Early Childhood Caries is dental caries (tooth decay or cavities) that affect children six years of age or younger. Any sign of a cavity in a child younger than 3 years is termed as Severe Early childhood caries. Severe ECC begins very soon after the teeth erupt in the mouth and the cavities progress rapidly. Some young children with ECC may be severely underweight because of associated pain and disinclination to eat.

When the baby falls asleep whilst feeding on a milk bottle or sipper, the last mouthful of milk is not swallowed. This milk pools around the teeth and can cause decay. The upper front teeth and molars are the teeth that are affected the most. Commonly called Nursing/ Baby Bottle Decay, this can also occur when the child is fed other sweetened liquids in a bottle. Once milk teeth start to erupt, breastfeeding through the night, coupled with a lack of tooth brushing and the introduction of sugars in the diet, can lead to Nursing Decay as well. The child sleeps whilst feeding and liquid pools around the teeth. This liquid provides an excellent environment for cavity-forming bacteria. These bacteria grow in the plaque in the absence of tooth brushing.

• Tooth brushing should begin when the first tooth erupts in the mouth. Dietary sugars should not be introduced except natural sugars present in fruit etc.
• Breastfed infants: Unrestricted feeds through the night should be avoided after the first milk tooth begins to erupt. Night feeds cannot be avoided in infants who cut their milk teeth very early (3-6 months). In order to prevent milk from pooling, we recommend that you wipe the teeth with a clean soft cloth made wet with boiled water after every feed.
• Bottle-fed infants: Do not put your baby to sleep with a bottle. Wean your baby from the bottle at 12 to 14 months of age. Encourage your baby to drink from a cup as they approach their first birthday.
• Repetitive consumption of any liquid from a bottle or a no-spill training cup (sipper) should be avoided.
• An oral health consultation visit with a pediatric dentist within 6 months of the first tooth's eruption and no later than 12 months of age is recommended to educate parents and provide anticipatory guidance for prevention of dental disease. 
•Improving the dental health status of the mother/ primary caregiver lessens the infant’s risk of developing severe ECC

• Tooth decay (dental caries), is the most common of all childhood dental diseases. Treatment would depend on the extent of decay and how long the milk tooth is expected to function in the mouth.
• In infants and toddlers whose age does not permit cooperation for operative procedures (drilling and filling), the use of Silver Diamine Fluoride (SDF) is invaluable.
• Operative treatment required may include fillings, root canal treatment, pediatric crowns (caps), space maintainers, habit breaking appliances, preventive dental treatment, orthodontic treatment etc.