Early childhood caries is a very aggressive type of decay that begins in the upper front teeth as soon as they erupt in infants and spreads throughout the mouth. The underlying pathological mechanism is that the baby sleeps with a bottle in their mouth or falls asleep while breastfeeding. During sleep, the body’s saliva production (the most important defense mechanism that cleans the mouth and neutralizes acids) is reduced to almost zero. The lactose (milk sugar) in the milk, formula, or breast milk in the bottle is rapidly fermented by cariogenic (cavity-causing) bacteria in the mouth and converted into acid. The enamel of the defenseless, newly erupted baby teeth, which remain in this acid bath until morning, rapidly dissolves, and the process, which begins with chalky white spots, soon results in the complete disintegration of the teeth, leaving only black roots.
