Early Childhood Caries – Case Discussion

A 5 year old child walked into the clinic complaining of severe pain and multiple missing teeth that were extracted earlier due to severe caries. According to the history taken from the mother,it was clear that the child suffers from a condition called “Early Childhood Caries”.

 Signs of early childhod careis that could identified from the images above are the following:

• a dull white band on the tooth surface closest to the gum line – this is the first sign and usually remains undetected by parents
• a yellow, brown or black band on the tooth surface closest to the gum line – this indicates progression to decay
• teeth that look like brownish-black stumps – this indicates that the child has advanced decay.

According to the statistics published in various research,4 out of 10 children starting school have decay in their primary dentition.as it’s a significant public health issue. According to various studies it is five times more common than asthma and 7 times more common that hay fever. It develops on smooth surface caries shortly after the eruption of the deciduous teeth and progressing rapidly.

The progression of this disease can lead to an overall impact on the health issue. Although it be arrested it needs to be detected early. ECC is defined as the presence of one or more decayed (non cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child under the age of six.

Associated Risk factors

• High consumption of sugars. 
• Frequent night time bottle-feeding with milk and libitum breast-feeding
• Night time bottle feeding with juice, repeated use of a sippy or no-spill cup, and frequent in-between meal consumption of sugar-added snacks or drinks (e.g., juice, formula, soda) 
• Frequent consumption of between-meal snacks and beverages containing sugars increases the risk of caries due to prolonged contact between sugars in the consumed food or liquid and cariogenic bacteria on the susceptible teeth.

 Recommendations: 

• The infants should not be given juice from bottles or covered cups that allow them to consume juice throughout the day
• Intake of 100 percent fruit juice should be limited to no more than four to six ounces per day for children one through six years old
• Newly-erupted teeth, because of immature enamel, and teeth with enamel hypoplasia may be at higher risk of developing caries.

References:

American Academy of Paediatric Dentistry