PREVENTION OF EARLY CHILDHOOD CARIES

Prevention Of Early Childhood Caries

Prevention Of Early Childhood Caries

Introduction

Early childhood caries (ECC) is a virulent form of dental caries that can destroy the primary dentition of toddlers and preschool children. It occurs worldwide, afflicting predominantly disadvantaged children. High-risk North American populations include Hispanic and Native American children, as well as children enrolled in Head Start, a federally funded program for preschool children living in poverty.

The prevalence of EEC among these children ranges from 11% to 72%. ECC is an infectious disease, and Streptococcus mutans is the most likely causative agent; diet also plays a critical role in the acquisition and clinical expression of this infection. Early acquisition of S. mutans is a key event in the natural history of the disease. Acquisition may occur via vertical or horizontal transmission. Primary oral colonization by S. mutans coupled with caries-promoting feeding behaviours results in accumulation of these organisms to levels exceeding 30% of the total cultivable plaque flora which in turn leads to rapid demineralization of tooth structure.

Treatment of ECC is costly because the cooperative capacity of babies and preschool children usually necessitates the use of general anesthesia. Treatment usually consists of restoration or surgical removal of carious teeth along with recommendations regarding feeding habits. However, this approach has resulted in unacceptable clinical outcomes, and relapse rates of approximately 40% have been reported within the first year after dental surgery. Primary prevention of ECC has largely been restricted to counselling parents about caries-promoting feeding behaviours. This approach has also had minimal success. Newer strategies addressing the infectious component through use of topical antimicrobial therapy appear promising.

Early childhood caries, also known as baby bottle caries, baby bottle tooth decay, and bottle rot, is a syndrome characterized by severe decay in the teeth of infants or young children. Early childhood caries (ECC) is a very common bacteria infection. Its prevalence is epidemic; in the US its rate is highest in minority and rural populations, at times infecting over 70% of the children. A large body of scientific evidence indicates that ECC is an infectious and transmissible disease, with Streptococcus mutans the primary microbiological agent in the disease. The disease process begins with the transmission of the bacteria to the child, usually from the primary caretaker, the mother. Mothers with untreated dental disease present a very high risk to their children.

Prevention of Early Childhood Caries

The American Academy of Pediatric Dentistry says that frequent consumption of liquids containing fermentable carbohydrates (e.g., juice, milk, formula, soda) increases the risk of dental caries due to prolonged contact between sugars in the liquid and cariogenic bacteria on the teeth. Poor feeding practices without appropriate preventive measures can lead to a distinctive pattern of caries in susceptible infants and toddlers commonly known as baby bottle tooth decay (BBTD), a form of severe early childhood caries (ECC). Frequent bottle feeding at night, and extended and repetitive use of a no-spill training cup are associated with ECC. Children experiencing caries as infants or toddlers have a much greater probability ...