Beyond the DMFT: The Human and Economic Cost of Early Childhood Caries

Department of Dentistry, Nationwide Children's Hospital, 700 Children's Drive, Columbus, Ohio 43205, USA.
Journal of the American Dental Association (1939) (Impact Factor: 2.24). 07/2009; 140(6):650-7. DOI: 10.14219/jada.archive.2009.0250
Source: PubMed

ABSTRACT Early childhood caries (ECC) is the most common disease of childhood and often is accompanied by serious comorbidities affecting children, their families, the community and the health care system. This report describes morbidity and mortality associated with ECC and its treatment.
The authors reviewed the literature for descriptions and quantification of morbidity associated with ECC and organized a wide range of studies into a visual model--the morbidity and mortality pyramid--that begins to convey the breadth and depth of ECC's penetration.
ECC exacts a toll on children, affecting their development, school performance and behavior, and on families and society as well. In extreme cases, ECC and its treatment can lead to serious disability and even death. In finding access to care and managing chronic pain and its consequences, families experience stress and, thus, a diminished quality of life. Communities devote resources to prevention and management of the condition. The health care system is confronted with management of the extreme consequences of ECC in hospital emergency departments and operating rooms.
Traditional epidemiologic measures such as the decayed-missing-filled teeth (dmft) index do not adequately portray the effects of ECC on children, families, society and the health care system.
The impact of prevention and management of ECC requires the attention of health care professionals and decision makers and extends well beyond the dental office to regulatory and child advocacy agencies as well as public health officials and legislators.

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    • "Alterations in the composition of the oral microbiota are associated with the initiation and development of oral diseases such as dental caries and periodontal disease (Liljemark and Bloomquist, 1996). These diseases can lead to severe pain, impaired quality of life and infections such as cellulitis and osteomyelitis (Casamassimo et al., 2009; US-NLM, 2010a). More importantly, they can predispose patients to potentially fatal diseases such as infective endocarditis (Biswas et al., 2010; Nomura et al., 2013). "
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    • "Although levels of dental caries have decreased globally during the past decades, caries is still highly prevalent and a major cause of oral pain, and impacts on the quality of life of children in numerous countries (Casamassimo et al., 2009; Krisdapong et al., 2009). Many children have untreated dental decay that causes toothache and impacts on daily life activities such as eating, sleeping, studying and emotional stability (Krisdapong et al., 2009; Lewis and Stout, 2010). "
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