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Presentation and Teeth Affected
Early Childhood Caries (ECC) affects the teeth that erupt first, those least protected by saliva, and those with grooved surfaces. Recall that the typical pattern of primary tooth eruption is as follows. (Refer to Chapter 2: Dental Development > Tooth Eruption for more information.)

 
1.
Lower (mandibular) central incisors
 
2.
Upper central incisors
 
3.
Lateral incisors
 
4.
First molars
 
5.
Canines (cuspids)
 
6.
Second molars

As several pictures in the Chapter 2 Photo Gallery illustrate, ECC tends to first affect the upper (maxillary) incisors because they erupt earliest, then the primary molars. The molars become involved because of their grooved surfaces. Food easily becomes lodged in the pits and fissures, which are difficult areas to clean with a toothbrush. The canines tend to be spared because they are smooth teeth that erupt later, whereas the lower teeth are better protected by saliva and the tongue.
 
 
Early Childhood Caries (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.
View the Chapter 4 Photo Gallery.