Dental caries in young children frequently appears first on the maxillary primary incisors, where the liquids ingested by the infant sucking on a bottle or breast remain pooled away from salivary flow. This so-called early childhood caries can rapidly progress to result in rampant destruction of the primary dentition. ECC can affect children from all socioeconomic classes but is most often found in children of new immigrants or those with lower socioeconomic status. The treatment of ECC is costly, and treatment relapses are frequent. Prevention and treatment of ECC focus on inhibition of the growth of oral bacteria. Strategies include reducing the frequency of exposure to bacterial substrates, as well as controlling the growth of oral bacteria. Topical antibacterials such as 10 percent povidone iodine show promise for future use in the inhibition of ECC in young children.