Hindawi Publishing Corporation International Journal of Dentistry Volume 2011, Article ID 725320, 7 pages doi:10.1155/2011/725320 Review Article Early Childhood Caries Yumiko Kawashita, Masayasu Kitamura, and Toshiyuki Saito Department of Oral Health, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8588, Japan Correspondence should be addressed to Yumiko Kawashita, yumiko-t@nagasaki-u.ac.jp Received 1 June 2011; Revised 25 July 2011; Accepted 28 July 2011 Academic Editor: Figen Seymen Copyright © 2011 Yumiko Kawashita et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Dental caries is one of the most common childhood diseases, and people continue to be susceptible to it throughout their lives. Although dental caries can be arrested and potentially even reversed in its early stages, it is often not self-limiting and progresses without proper care until the tooth is destroyed. Early childhood caries (ECC) is often complicated by inappropriate feeding practices and heavy infection with mutans streptococci. Such children should be targeted with a professional preventive program that includes oral hygiene instructions for mothers or caregivers, along with ﬂuoride and diet counseling. However, these strategies alone are not suﬃcient to prevent dental caries in high-risk children; prevention of ECC also requires addressing the socioeconomic factors that face many families in which ECC is endemic. The aim of this paper is to systematically review information about ECC and to describe why many children are suﬀering from dental caries. 1. Introduction The term “dental caries” is used to describe the results, signs, and symptoms of a localized chemical dissolution of the tooth surface caused by metabolic events taking place in the bioﬁlms (dental plaque) that cover the aﬀected area [1]. Children in the age range of 12–30 months have a special caries pattern that diﬀers from that in older children. Caries aﬀects the maxillary primary incisors and ﬁrst primary molars in a way that reﬂects the pattern of eruption. The longer the tooth has been present and exposed to the caries challenge, the more it is aﬀected. The upper incisors are most vulnerable, while the mandibular incisors are protected by the tongue and by saliva from submandibular and sublingual glands [1]. This pattern of dental caries has been labeled variously as “bottle caries,” “nursing caries,” “baby bottle tooth decay,” or “night bottle mouth.” These terms suggest that the prime cause of dental caries in early childhood is inappropriate bottle feeding. Current evidence suggests that use of a sugar-containing liquid in a bottle at night may be an important etiological factor, although it is not necessarily the only etiological factor. Therefore, it is recommended that the term “early childhood caries (ECC)” be used when describing any form of caries in infants and preschool children [2, 3]. ECC begins with white-spot lesions in the upper primary incisors along the margin of the gingiva. If the disease con- tinues, caries can progress, leading to complete destruction of the crown [4, 5]. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary [6] and the permanent dentitions [7]. Not only does ECC aﬀect teeth, but the consequences of this disease may also lead to more widespread health issues. Infants with ECC grow at a slower pace than caries-free infants. Some young children with ECC may be severely underweight because of associated pain and their disinclination to eat [8]. ECC may also be associated with iron deﬁciency [9]. Dental caries is a preventable disease, and it can be stopped and even potentially reversed during its early stages. People remain susceptible to the disease throughout their lives. The objective of this paper is to demonstrate why many children are suﬀering from dental caries by reviewing published reports on prevalence, process, risk factors, treat- ment, prevention, and future approaches to prevent ECC (Figure 1).