Early childhood caries (ECC) affects primary maxillary anterior teeth (Figure 2). It occurs when sugared liquids (including milk) lay against the anterior region of the mouth for prolonged periods, such as when a child is allowed to fall asleep with a bottle or while nursing. This is why ECC is also often termed nursing bottle caries, baby bottle caries, or nursing caries.
According to the epidemiological data presented in the most recent National Health and Nutrition Examination Survey (NHANES), ECC affects 1% of children by the age of 12 to 24 months, and 5% by 35 months. The condition is more prevalent in poor people, and in people of minority races, with as many as 80% of children under 5 in the Native American population having ECC.16