Update on Early Childhood Caries Since the Surgeon General's Report

Department of Health Promotion and Policy, University of Maryland Dental School, Baltimore, Maryland 21201, USA.
Academic pediatrics (Impact Factor: 2.01). 11/2009; 9(6):396-403. DOI: 10.1016/j.acap.2009.08.006
Source: PubMed


The 2000 Surgeon General's Report on Oral Health included a limited discussion of the condition known as early childhood caries. Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, early childhood caries is arguably one of the most serious and costly health conditions among young children. A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci, also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk. On the basis of this knowledge of specific risk factors for an individual, different preventive strategies and different intensities of preventive therapies can be implemented. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with a fluoridated dentifrice, systemic fluoride supplement to children who live in a nonfluoridated area and who are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent.

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Available from: Norman Tinanoff, Jan 22, 2014
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    • "Dental caries remains one of the most prevalent diseases in children. It is the most common pediatric disease in the United States [19]. In England, it is the 4th most common reason for a child’s admission to hospital [20]. "
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    ABSTRACT: Background : In a previously reported randomised controlled trial, advising first time mothers on the prevention of early childhood caries from before their child was born, decreased the prevalence of early childhood caries at 20 months of age 5-fold. Objective: We examined the effect of the intervention on the frequency and nature of dental visits up to 7 years of age. Methods: Of 649 expectant mothers who participated in the trial, 277 completed a “Child Oral Health Survey” 7 years later. Their answers were compared with those of a comparison group of 277 mothers selected at random among those living in the same area with a first child born in the same year enrolled with the South Australian School Dental Services (SA SDS). Results: Only 1.5% of children had a dental visit before 12 months of age and only 4% before 2 years of age unless a dental problem had arisen. The age at the first visit did not differ among groups, but the reasons for the visit did as did the number of visits and the need for treatment under sedation or anaesthesia. In the trial group, 34% of first visits were for pain, 29% for injury, and 29% for concern with appearance. In the comparison group, pain was the main concern in 49%, injury in 9.5%, and appearance in 25% (p=0.019). Over time, children in the trial had an average of 2.2 visits compared with 3.1 in the comparison group. In the intervention group of the trial, no child had required treatment under sedation or general anaesthesia compared with 2.9% in the control group, and 6.5% in the comparison group. Only 15% of mothers reported that they had received any information on caries prevention from health care professionals other than dental care practitioners. Conclusion: Providing first-time mothers with guidance on the prevention of childhood caries decreased the use of dental services to deal with problems in preschool children.
    The Open Dentistry Journal 06/2014; 8(1):104-8. DOI:10.2174/1874210601408010104
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    • "Due to its high prevalence, impact on quality of life, potential for increasing risk of caries in the permanent dentition, and role in oral health inequalities, ECC is recognised as a serious public health problem [3]. Socioeconomic, sociocultural, and sociobehavioural determinants are believed to influence specific risk factors for ECC such as dietary and feeding practices, oral hygiene, and dental attendance patterns [6, 7]. "
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    ABSTRACT: Background. Early childhood caries (ECC) is a public health problem due to its impact on children's health, development, and wellbeing. The objective of this study was to assess the caries experience in 3–5-year-old children and to evaluate the relationship with their mothers' practices regarding feeding and oral hygiene habits in Kanpur. Method. A cross-sectional survey was undertaken on 2000 (974 boys and 1026 girls) children aged 3–5 years from a random sample of preschools in Kanpur district, India. Dental caries experience was recorded using WHO criteria. A pretested questionnaire with 9 questions was used for collecting information regarding mothers' practices regarding feeding and oral hygiene practices. Chi-square test (χ2) and Student's t-test were used for statistical analysis. Results. The prevalence of ECC was 48% with mean dmft of 2.03 ± 2.99. Boys (57%) were affected more than girls (43%) which was found to be statistically significant (P < 0.05). Caries prevalence was high and statistically significant (P < 0.05) among those who were breast fed for longer duration, during nighttime, those falling asleep with bottle, and those fed with additional sugar in milk. Conclusion. Determining the role of feeding practices on early childhood caries can help in the development of appropriate oral health promotion strategies.
    12/2013; 2013:275193. DOI:10.1155/2013/275193
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    • "About ten percent of the children were assessed to have a high caries risk and they had an extra visit at the age of 18 months. The risk factors that were agreed upon by a team of dental professionals included visible plaque or caries on child's teeth, sugary drink as a thirst-quencher, bedtime feeding, special health care need [18] [19], parent's nonchalant attitude to dental care, serious social problems in the family, or an immigrant family background [20]. The following visit for all children was at the age of 24–36 months. "
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    ABSTRACT: Objective. The study assessed whether the new family-based programs in health promotion or the training of dental professionals had an impact on the colonization of mutans streptococci (MS) in young children. Material and Methods. The participants were children born in 2008 and inhabitants of Vantaa aged 24-36 months. The families with first-born children were invited to a questionnaire study. Vantaa was categorized into three matching areas, which were randomly assigned to different programs. New counseling methods were trained. The routine program used earlier served as the control group. The children born in 2006 served as a historic control. The outcome measure was the presence of MS. Statistical method was logistic regression. Results. Colonization of MS was found only in few children born in 2006 or 2008; 15% and 11%, respectively. Within the 2008 birth cohort, the addition of parental counseling did not improve the routine program. Instead, the father's advanced level of education (P = 0.044) and the child's reported the use of xylitol at least three times a day (P = 0.014) associated with negative MS scores. Conclusions. The routine program and training of the professionals seem to reduce the proportion of children with MS more than adding parental self-care to oral health programs.
    International Journal of Dentistry 11/2013; 2013:757938. DOI:10.1155/2013/757938
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