Early Childhood Caries (ECC)

Berkowitz (2003) defined Early Childhood Caries (ECC) as dental caries that cause demineralization of tooth enamel from metabolism of organic acid followed by damage of the tooth surface. Below are several factors that cause ECC and ways to prevent them:

  • Poor oral health. Studies shows that, most of the parents have a basic knowledge on cariogenic food (food that causes tooth decay) like candies, cakes, cookies, sweetened food and beverages. But, they are lacking in terms of attitude and practice of oral hygiene. Hence, remind your kids to brush their teeth before bed time or you could brush together with them!

  • Prolonged and night-time-bottle-feeding practices. Majority of children who are put to bed with a bottle which contains milk, infant formula or sugary beverages (Milo, Horlicks, Ovaltine, etc.) may develop ECC. I understand that some kids need to drink before bed time, therefore, preferably to make sure they’re rinsing with plain water first before go to bed.

  • Low intake of calcium during pregnancy leads to greater possibility of having ECC. The research is still ongoing and debatable whether lack of calcium intake associates to ECC. But there are possibilities! Therefore, make sure you’re eating calcium rich foods (dairy products, green leafy vegetables, soy products, etc) during your pregnancy.


Berkowitz, R. J. (2003). Causes, Treatment and Prevention of Early Childhood Caries: A Microbiologic Perspective. Journal of the Canadian Dental Association 2003; 69 (5): 304

Mahan, L. K., Escott-Stump, S. & Raymond, J. L. (2012). Krause’s Food and Nutrition Care Process, 13th Edition, Nutrition for Oral and dental Health Saunders Elsevier.

Tinanoff., N. & O’Sullivan, D. M. (1997) Early Childhood Caries: Overview and Recent Findings. American Academy of Pediatric Dentistry

NORSHAKINA BINTI ABDUL GHARIFF is a dietitian from Subang Jaya Medical Center. Received her degree in Dietetics from International Islamic University Malaysia (IIUM). Have deep interest in pediatrics, children and adolescents and her final year project entitled ‘The Assessment of Physical Activity Status in Adolescents in Kuantan’ makes her believed that optimal nutrition together with exercise in the early life stages is essential in life and has lifelong positive effects.

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