the #1 chronic disease among kids in the world (and how to prevent it)

Affecting 60-90% of kids (and most adults) in industrialized nations 

Cavities have become so common among children that we often think of them as “normal”. But normal is a dangerous word for an infectious disease with disastrous consequences.

Early Childhood Caries (ECC) is so widespread that it is often considered the #1 chronic disease among kids in the world. The World Health Organization estimates that dental caries affect between 60-90% of schoolchildren (and most adults) in industrialized countries. If untreated, tooth decay can lead to serious, painful and even life-threatening conditions such as massive infections, a compromised airway and blood clots.


What are Early Childhood Caries (ECC)?

The American Dental Association (ADA) recognizes Early Childhood Caries as a significant public health problem among preschool-age children.

A child fits the definition of ECC if:
  • they are between 0-6 years of age
  • they have one or more decayed, missing or filled tooth surfaces in any primary tooth (also known as a “baby” tooth or “milk” tooth)




Cavities reflect systemic disparities

Cavities affect the general population, but they disproportionately affect low-income, Latino, and African American children. According to the Center for Disease Control and Prevention (CDC), in the United States, children from low-income families are twice as likely to have cavities than children from higher-income households.

Tooth decay exacerbates existing barriers to equality. Children with dental disease are more likely to get lower grades and miss more school than children with healthy teeth. Cavities can cause physical pain and emotions such as shame and embarrassment, which can impair a child’s ability to learn, play and socialize.

Factors that augment the incidence of Early Childhood Caries include:
  • Lack of access to health insurance and dental care
  • Food “deserts” in both urban and rural areas where low-income families have limited access to affordable, nutritious food
  • Access to cheap, highly processed food and beverages, primarily nutrient-poor carbohydrates

A Global Issue

The World Health Organization (WHO) states that Early Childhood Caries are a prevalent oral disease on the continents of America and Asia, where processed foods and refined sugar have replaced many traditional foods. Currently, dental decay appears to be less prevalent on the continent of Africa, but this is changing as processed, sugary foods displace ancestral diets.


What’s the difference between Cavities, Caries, and Tooth Decay?

Cavities, caries, and tooth decay all refer to the same basic issue, and are often used interchangeably.

Cavities are small holes that form on the surface of the tooth. These pitted holes are caused by caries (tooth decay). Tooth decay is caused by a buildup of bacteria and acid on the tooth. This acid is produced as a result of excess sugars and starches left over in the mouth after you eat or drink.




What causes cavities?

In order to understand why we get cavities, we must first understand the epic battle that is waged in your mouth every single day. The battlefield is your oral cavity, which includes your gums, oral walls, teeth and tongue. On one side are harmful bacteria that eagerly consume sugars. On the other side is your tongue and your saliva, defending your teeth from acid attack. As long as your saliva has enough of the right minerals from the food you eat, it will faithfully and continuously deposit calcium, phosphate and fluoride in your mouth to remineralize your teeth.


The mouth microbiome

Your mouth is home to around 600 species of bacteria — tiny microorganisms living in a community called a microbiome. Many of these bacteria are harmless or even beneficial, but some (like Streptococcus mutans) are a problem because they cause tooth decay.

A healthy mouth has a balanced microbiome, and is able to keep bacterial populations in check. When harmful bacteria grow more quickly than the body is able to neutralize them, acid and decay are sure to follow.


Saliva saves the day

Saliva is a neutral alkaline fluid made up of water, protein, salts and enzymes. It is constantly flowing through our mouths, and it does more for our health than we ever give it credit for.

Saliva helps us:
  • break down and digest starches
  • moisturize the gums, tongue and oral walls
  • taste and swallow foods and liquids
  • reduce infection
  • remineralize teeth

In addition to these important functions, saliva attempts to keep bacteria in check, neutralize acid, and remineralize the enamel of the teeth. Your saliva wages a constant battle to protect the enamel of your teeth. Each wave of healthy saliva deposits calcium, phosphate, and fluoride into the enamel to naturally heal and rebuild your teeth. This process is called remineralization.


How tooth decay works

  1. Every time you eat, tiny particles of food stick around and ferment on the surface of your teeth.
  2. When exposed to enzymes in the saliva, carbohydrates break down into sugars which feed the bacteria.
  3. The bacteria begins to feast on these sugars, producing acid as a byproduct.
  4. If it isn’t neutralized in time, this acid begins to eat away at the surface of your tooth, causing holes known as cavities or dental caries.

Carbohydrates (aka carbs) can be broken down into two categories:
  • Simple carbohydrates such as table sugar, high fructose corn syrup, and honey
  • Complex carbohydrates such as pasta, bread, crackers, rice, and potatoes

Both types of carbohydrates, simple and complex, have the same effect in the mouth — any particles left behind will feed the bacteria and create tooth-destroying acid.


Your teeth are alive

Because they are hard and inflexible, it is easy to forget that the teeth are actually living, sensory organs.

The tooth has three basic layers:
  • Enamel is the outermost layer, and is the hardest tissue in your body.
  • Dentin is the middle layer of mineralized tissue that protects from heat and cold.
  • Pulp is the innermost layer where the blood vessels and nerves are found.

The longer acid (the byproduct produced when bacteria consumes sugar) goes unchecked, the deeper the acid holes become in the enamel. Eventually, an untreated cavity will penetrate the dentin and reach the pulp, exposing the nerves and causing excruciating pain. At this point, the entire tooth can become infected and will need to be extracted.

The good news is, there is a lot we can do to help babies and children win the battle against dental caries.




Turning the Tide on Early Childhood Cavities

Thankfully, cavities are preventable, which means that with increased awareness, advances in pediatric dentistry and public health measures, we can vastly improve children’s dental health. With a proactive approach, we can turn the tide on tooth decay.

If you notice cavity symptoms in your child, there is no time to waste! Take solid steps to stop dental caries before they get worse, and focus on preventing them in the future.

The three most common approaches to cavity prevention are:

  1. Oral hygiene habits like brushing and flossing after meals and snacks to keep sugars, bacteria and acid in check.
  2. Fluoride to be consumed in toothpaste, gel, mouthwash, or in drinking water to help remineralize the teeth.
  3. Sealant is a thin plastic coating applied to the chewing surfaces of the teeth by a dentist to prevent decay.

At health:latch, we believe that holistic solutions to the problem of tooth decay in children go well beyond this.

From a public health perspective, the disparities of ECC point to systemic issues that have yet to be resolved in America and the world. We believe that all children deserve access to quality preventative dental care and healthy tooth-building food, especially children of color from low-income families.


#1 Early Childhood Dental Care

Every single baby should have their first dental appointment BEFORE their first birthday, including children from low-income families without insurance. Children who receive preventative dental check-ups and regular cleanings are much less likely to develop cavities. Education and support for parents (ideally starting before birth) can help them prepare for their baby’s gum and tooth care.




#2 Screening for Oral Function

Babies and children should be screened for oral restrictions at birth and in early childhood. Tongue ties, lip ties and buccal ties are related to mouth breathing, enlarged tonsils, tooth crowding, jaw issues, and so much more. All of these issues contribute to tooth decay. Early Childhood Caries can be greatly reduced and prevented by addressing oral restrictions as early as possible with a proper release procedure and follow-up care with a circle of healthcare professionals.


#3 Childhood Nutrition

In his book The Dental Diet, the Australian dentist Dr. Steven Lin highlights the importance of a healthy diet for healthy teeth. He advocates for a return to ancestral foods rich in minerals, fat-soluble vitamins, and healthy fats for both oral health and overall health. A healthier diet for children will not only reduce their consumption of processed simple carbohydrates and sugary foods — it will actually strengthen their teeth from within so that their enamel will be stronger and less susceptible to decay.

Nutrition education on its own is not enough. We must also support efforts to make whole, unprocessed and nutrient-rich foods accessible and affordable for low-income families in both urban and rural areas. Projects like the Edible Schoolyard put free sustainable school lunches in public schools and promote hands-on nutrition education for children.


#4 Prenatal Nutrition

Oral development begins in the womb. During pregnancy, women are more likely to experience cavities because the body will actually reallocate minerals from the teeth for the benefit of the growing fetus. Making sure that pregnant moms have a healthy diet complete with tooth-building minerals will protect their own dental health from cavities, as well as provide their growing fetus with the nutrients it needs for healthy oral development.

The bottom line is that it is up to us as parents and healthcare providers to come together to turn the tide on early childhood cavities.


Finding help & treatment for ECC

The team at health:latch can help diagnose and determine the best treatment plan for overcoming ECC issues.

Treating early childhood cavities (ECC) requires a multi-disciplinary approach that gets to the "root cause" of its presence. If you suspect an oral restriction could be the cause of your child’s chronic cavities, surround yourself with healthcare providers who can help.

To set yourself up for success, you want a team that communicates with each other across disciplines for a holistic health approach. A custom approach to address accompanying issues like oral restrictions, speech & language issues, and airway health & sleep will help your family have the best possible outcome.


Learn more about the health:latch clinic and how we can help with your family's specific needs here.

take the free intuition builder

Learn more about you or your child's symptoms and receive a personalized video & next steps to take from Dr. Thomas!

New call-to-action