the contents could be lukewarm water or unsweetened mixes .Avoid giving the infant sugary or sweet liquids. Weaning from the bottle should be ideally completed by a year of the child’s age. If the child requires oral stimulation, a pacifier may be provided but making sure that it is not dipped in any solution that may cause harm to the teeth.

Before the first tooth makes its appearance the gums of the child may e rubbed with a soft moist cloth or gauze to help in removing milk residue. When the first tooth makes does appear the mouth should remain bacteria free. A soft toothbrush may be introduced from the age of two. This may also be accompanied by a pea sized amount of fluoridated toothpaste. Attention should be placed that the amount of the tooth paste does not exceed this as this ma lead to Fluorosis (spotting) on the teeth. Monitor the child for good hygiene. Mother and caregivers are requested not to share utensils and cups, spoons etc with the children to avoid any bacterial interchange.

A little goes a long way as the saying goes so tread the path with caution. When your child smiles may you only see the pearly whites unfold.