Caries in infants and young children long has been recognized as a clinical entity and described variously as nursing caries, nursing bottle syndrome and so on. Although prolonged use of the baby bottle is believed to be associated with increased risk of caries, use of the bottle may not be the most important factor in caries development. The term early childhood caries (ECC) has been suggested because it more closely reflects the multifactorial etiologic process involved in the disease. A case of ECC treated in a general dental practice and managed under local anesthesia is reported.