Stages, risk factors and prevention of early childhood caries


  • Ameera Ibrahim Amer Department of Pediatric Dentistry, East Jeddah Hospital, Jeddah, Saudi Arabia
  • Kholoud Saeed Almohammadi Ministry of Health, AlBaha, Saudi Arabia
  • Omar Sami Al-Majed College of Dentistry, King Faisal University, Hofuf, Saudi Arabia
  • Sultan Hasan Al Harbi Buraidah Central Hospital, Buraidah, Saudi Arabia
  • Rahmah Mutlaq Aljohani College of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
  • Leena Mustafa Sabri College of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia
  • Anas Ziyad Rambo Almeswak Dental Clinics, Jeddah, Saudi Arabia
  • Emtenan Abobakr Barnawi College of Dentistry, Taibah University, Medina, Saudi Arabia
  • Fatemah Aadel Madani Ministry of Health, Medina, Saudi Arabia
  • Amal Saad Alahmri Dental Department, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
  • Laila Khalid Halawani College of Dentistry, Ibn Sina National College, Jeddah, Saudi Arabia



Early childhood caries, Classification, Stages, Management, Prevention, Risk factors, Epidemiology


Early childhood caries is a common condition that affects children and young infants. In addition to the effect of the condition on the child's oral health, it has been furtherly shown that many systemic consequences are usually associated. Therefore, it has been reported that these conditions can significantly impair the quality of life of corresponding families based on economic and health-related burdens. Affected children usually present with variable degrees of the condition, and some complications might be associated. Many risk factors have been reported in the literature for developing the condition in children. These include the presence of certain bacterial pathogens (especially through vertical transmission), dietary habits, and poor oral hygiene. Evidence indicates that these risk factors significantly contribute to the development of early childhood caries and the importance of the child's socioeconomic status and his caregivers. Targeting these factors would significantly reduce the risk of developing the condition, in addition to fluoridation as suggested by various relevant investigations.


Naidu R, Nunn J, Donnelly-Swift E. Oral health-related quality of life and early childhood caries among preschool children in Trinidad. BMC Oral Health. 2016;16(1):1-9.

Filstrup SL, Briskie D, da Fonseca M, Lawrence L, Wandera A, Inglehart MR. Early childhood caries and quality of life: child and parent perspectives. Pediatric Dentistry. 2003;25(5):431-40.

Abanto J, Carvalho TS, Mendes FM, Wanderley MT, Bönecker M, Raggio DP. Impact of oral diseases and disorders on oral health‐related quality of life of preschool children. Community Dentistry Oral Epidemiol. 2011;39(2):105-14.

Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dental Asso. 2009;140(6):650-7.

Chrisopoulos S, Harford J, Ellershaw A. Oral health and dental care in Australia: key facts and figures 2015. 2016.

BaniHani A, Deery C, Toumba J, Munyombwe T, Duggal M. The impact of dental caries and its treatment by conventional or biological approaches on the oral health‐related quality of life of children and carers. Int J Paediatr Dentistry. 2018;28(2):266-76.

Righolt A, Jevdjevic M, Marcenes W, Listl S. Global-, regional-, and country-level economic impacts of dental diseases in 2015. J Dental Res. 2018;97(5):501-7.

Johnston T, Messer LB. Nursing caries: literature review and report of a case managed under local anaesthesia. Aus Dental J. 1994;39(6):373-81.

Nguyen TM, Huan VT, Reda A. Clinical features and outcomes of neonatal dengue at the Children's Hospital 1, Ho Chi Minh, Vietnam. J Clin Virol. 2021;138:104758.

Veerkamp JS, Weerheijm KL. Nursing-bottle caries: the importance of a development perspective. ASDC J Dentistry Children. 1995;62(6):381-6.

Berkowitz RJ. Causes, treatment and prevention of early childhood caries: a microbiologic perspective. J Can Dental Asso. 2003;69(5):304-7.

Davies GN. Early childhood caries--a synopsis. Community Dentistry Oral Epidemiol. 1998;26(1):106-16.

Nurelhuda NM, Al-Haroni M, Trovik TA, Bakken V. Caries experience and quantification of Streptococcus mutans and Streptococcus sobrinus in saliva of Sudanese school children. Caries research. 2010;44(4):402-407.

Tanzer JM, Livingston J, Thompson AM. The microbiology of primary dental caries in humans. J Dental Education. 2001;65(10):1028-1037.

Caufield PW, Griffen AL. Dental caries. An infectious and transmissible disease. Pediatr Clin N Am. 2000;47(5):1001-19.

Schafer TE, Adair SM. Prevention of dental disease. The role of the pediatrician. Pediatr Clin N Am. 2000;47(5):1021-42.

Milnes AR, Bowden GH. The microflora associated with developing lesions of nursing caries. Caries Res. 1985;19(4):289-97.

Berkowitz RJ, Turner J, Hughes C. Microbial characteristics of the human dental caries associated with prolonged bottle-feeding. Arch Oral Biol. 1984;29(11):949-51.

Caufield PW, Cutter GR, Dasanayake AP. Initial acquisition of mutans Streptococci by infants: evidence for a discrete window of infectivity. J Dental Res. 1993;72(1):37-45.

Türksel Dülgergil C, Satici O, Yildirim I, Yavuz I. Prevention of caries in children by preventive and operative dental care for mothers in rural Anatolia, Turkey. Acta Odontol Scand. 2004;62(5):251-257.

Berkowitz RJ, Jones P. Mouth-to-mouth transmission of the bacterium Streptococcus mutans between mother and child. Archives Oral Biol. 1985;30(4):377-9.

Caufield PW, Childers NK, Allen DN, Hansen JB. Distinct bacteriocin groups correlate with different groups of Streptococcus mutans plasmids. Infection Immunity. 1985;48(1):51-6.

Weerheijm KL, Uyttendaele-Speybrouck BF, Euwe HC, Groen HJ. Prolonged demand breast-feeding and nursing caries. Caries Res. 1998;32(1):46-50.

Slavkin HC. Streptococcus mutans, early childhood caries and new opportunities. J Am Dental Asso. 1999;130(12):1787-92.

Wendt LK, Hallonsten AL, Koch G, Birkhed D. Analysis of caries-related factors in infants and toddlers living in Sweden. Acta Odontol Scand. 1996;54(2):131-7.

Quiñonez RB, Keels MA, Vann WF Jr., McIver FT, Heller K, Whitt JK. Early childhood caries: analysis of psychosocial and biological factors in a high-risk population. Caries Res. 2001;35(5):376-83.

Ramos-Gomez FJ, Tomar SL, Ellison J, Artiga N, Sintes J, Vicuna G. Assessment of early childhood caries and dietary habits in a population of migrant Hispanic children in Stockton, California. ASDC J Dentistry For Children. 1999;66(6):395-403.

Ruottinen S, Karjalainen S, Pienihäkkinen K. Sucrose intake since infancy and dental health in 10-year-old children. Caries Res. 2004;38(2):142-8.

Ismail AI, Tanzer JM, Dingle JL. Current trends of sugar consumption in developing societies. Community Dentistry Oral Epidemiol. 1997;25(6):438-43.

Weinstein P, Domoto P, Koday M, Leroux B. Results of a promising open trial to prevent baby bottle tooth decay: a fluoride varnish study. ASDC J Dentistry For Children. 1994;61(5-6):338-41.

Tang JM, Altman DS, Robertson DC, O'Sullivan DM, Douglass JM, Tinanoff N. Dental caries prevalence and treatment levels in Arizona preschool children. Public Health Rep. 1997;112(4):319-29.

AlMarshad LK, Wyne AH, AlJobair AM. Early childhood caries prevalence and associated risk factors among Saudi preschool children in Riyadh. Saudi Dental J. 2021.

Oulis CJ, Berdouses ED, Vadiakas G, Lygidakis NA. Feeding practices of Greek children with and without nursing caries. Pediatric Dentistry. 1999;21(7):409-16.

Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. The Cochrane Database Systematic Rev. 2002(1):Cd003517.

Ramos-Gomez F, Crystal YO, Ng MW, Tinanoff N, Featherstone JD. Caries risk assessment, prevention, and management in pediatric dental care. General Dentistry. 2010;58(6):505-17.

Naylor MN. Diet and the prevention of dental caries. J Royal Society Med. 1986;79(14):11-4.

Sanders TA. Diet and general health: dietary counselling. Caries Res. 2004;38(1):3-8.

Misra S, Tahmassebi JF, Brosnan M. Early childhood caries--a review. Dental update. 2007;34(9):556-558, 561-552, 564.

Moynihan PJ. Update on the nomenclature of carbohydrates and their dental effects. J Dentistry. 1998;26(3):209-18.

Bratthall D, Hänsel-Petersson G, Sundberg H. Reasons for the caries decline: what do the experts believe? Eur J Oral Sci. 1996;104(4 ( Pt 2)):416-422; discussion 423-415, 430-412.

Jenkins GN. Recent changes in dental caries. Bri Med J. 1985;291(6505):1297-8.

Featherstone JD. The continuum of dental caries--evidence for a dynamic disease process. J Dental Res. 2004;83C:C39-42.

Adair P, Ashcroft A, Pine C, Harris R. Community Oral Health. 2007.

Dülgergil CT, Colak H. Rural dentistry: Is it an imagination or obligation in community dental health education? Nigerian Med J. 2012;53(1):1-8.

Ercan E, Dülgergil CT, Yildirim I, Dalli M. Prevention of maternal bacterial transmission on children's dental-caries-development: 4-year results of a pilot study in a rural-child population. Arch Oral Biol. 2007;52(8):748-52.

Kishi M, Abe A, Kishi K, Ohara-Nemoto Y, Kimura S, Yonemitsu M. Relationship of quantitative salivary levels of Streptococcus mutans and S. sobrinus in mothers to caries status and colonization of mutans Streptococci in plaque in their 2.5-year-old children. Community Dentistry Oral Epidemiol. 2009;37(3):241-9.

King NM, Anthonappa RP, Itthagarun A. The importance of the primary dentition to children-Part 1: consequences of not treating carious teeth. Hong Kong Practitioner. 2007;29(2):52.

Amjad HW. Prevalence and risk factors of nursing caries in Adelaide, South Australia. Pediatric Dental J. 1999;9(1):31-6.

Drury TF, Horowitz AM, Ismail AI, Maertens MP, Rozier RG, Selwitz RH. Diagnosing and reporting early childhood caries for research purposes. A report of a workshop sponsored by the National Institute of Dental and Craniofacial Research, the Health Resources and Services Administration, and the Health Care Financing Administration. J Public Health Dentistry. 1999;59(3):192-7.

De Grauwe A, Aps JK, Martens LC. Early Childhood Caries (ECC): what's in a name? Eur J Paediatr Dentistry. 2004;5(2):62-70.




How to Cite

Amer, A. I., Almohammadi, K. S., Al-Majed, O. S., Al Harbi, S. H., Aljohani, R. M., Sabri, L. M., Rambo, A. Z., Barnawi, E. A., Madani, F. A., Alahmri, A. S., & Halawani, L. K. (2022). Stages, risk factors and prevention of early childhood caries. International Journal Of Community Medicine And Public Health, 9(2), 1045–1050.



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