Early Childhood Caries (ECC) is a rampant dental disease that affects mostly young children. The American Dental Association (ADA) defines ECC as "the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in any primary tooth in a preschool-age child between birth and 71 months of age."

Once a tooth becomes cavitated, a restoration or filling is usually required. Even more significant decay to the teeth may require treatment as serious as steel or veneer crowns, in which the decayed or weakened area is removed and repaired with a ‘cap’ or crown that is fitted over the remainder of the tooth. Crowns are applied if decay is extensive and there is limited tooth structure that may cause weakened teeth.

Dental caries are generally painless until the decay becomes very large inside the tooth and destroys the nerves and blood vessels in the tooth. If the decay is left untreated, a tooth abscess can develop and the internal structures of the tooth, the pulp, can be destroyed. Decay to the tooth’s inner pulp is extremely critical because the pulp is made up of nerves, connective tissue, and blood vessels that help nourish the tooth.

A toothache or tooth pain is equated with damage to the tooth’s pulp; the pulp is the most sensitive area of the tooth. Treatment for decay to the tooth’s pulp requires either pulp therapy or extraction, which is typically accompanied with general anesthesia or sedation and followed by more complex fillings and crowns to restore the teeth.

A root canal is recommended if the nerve in a tooth dies from decay. During a root canal the center of the tooth, the nerve and blood vessel tissue or the pulp, is removed along with decayed portions of the tooth. The roots are then filled with a sealing material and the tooth is filled. A crown may be placed over the tooth if needed.