Dental management of severe early childhood caries

Abstract

Background: Early childhood caries (ECC) is the new term given to dental decay in infants and toddlers. Severe ECC (S-ECC) is the most devastating caries, which is typical and follows a definite pattern. It is diagnosed by its clinical appearance and history of the child’s nursing/dietary habits. This article focuses on complete oral rehabilitation of two S-ECC patients. Case Presentation: Case 1: A 4 year-old boy accompanied by his mother reported to our department with the chief complaint of pain in the lower left back tooth region. A diagnosis of S-ECC was made based on history, examination and radiographic findings. Preventive regimens were enforced starting with parent counseling regarding oral hygiene. Case 2: A 6-year-old girl reported to our department with the chief complaint of masticatory difficulty and food lodgment in the upper right and left back tooth region. With detailed history and examination, a diagnosis of S-ECC was made. Again management was started by enforcing preventive treatment protocols with diet counseling, oral hygiene and brushing instructions, use of fluoridated tooth paste and professional acidulated phosphate fluoride application. Conclusion: Successful dental treatment for S-ECC can be rendered if the parents and the child are motivated and counselled. Treatment should be aimed at modifying all the four factors in caries tetralogy. Because of its aggressive nature, treatment should be specific for each individual patient.