Management of early childhood caries

Abstract

It is a dental disease with acute onset involving many or all of the erupted teeth, rapidly destroying coronal tissue, often on surfaces normally resistant to decay, and leading to early pulpal involvement.(f.4) Ripa in 1988 called it 'nursing caries' which typically was found in an infant or toddler who frequently falls asleep sucking a nursing bottle filled with sweetened fluid.(f.5) Milnes' review in 1996 of the epidemiology of caries in infants and young children includes the terms 'nursing caries', 'nursing bottle syndrome', 'night bottle mouth' and 'baby-bottle tooth decay'.(f.6) The Center for Disease Control and Prevention (CDC) held a conference in 1994, which addressed several major issues relating to the epidemiology of caries in infants and young children. Although prolonged use of the baby bottle, especially use of the bottle at bedtime, is believed to be associated with an increased risk of caries, use of the baby bottle is not the only, and may not be the most important, factor in caries development. Hence, the CDC recommended using the term early childhood caries or ECC when describing any form of caries in infants and pre-school children. The rationale was that such a term would better reflect the multifactorial etiologic process involved in the disease. Caries in young children has long been recognized as a clinical entity that has been described with various terms like nursing caries and nursing bottle syndrome. Prolonged use of the baby bottle is believed to be associated with increased risk of caries. However, it may not be the most important factor in caries development. Hence, the term early childhood caries (ECC) has been suggested because it better reflects the multifactorial etiologic process involved in the disease. A basic understanding of a child's normal emotion, his fear and anxiety, can help the dentist and other staff members prevent, minimize or overcome the effect on children in the dental surgery. A case of ECC treated in a family dental practice and managed under local anaesthesia has been reported. The restoration of the dentition to function and aesthetics, with the resultant increase in self-confidence of the patient, is rewarding for the dental team.