Hradec Kralove, Czech Republic - Parents typically react with happy smiles when they notice that first little tooth peeping out from a baby's pink gum.
But dental researchers in the Czech Republic warn parents that without immediate and proper attention, the very first tooth can trigger a chain of events that ruins a child's chance to grow up with a pretty smile.
The risk, according to doctors Ana Lucia Semainario and Romana Ivancakova at Charles University's Department of Dentistry in Hradec Kralove, is called "early childhood caries" or ECC.
ECC includes any tooth decay in a child under 36 months, and it is closely linked with so-called "baby bottle syndrome".
Babies with untreated ECC can suffer a lifetime of tooth trouble.
"Unfortunately, many parents underestimate the importance of the first dentition (tooth emergence)," Semainario wrote recently in the Czech medical journal Acta Medica.
"Primary teeth not only keep space for permanent ones, but also are necessary for speaking, chewing and appearance, which is important for a child's self-esteem," she said.
ECC begins innocently. A combination of bacteria transmitted from mother's mouth and any sugar-sweetened beverage can launch the decay process even on that cute first tooth.
Frequent and prolonged exposure of a baby's tooth to sweet drinks, including fruit juice and breast milk, allows plaque to form. In turn, the plaque gives the dangerous bacteria Streptococcus mutans a place to settle and eat away the teeth.
The first cavities usually erupt on front, upper teeth that rub against a bottle nipple. The decay can quickly spread to other teeth.
"Frequent use of a baby bottle during the night has the most harmful effect," when the child sleeps with a bottle in the mouth," Semainario said.
"During this time the liquid with sugar stays around the teeth for many hours, giving an excellent source of nutrition for oral bacteria."
Other researchers have found that serious tooth decay can begin in babies as young as six months old. In one study, 20 percent of babies with ECC were under age 14 months.
Babies from low-income families are often at high risk. In some poor areas, ECC has been found in 90 percent of children under three years old.
But wealthier families are not exempt. For example, a general study of children in Rome found nearly eight percent afflicted with ECC.
Semainario and Ivancakova advise parents to be aware of the danger and take preventative steps, even before baby is born.
One recommendation is that a mother should practise good oral hygiene during and after pregnancy to reduce the bacteria count in her saliva, thus reducing the chance of transmission to baby.
Also they say a baby's teeth - even that first one - should be thoroughly brushed at least twice a day and after every feeding.
A baby should not be allowed to fall asleep with a bottle in its mouth, and regular dental checkups should begin as soon as the first tooth arrives. - Sapa-dpa