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Key Points
 
Bacteria, sugar, and teeth are each critical elements in the formation of caries.
 
Caries do not form in the absence of bacteria, regardless of sugar intake.
 
It takes 20-40 minutes for acids produced during a meal to be neutralized, at which time the tooth can begin to remineralize.
 
It is possible to reverse the demineralization process before cavitation occurs.
 
Streptococcus mutans is the primary bacteria involved in caries development and is transmitted from the mouth of a caregiver to the infant.
 
The virulence of Strep mutans varies with the strain; although you cannot modify the type, you can alter the number of bacteria present.
 
Brushing, flossing, professional cleanings, Xylitol, fluoride, and special mouthrinses can decrease the number of bacteria in a child's mouth.
 
S mutans is transmitted through saliva, such as when a caregiver tastes a child's drink before serving or shares utensils.
 
The risk of demineralization and caries development is in direct relationship to the frequency in which the teeth are exposed to sugar.
 
All fermentable sugars can be metabolized by bacteria.
 
Because certain medications contain sugar, physicians should be mindful when prescribing them.
 
Brushing teeth immediately after eating sticky foods and choosing fresh fruit, vegetables, and whole grain snacks helps to decrease caries risk.
 
Enamel serves as a physical barrier to bacterial invasion of the root.
 
The acid produced by bacteria demineralizes the tooth's enamel, increasing a child's risk for caries.
 
Children tend to have teeth similar to their parents because they learn their parent's eating and oral hygiene patterns.
 
The health and strength of the enamel can be modified by changing health behaviors.
 
The alkaline properties of saliva allow it to buffer acid, thereby decreasing demineralization.
 
Saliva contains numerous bacteriostatic substances.
 
Saliva aids in remineralization by supplying calcium, phosphate, and fluoride to help construct enamel.
 
Decreased saliva production promotes the development of caries.
 
Children with known or suspected decreased saliva production should be monitored closely by a dentist.
 
Early Childhood Caries (ECC) affects children younger than the age of 5.
 
ECC spreads rapidly within the mouth, typically resulting in severe disease.
 
Caries development is independent of the method of feeding.
 
ECC is concentrated among poor and minority children, with 80% of tooth decay occurring in 25% of children.
 
ECC affects the teeth that erupt first, those less protected by saliva, and those with grooved surfaces.
 
The upper maxillary incisors tend to be affected by ECC first, followed by the first and second primary molars.
 
The molars are at high risk of caries development because of their grooved surfaces, as food becomes lodged in the pits and fissures.
 
The canines and lower teeth are less likely to be affected by ECC.
 
If intervention occurs during the white spot stage (second stage), ECC is entirely reversible.
 
Dentine caries affect the nerve and pain fibers, at which stage sensitivity to heat and cold, as well as pain, develop.
 
ECC has a significant effect on children's overall health.
 
ECC is a strong predictor of caries development in permanent teeth.
 
Approximately 51 million school hours are missed per year for dental problems, with poor, Hispanic females missing school most often.
 
The financial burden of repairing ECC is enormous, with such costs far exceeding those of preventive dental care.
 
Ethnicity and socioeconomic status can impact a child's likelihood of developing caries.
 
If a parent or sibling has caries, it is likely that the child will have them, too.
 
Children with special health care needs or certain chronic medical conditions have increased risk of developing caries.
 
The presence of even a single cavity in a young child is a strong risk factor for future decay.
 
ECC is a preventable disease.
 
ECC has a significant effect on overall health.
 
Physicians can impact ECC with proper anticipatory guidance.
 
Fluoride should be provided both topically and systemically.
 
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