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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    • "La caries dental en la infancia se puede prevenir , sin embargo, continúa siendo una preocupación de salud pública importante, identificada como una de las enfermedades crónicas más prevalente de la infancia . Para disminuir los riesgos de que el niño sufra de caries de infancia temprana, se debe empezar con la educación de la madre, principalmente enfocando la importancia de una correcta higiene oral y una adecuada alimentación del niño (Tinanoff & Risine, 2009). Se recomienda que la higiene oral del niño debe ser realizada por los padres hasta que el niño sea autónomo (8 a 10 años) (Palma & Cahuana, 2010). "

    Full-text · Article · Aug 2015
    • "This is a key issue, because at this early stage of the child's development, the course is set for future oral health of the adolescent and adult. Early Childhood Caries (ECC) is among the most common dental diseases in preschool children worldwide (Azevedo et al., 2005; Peterson-Sweeney & Stevens, 2010; Yost & Li, 2008), and has become a public health problem especially in socially deprived areas of industrialized countries (Pine et al., 2004; Tinanoff & Reisine, 2009). Main risk factors for developing ECC are low socio-economic status of the parents, insuffi cient dental care after eruption of the fi rst tooth, and most importantly , frequent consumption of sugary beverages from a nursing bottle (Declerck et al., 2008). "
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    ABSTRACT: Purpose: To assess midwives' knowledge about oral health and early caries prevention during perinatal care for mothers and babies. Study design and methods: A survey developed by the investigators was conducted among midwives to assess their knowledge about caries etiology, their attitude toward their role in early caries prevention, and prophylactic measures recommended during pregnancy, and after birth, for their babies. Self-administered questionnaires were sent to 180 midwives in hospitals and 323 midwives from a midwives' association in Hesse, Germany. Results: Response rates were 46% (83/180) and 56% (181/323); a total of 264 questionnaires were evaluated. Most midwives were familiar with the term Early Childhood Caries (ECC), over 90% knew the role of acidic bacteria, carbohydrates, and insufficient oral hygiene in caries etiology. A vast majority of the midwives considered caries prophylaxis as essential, and saw this topic as part of their core area of competence. Only 60% informed the pregnant women in their care about pregnancy gingivitis. Almost all midwives gave recommendations about caries prophylaxis. The risk for developing ECC was explained to the pregnant women and mothers/parents by 92% of the midwives. Recommendations concerning regular dental visits for small children were given by 80% of the midwives. Clinical implications: The time-intensive medical care of families through advanced practice nurses or midwives offers opportunities for better education about caries prophylaxis. A consensus of all the involved healthcare professional groups, including dentists, obstetricians, advanced practice nurses, midwives, pediatric nurses, and pediatricians, is needed to provide uniform recommendations for prophylaxis and prevention of ECC.
    No preview · Article · Jul 2014 · MCN The American Journal of Maternal/Child Nursing
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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.
    Full-text · Article · Jun 2014 · The Open Dentistry Journal
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