Prevention Of Early Childhood Caries

Question 1

What’s early childhood carues

Answer 1

• EARLY CHILDHOOD CARIES :ECC is defined as the presence of 1 or more decayed, missing (due to caries), or filled tooth surfaces in any primary tooth 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

Early Childhood Caries (S-ECC).
• One of the first major hazards to the child’s primary dentition is Early childhood caries. This condition has also been referred to as
“nursing caries,” nursing bottle caries, nursing bottle mouth, baby-bottle syndrome, baby-bottle tooth decay (BBTD), and bottle-mouth caries.

• Dental Caries- An Infectious Disease:
• Evidence suggests that dental caries is an infectious disease process initiated via the transmission of S. mutans from parents to their infants

Question 2

characteristics of S. mutans

Answer 2

1. Permanent S. mutans colonization of the oral cavity in infants occurs only after the eruption of teeth.
2. S. mutans has difficulty colonizing in an oral cavity already colonized by mature oral flora.
3. Sucrose facilitates the adherence of S. mutans to the tooth surface.
   4- The source of infection of the infant with S. mutans is from within the family, most likely the mother.
   5- A minimum threshold level of maternal S. mutans is necessary for transmission of the microorganism to the infant.

Question 3

Transmission rates increase when parents:

Answer 3

• Share utensils or toothbrushes.
• Taste food or drink before serving it.
• “Clean” a dropped pacifier with saliva.
• Allow a child to place fingers into an adult’s mouth

Question 4

A pregnant woman is often at considerable risk of caries development???.

Answer 4

• It is caused by continual, prolonged exposure of the primary teeth to milk, infant formula, fruit juices, soft drinks, or other sugar/carbohydrate-containing fluids placed in the nursing bottle.

Question 5

What etiology of EEC

Answer 5

• Early childhood caries can also occur in some breast-fed children who are nursed every time the infant indicates a desire for feeding (demand feeding, with 10 or more nursing events over a 24hour
• period)
• Once teeth erupt and plaque accumulates, the ingestion of sugar-containing fluids during bedtime or naptime places the child at considerable risk for dental caries since salivary flow decreases during sleep and the fluid pools around the teeth, creating a highly acidic environment.

Question 6

What are affected teeth?

Answer 6

• ECC tends to affect the upper (maxillary) incisors first because they erupt earliest and are less protected by saliva.
• The primary molars are affected next grooved surfaces because of their
• The lower teeth are better protected by saliva and the tongue.

Question 7

Classification of Early Childhood Caries:

Answer 7

• Mild Early Childhood Caries
• Moderate Early Childhood Caries
• Severe Early Childhood Caries

Question 8

COMPLICATIONS OF ECC

Answer 8

• Extreme Pain
• Spread of Infection
• Difficulty chewing,
• Poor nutrition, below average weight
• Extensive and costly dental treatment
• Poor self-esteem, behavioral and social interaction problems
• Speech development problems
• Lost school days and difficulty learning

Question 9

Prevention of ECC: enumerate

Answer 9

A Proactive Approach

Public and Professional Attitudes

Early Dental Care

Infant Oral-Health Education

Question 10

Talk a bout A Proactive Approach

Answer 10

As health professionals can identify the potential for the development of disease and have effective measures available for preventing the initiation of disease, it is a sound and logical practice to intervene prior to the onset of disease whenever possible rather than to wait and treat the effects of the disease

Question 11

Public and Professional Attitudes talk about it

Answer 11

Public and Professional Attitudes According to parents, the major reasons for them seeking early dental evaluations are:

• Desire for information on preventing tooth decay for their child
• Desire to avoid unpleasant experiences that the parents had suffered
• Desire to learn what their role is in their child’s oral health
• Recommended by their pediatrician or family physician

Question 12

Talk a boat early dental care

Answer 12

• The newborn should become accustomed to oral care early.
• After feeding, the ridges where the teeth will later appear and the palate should be gently wiped with gauze or a soft washcloth.
• Traditionally recommended that a child should visit the dental office no later than 21/2 years of age.
• Ideally, the child’s first dental visit should occur at 6 months of age and no later that at 1 year of age

Question 13

Talk about infant oral health education

Answer 13

• The American Academy of Pediatric Dentistry states: “Infant dental care begins with dental health counseling for the newborn, which should include a dental office visit for preventive oral health counseling no later than 12 months of age
• However, for those children who are delayed in erupting teeth, the first visit may be postponed, but should occur within 6 months following the eruption of the first tooth.”

Question 14

Talk about A Protocol for Early Preventive Intervention

The Interview

Answer 14

The Interview Experience shows that the interview and preventive counseling are best accomplished before the examination of the infant for the following reasons:

1. Specific parental concerns can be identified and addressed during the examination.
2. Should the infant fuss during the examination (normal behavior) the parent(s) usually direct their attention toward the child during the ensuing discussion and not toward the dentist.
3. The child can be kept busy with toys, etc., before the examination in a nonthreatening environment and the parent(s) will be better able to direct their attention toward the dentist.

The Interview

1. GROWTH AND DEVELOPMENT.
2. FEEDING HISTORY.
3. MEDICAL HISTORY.
4. PREVENTIVE ASSESSMENT,
5. FLUORIDE SUPPLEMENTATION.
6. ORAL HYGIENE.

Question 15

Talk about the interview decisions

Answer 15

1. GROWTH AND DEVELOPMENT • An abnormal pattern of development may be discovered or suspected, prompting a referral for further evaluation.
2. FEEDING HISTORY.

• Knowledge of the feeding patterns during infancy is critical to assist the dentist in assessing the child’s risk for developing early childhood caries by discovering potentially harmful feeding habits and to help form a basis for recommendations regarding proper feeding practices that minimize the potential for dental disease

3. MEDICAL HISTORY

• A complete medical history is important.
• Knowledge of any systemic conditions that may adversely affect dental health will assist in developing appropriate preventive strategies

4. PREVENTIVE ASSESSMENT • Information regarding dental development, dental health attitudes, and current oral hygiene practices will serve as a starting point for counseling parents regarding an appropriate preventive program for their child.
5. FLUORIDE SUPPLEMENTATION

• It is important to know if the child has access to fluoride in drinking water. It is not sufficient to establish that a family lives in a fluoridated community.
• On occasion, the family may drink bottled water, which contains an unknown quantity of fluoride
• an accurate assessment of all potential sources of fluoride intake should be explored before making recommendations regarding fluoride supplementation. any

6. ORAL HYGIENE

• An assessment of current tooth-cleaning activities is important to establish the parents’ role in oral hygiene for their child.
• If the infant’s teeth are being brushed, it is important to establish how, when, and by whom, and inquire whether the parents experience any difficulties during the process

Question 16

Talk about counseling and oral hygiene

Answer 16

Based upon the information gathered to this point, the practitioner is ready to provide recommendations on how parents can play an active role in preventing dental disease in their child by assuming the responsibility for the following procedures.

Oral Hygiene

• A parent must assume total responsibility for tooth cleaning in infants and young children. Many children are unable to perform adequate plaque removal until 6 to 8 years of age.
• Tooth cleaning should be done in a comfortable location and pleasant environment. Positioning will be demonstrated during the examination.
• A dentifrice is not necessary for infants. In many cases, it may be a source for objection because of the taste and foaming action.

Oral Hygiene

• If a dentifrice is used, only a pea-sized amount should be placed on the brush to avoid ingestion of excess fluoride.
• Tooth cleaning should be accomplished with a small, soft-bristled toothbrush.
• Tooth cleaning should be accomplished at least once daily.
• The evening tooth cleaning may be easier to accomplish following the infant’s last feeding instead of waiting until just before bedtime since a tired infant can frequently be fussy during the procedure.

Diet Management

• Infants should be weaned from the bottle around 12 months of age.
• The bottle should not be used as a pacifier nor given during bedtime or naptime.
• Only formula or milk should be offered in the bottle.
• Frequent, prolonged episodes of breast-feeding could be a caries risk.

Question 17

Talk a bout diet management

Answer 17

Diet Management

• Infants should be weaned from the bottle around 12 months of age.
• The bottle should not be used as a pacifier nor given during bedtime or naptime.
• Only formula or milk should be offered in the bottle.
• Frequent, prolonged episodes of breast-feeding could be a caries risk.

Bed time bottle alternatives

• Stuffed toy
• Blanket
• Clean pacifier
• Rocking
• Back rub
• Read or sing to child.
• Sleeping with the child and allowing nursing through the night should be avoided.
• Infants and young children generally will eat more frequently than three times daily.
• Between-meal snacks should consist of foods that have a low cariogenic potential.
• Total amount of cariogenic foods is not the issue, rather the frequency of ingestion and retentiveness of the food are the factors that contribute to the caries risk.

Question 18

Talk about The Examination

Answer 18

The Examination

• The dental chair and overhead light are neither required nor very useful for examining children this young.
• Since one of the prime objectives is to provide a dental examination in a pleasant, nonthreatening manner, the procedure is best accomplished in the knee-to-knee position for children under 3 years of age.

Question 19

Talk about Anticipatory Guidance

Answer 19

Anticipatory Guidance Anticipatory guidance is a process for preparing the parents for upcoming developmental changes and concerns that may arise before the next scheduled dental visit in order to minimize the negative effects that may arise.

Question 20

Talk about Concluding the Appointment

Answer 20

Concluding the Appointment

• Provide the parents with a summary of your clinical findings.
• Make appropriate recommendations based upon the clinical findings.
• Solicit and answer any remaining questions that the parents may have
• Reinforce the parents’ role and responsibilities in their child’s oral-health care.
• Establish an optimal fluoride program (pending any water analysis). Distribute educational pamphlets/brochures as desired.
• Provide anticipatory guidance information.
• Establish an appropriate recall schedule

Establishing a Recall Schedule The recall appointment may be scheduled for 3, 6, or 12 months depending upon the child’s potential risk for developing dental disease based upon clinical findings, stage of dental development, and feeding or diet patterns