Early childhood caries: an update.

Early childhood caries is the currently accepted term used to describe dental caries occurring in infants and toddlers. It is a multifactorial, transmissible and infectious disease that has recently been under scrutiny in the literature. The microflora, substrate, saliva and host are key factors involved in the pathogenesis, together with the immature host defence system and developing bacterial flora. Immature enamel surfaces and developmental defects of enamel should also be considered in the aetiology. This paper addresses the controversies of the cariogenicity of bovine milk, human breast milk and infant formulas. Clinical management should be planned according to age, extent of lesions, compliance of primary caregivers and where treatment is rendered (private or public sector). Cases of early childhood caries need comprehensive restorative management and preventive treatment together with the help of other health care professionals.