4 of research has been called “life-course epidemiology” [38]. The life-course framework for investigating the etiology and the natural history of chronic diseases proposes that advantages and disadvantages are accumulated throughout life, generating diﬀerentials in health along the life course and leading to large eﬀects in later life. Children with a history of dental caries, whose primary caregiver or siblings have severe dental caries, are regarded as being at increased risk for the disease [37, 39]. Moreover, children’s experience of socioeconomic disadvantage aﬀects adult dental health [40]. However, a cross-sectional study in Japan reported that dental caries in 3-year-old children was more strongly associated with child-rearing behaviors than mother-related factors, such as health insurance, health behaviors, and dental health status [41]. 5. Treatment Determining the causes of dental caries in children, pro- viding education on oral health matters to their parents or caregivers, and controlling demineralization are especially important because children’s cooperative capacity is low. Interventions aimed at improving the intraoral environment can reduce the risk of dental caries and can arrest dental caries. Treatment sometimes consists of restoration or the surgical removal of carious teeth. However, this approach does little to bring the disease under control because the recurrence of caries around restored teeth and the occurrence of further decay are common [18, 42]. Relapse rates of approximately 40% within the ﬁrst year after dental surgery have been reported. Thus, dental caries management in many countries has shifted toward a largely preventative and preservative approach rather than surgical treatment. Prevention and preservation of tooth tissue are desirable as the normal treatment for dental caries because we know that dental caries progresses slowly in most people, prevention is eﬀective, and excessive and premature surgical treatment can cause harm [43–45]. When restorative intervention is needed, modern microrestorative techniques that use new adhesive materials can also preserve tooth structure [46]. 6. Prevention 6.1. Target Cariogenic Feeding and Primary Acquisition of MS. Prevention of cariogenic feeding behavior is one approach for preventing ECC. Sugared beverage consumption with nursing bottles or “sippy cups” enhances the frequency of enamel demineralization. This type of feeding behavior during sleep intensiﬁes the risk of dental caries because oral clearance and salivary ﬂow rates decrease during sleep. Thus, sugared beverage consumption with nursing bottles should be reduced or stopped. Also, the knowledge that the most important risk factor related to dental caries in babies is acquisition of MS should help in determining an optimal preventive approach and interceptive treatment. A promising approach toward primary prevention of ECC is the development of strategies International Journal of Dentistry that target the infectious component of this disease, such as preventing or delaying primary acquisition of MS at an early age through suppressing maternal reservoirs of the organism. For this reason, it is better if prevention of ECC begins in the prenatal and perinatal periods (including pregnancy and the ﬁrst month after birth) and addresses the health of both the mother and the infant. The mother’s or caregiver’s teeth should be examined. Infants whose mothers have high levels of MS due to untreated dental decay are at greater risk of acquiring the organisms. Dental management of the mother can delay infant inoculation [47]. 6.2. Topical Antimicrobial Therapy. Topical antimicrobial therapies have been recently described. Topical application of a 10% povidone-iodine solution to the dentition of infants every 2 months in a double-blind, placebo-controlled clinical trial for 1 year increased the number of caries-free infants [48]. These infants were at high risk for ECC as they were all colonized by MS and had decay-promoting feeding behaviors. This study suggested that povidone- iodine had suppressive eﬀects on the oral colonization of MS and prevented dental caries. However, povidone-iodine has strong bactericidal/virucidal eﬀects and demolishes normal ﬂora in the pharynx and the oral cavity, which interfere with pathogenic viral invasion [49]. Therefore, povidone-iodine should not be routinely used. In another study, 6 monthly applications of a 40% chlorhexidine varnish were eﬀective in a 37.3% reduction in caries increment without side eﬀects [50], and this reduction was also close to that found in a meta-analysis regarding the eﬀectiveness of ﬂuoride varnish on caries prevention in primary teeth, 33% (95% CI = 19–58%) [51]. Topical 0.12% chlorhexidine gluconate could signiﬁcantly reduce MS levels, but chlorhexidine therapy was much less eﬀective at reducing the levels of lactobacilli in the human mouth. Current chlorhexidine products require patient compliance with a rinse that tastes bad and has the potential to stain, and it must be applied numerous times to be eﬀective [52]. Moreover, a systematic review reported that the evidence for a caries-preventive eﬀect of chlorhexidine varnish in children and adolescents was inconclusive [53]. 6.3. Fluoride. To prevent ECC by home-care approaches, brushing by caregivers using a small quantity of ﬂuoride- containing toothpaste is essential and should start as soon as teeth erupt. Pine et al. [54] showed the beneﬁt of twice daily brushing in newly erupted ﬁrst molar teeth compared to brushing once daily or less. This study also showed the importance of parental beliefs. If parents feel strongly that there is time to check the condition of their child’s teeth, the odds that their child will actually brush twice daily are about three times greater. Thus, it is important to support parents and convince them that their eﬀorts make sense for their child’s dental health and that they really can contribute. Moreover, community and professional care approaches have been used to prevent ECC [55]. Early screening for signs of dental caries development, starting from about 7- 8 months of age, could identify infants who are at risk