Lecture Title: Restorations of the primary anterior teeth: Is it possible? Early childhood caries (ECC) in children is typically observed clinically as a white spot lesion. Later it will eventually resulting in cavity if demineralisation is extensive. ECC is referred to presence of 1 or more decayed (non-cavitated or cavitated lesions), missing (due to caries) or filled tooth surfaces in a child under the age of 6. In children younger than 3 years of age, any sign of smooth surface caries is indicative of severe ECC (S-ECC). S-ECC in primary young children that occur abruptly, spreading widely and rapidly and is burrowing in nature resulting in early involvement of dental pulp. Caries prevalence in Malaysia among 6-yr-old remains high with small decline from 76.1% in 2005 to 71.3% in 2015 (NOHPS). Restorative treatment of ECC is based on removal of caries and treatment approach taken should take into consideration of the child’s risk factor and age. In addition, the choice of restorative material used can be influenced by site and extent of decay, child’s ability to cooperate and longevity of restorations.