The report by Milgrom et al1 on a randomized clinical trial of topical xylitol to prevent dental caries in infants and toddlers highlights the pressing need to eliminate an overwhelmingly preventable disease that remains rampant among our children. Early childhood caries (ECC) is well understood by microbiologists and research dentists—if not by the general public and their health care providers—as ordinary tooth decay run amok. It most commonly manifests as extensive tooth destruction and associated pain, with or without infection, by age 22 months and sometimes much earlier.
Edelstein BL. Solving the Problem of Early Childhood CariesA Challenge for Us All. Arch Pediatr Adolesc Med. 2009;163(7):667-668. doi:10.1001/archpediatrics.2009.107