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Seminar14 Ecc 180105064549
Seminar14 Ecc 180105064549
EARLY
CHILDHOOD
CARIES
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◦ Dr. Ellias Fass, 1962 – 1st published comprehensive
description of caries in infants and termed as “ Nursing bottle
caries”.
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IN 1994, CONFERENCE AT THE CENTRES
FOR DISEASE CONTROL AND PREVENTION
“EARLY CHILDHOOD CARIES”
The link between bottle habits and caries was not absolute.
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TERMINOLOGIES –
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Rampant caries Nursing caries
◦ Acute, Widespread, Rapid ◦ Specific form of RC
◦ All ages ◦ Age – infants, toddlers
◦ Primary + permanent ◦ Primary dentition
dentition
◦ Mandibular incisors ◦ Max incisors - molars
◦ Etiology: Multifactorial ◦ Bottle feeding, Pacifiers
dipped in honey, At will
breast feeding
◦ Treatment: Pulp therapy ◦ Topical Fluorides,
Maintenance of teeth
◦ Prevention: Dental health ◦ Dental health education
education
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DEFINITIONS
◦ Davies (1998): Complex disease involving maxillary primary
incisors within a month after eruption and spreading rapidly to
other primary teeth is called childhood caries.
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CLASSIFICATIONS
◦ Rule (1982):
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◦ In less developed countries and among the disadvantaged
groups in the developed countries, the prevalence has been
reported to be as high as 70%.
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◦ In a systematic review, Ismail and Sohn found that the
prevalence varied from 2.1% in Sweden to 85.5% in rural
Chinese children.
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ETIOLOGICAL RISK FACTORS
PRIMARY SECONDARY
• Dental plaque • Tooth maturation and
• Mutans Streptococci defects
• Infant feeding patterns • Race and ethnicity
• Tooth brushing • Acid fruit drink
• Salivary factors • Socioeconomic status
• Sugars
• Dental knowledge
• Oral Clearance of
carbohydrates • Stress
• Bovine milk • Other factors
• Human milk
• Fluorides
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Dental plaque:
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Mutans streptococci:
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◦ Furthermore, children who are exclusively breastfed also
appear to be susceptible to caries. This suggests that the role
of bottle in caries development is not as clear as previously
thought and further research is required.
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Tooth brushing:
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◦ A major problem confronting the investigation of the
relationship between tooth brushing and ECC is the
methodological issue of assessing the frequency of brushing,
quality of plaque removal, and actual levels of oral hygiene.
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Salivary factors:
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Sugars:
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Oral Clearance of Carbohydrates:
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Bovine milk:
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Human milk:
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Tooth maturation and defects:
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◦ Race, Ethnicity and Socioeconomic status:
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Dental Knowledge:
Stress:
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◦ Loss of school days and restricted activity
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COMPLICATIONS OF ECC
Effect on nutrition & weight:
• ECC inhibit adequate nutrition – affecting growth of the
body, specifically weight.
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PREVENTION OF ECC
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RAPIDD SCALE:
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3. Convenience and change difficulty
4. Child permissiveness
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COMMUNITY BASED EDUCATION
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◦ PREVENTION OF TRANSMISSION OF CARIOGENIC
BACTERIA:
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◦ A nonrandomized study divided mothers who had atleast 106
mutans streptococci per mm of saliva into test and control
groups.
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◦ On re-examination, it was found that children whose mothers
were in the experimental group had a DMFT of 5.2, which
was much lower as compared to the DMFT of control group,
which was 8.6.
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PROFESSIONAL AND HOME-BASED
PREVENTIVE APPROACHES
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◦ Professional treatment for ECC ranges from Diet
counseling to the prosthodontic rehabilitation of patient.
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◦ Use of probiotics chewable tables or supplements also showed
some evidence in controlling the caries in children. However,
its effectiveness to prevent ECC is still under investigation
(Hedayati-Hajikand et al 2015; Jorgensen MR et al 2016).
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Restorative Strategies for ECC:
◦ Anterior teeth
◦ Pulpotomy or pulpectomy.
◦ Extraction.
◦ Space maintainers.
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◦ Fluorides are very effective in preventing dental caries,
including fluoride toothpaste, water fluoridation, fluoride
mouth rinse, and professional topical fluoride application,
primarily by inhibiting mineral loss from the tooth.
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BARRIERS IN EARLY CHILDHOOD CARIES
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◦ The dental community lacks a shared vision of the definition
of the problem, how to prevent it and who is responsible for
planning and implementation.
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POLICY STATEMENT
◦ To decrease the risk of developing ECC, the AAPD
encourages professional and at-home preventive measures that
include:
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3. Implementing oral hygiene measures no later than the time
of eruption of the first primary tooth. Toothbrushing should be
performed for children by a parent twice daily, using a soft
toothbrush of age-appropriate size. In children considered at
moderate or high caries risk under the age of 2, a ‘smear’ of
fluoridated toothpaste should be used. In all children ages 2 to
5, a ‘pea-size’ amount should be used.
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4. Avoiding high frequency consumption of liquids and/or solid
foods containing sugar. In particular:
• Infants should not be put to sleep with a bottle filled with milk
or liquids containing sugars.
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• Parents should be encouraged to have infants drink from a cup
as they approach their first birthday. Infants should be weaned
from the bottle between 12 to 18 months of age.
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CONCLUSION
◦ ECC is a chronic, infectious disease
affecting young children, and
constitutes a serious public health
problem.
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◦ Dental problems in early childhood
have been shown to be predictive of
not only future dental problems but
also on growth and cognitive
development.
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REFERENCES
◦ Nikhil Marwah. Textbook of Pediatric Dentistry. Third
Edition. Jaypee Brothers Medical Publishers (P) Ltd., 2014.
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◦ Anil S and Anand PS (2017) Early Childhood Caries:
Prevalence, Risk Factors, and Prevention. Front Pediatr.
5:157.