Severe Early Childhood Caries Research Articles

Prevalence of Early Childhood Caries among the 3-5-year-old Children in Jeddah, Saudi Arabia.

IntroductionDental caries is a significant dental public health issue and it is the world's most common oral health condition among children. In the Kingdom, the prevalence and severity of early childhood caries has been rising.AimThe aim of the study is to establish the prevalence of early childhood caries among children aged 3-5 years in Jeddah as well as the associated risk factor of visiting a dentist.MethodologyThe research is based on a cross-sectional observational design. Children from both private and public schools were randomly selected from schools in all of Jeddah's regions until a sufficient sample size was attained. For the diagnosis of early childhood caries, the American Academy of Pediatric Dentistry criteria were used.ResultsIn Jeddah, the prevalence of early childhood caries is 57% among children aged 3-5 years.ConclusionCaries in young children is a public health issue. There should be an increased emphasis to the parents that the child should visit the dentist by 12 months of age as recommended by many professional organizations. Regular dental appointments would then help to lessen the caries burden on children at an early age. The Four A's treatment regimen is recommended to aid in the prevention and early detection of early childhood caries.How to cite this articleVanka S, Vanka A, Wali O, et al. Prevalence of Early Childhood Caries among the 3-5-year-old Children in Jeddah, Saudi Arabia. Int J Clin Pediatr Dent 2022;15(S-2):S197-S200.

Streptococcus mutans-associated bacteria in dental plaque of severe early childhood caries

ABSTRACT Background Streptococcus mutans (S. mutans) is a potential pathogenic bacteria of dental caries. However, the level of S. mutans is low in some children with severe early childhood caries (SECC) Aim To evaluate the effect of S. mutans level on dental microbiome and cariogenesis. Methods The oral microbiota was compared between caries-free group (CF) and SECC group.16S rRNA gene sequencing was used for S. mutans level bacterial community analysis. The candidate bacteria that were closely related with S. mutans abundance were identified and confirmed by absolute quantitative real-time PCR in clinical dental plaque samples from CF and SECC groups. Results Through in-depth analysis of dental plaque microorganism, Leptotrichia, Selenomonas and Prevotella_7 were found in the S. mutans-low group (p < 0.05) and Porphyromonas, Selenomonas_3 were found in the S. mutans-high group (p < 0.05). Through quantitative real-time PCR, Leptotrichia, Selenomonas and Prevotella_7 were identified as the potential biomarkers of SECC when S. mutans was at a low level. Conclusion Leptotrichia, Selenomonas and Prevotella_7 are identified as potential biomarkers in SECC with a low abundance or without S. mutans. Our study may shed light on the understanding of caries occurrence in SECC with low abundance of S. mutans. Abbreviations S. mutans, Streptococcus mutans; CF, caries-free; SECC, severe early childhood caries; ECC, early childhood caries; rRNA, ribosome RNA; qPCR, Quantitative real-time PCR; OTUs, operational taxonomic units; ANOVA, analysis of variance; LDA, Linear discriminant analysis; LEfSe, Linear discriminant analysis effect size; COG, Groups of proteins; NMDS, Non-MetricMulti-Dimensional Scaling; IL-1β, interleukin −1β; IL-6, interleukin-6; IL-8, interleukin-8; IL-10, interleukin-10.

The Crosstalk Between Saliva Bacteria and Fungi in Early Childhood Caries.

Early childhood caries (ECC) is the most prevalent oral disease in children, which greatly affects the quality of life and health condition of the patients. Although co-infection of oral streptococci and fungi has been well recognized in the development of ECC, the correlation between other core members of oral mycobiome and ECC progression remains unclear. In the current study, saliva samples obtained from severe ECC (SECC), ECC, and caries-free children were collected, and both V3–V4 16S rRNA and ITS1 rRNA gene amplicon sequencing were performed to investigate the salivary bacterial and fungal profiles. Significant alteration of salivary fungal community in SECC/ECC children was observed compared with the caries-free control. The typing analysis determined the fungal community into five fungal types, which influenced the structure of salivary bacteria. By performing Spearman correlation analysis, carious phenotypes were positively related to Fusobacterium but negatively linked to Neocosmospora, and a significant correlation of cross-kingdom taxonomic pairs was identified. Our work demonstrated the interactions between oral bacteria and fungi at the community level, which may advance our knowledge on the etiological role of bacteria/fungi in the development of ECC and promote better management of this disease.

Diversity of site-specific microbes of occlusal and proximal lesions in severe- early childhood caries (S-ECC)

ABSTRACT Background Severe-early childhood caries (S-ECC) a global problem of significant concern, commonly manifest on the occlusal, and proximal surfaces of affected teeth. Despite the major ecological differences between these two niches the compositional differences, if any, in the microbiota of such lesions is unknown. Methods Deep-dentine caries samples from asymptomatic primary molars of children with S-ECC (n 19) belonging to caries-code 5/6, (ICDAS classification) were evaluated. Employing two primer pools, we amplified and compared the bacterial 16S rRNA gene sequences of the seven hypervariable regions (V2—V4 and V6—V9) using NGS-based assay. Results Bray-Curtisevaluation indicated that occlusal lesions (OL) had a more homogeneous community than the proximal lesions (PL) with significant compositional differences at the species level (p = 0.01; R- 0.513). Together, the occlusal and proximal niches harbored 263 species, of which 202 (76.8%) species were common to both , while 49 (18.6%) and 12 (4.6%) disparate species were exclusively isolated from the proximal and occlusal niches, respectively. The most commonl genera at both niches included Streptococcus, Prevotella, and Lactobacillus. S. mutans was predominant in PL (p ≤ 0.05), and Atopobium parvulum (p = 0.01) was predominant in OL. Conclusions Distinct differences exist between the caries microbiota of occlusal and proximal caries in S-ECC.

Prevalence of early childhood caries in South Africa: a systematic review

BackgroundThe prevalence of Early Childhood Caries (ECC) in South Africa was last determined in 2002 in a national survey. Since then only few scattered studies were conducted across pocketed communities in the country. There appears to be an increasing trend in dental caries prevalence in South Africa. Since South Africa has one of the highest burden of HIV in the world, less focus was spent on Non-Communicable Diseases (NCDs), it was only when HIV patients developed NCD’s did the government start evaluating NCDs. However, oral health is still not given enough attention within the health sphere. It is the hope of this systematic review to showcase the extent of dental caries amongst the future leaders of our country.ObjectivesThe systematic review presents the prevalence and severity of early childhood caries between age groups and provinces in South Africa from 1975 to 2014.DesignA systematic review of prevalence was performed. Settings and participants: All studies performed on children under the age of six who lived in South Africa were eligible to be included.Primary and Secondary outcome measuresThe prevalence of ECC and the dmft scores were the primary and secondary outcome measures.ResultsTwenty-one studies were included in the present review. The overall prevalence was 44.94% (95% confidence interval (C.I.) 39.73–50.15%) and the overall dmft score was 2.422 (95% C.I. 2.148–2.696).ConclusionsThe dmft score was the lowest in the Limpopo Province and highest in the Eastern Cape. ECC prevalence increased post-apartheid possibly on account of lifestyle changes due to the exodus from rural to urban and peri-urban areas.Registration The protocol of this systematic review was registered with PROSPERO, CRD42018112161, in November 2018.

Implementing Standardized Patient Caregivers to Practice Difficult Conversations in a Pediatric Dentistry Course.

IntroductionStandardized patient (SP) methodology has been used in health professional education to help students develop communication, deeper diagnostic reasoning, and critical thinking skills. Few examples demonstrate the use of SPs to practice difficult conversations with pediatric caregivers in the pediatric dentistry literature. The objective of this educational activity was to describe the implementation of three SPs in a pediatric dentistry course for second-year dental students.MethodsWe developed three SP encounters covering interactions with caregivers of an infant with severe early childhood caries, an adolescent on the path to gender affirmation, and a child with autism and dental caries whose caregiver was resistant to fluoride- and silver-containing dental materials. We describe the case design process, rubric construction and calibration, student debriefing, and pandemic modifications. We evaluated the effectiveness of the implementation by thematic analysis of student reflections following each encounter using a qualitative descriptive framework.ResultsEighty-three students completed each encounter. Qualitative analysis showed that students preferred a more realistic encounter by having a child or other distraction present. Students relied on different elements of motivational interviewing depending on the objective of each encounter and the age of the patient. Overall, the SP encounters were well received by students and faculty as an alternative or supplement to traditional student evaluation methods.DiscussionWe noted a number of lessons learned about implementing SP methodology in pediatric dental education. With these experiences now in place, future evaluations should measure student performance in the SP encounters against student performance during clinical care.

Reviewing Nutritional Status in Children with Severe Early Childhood Caries

Early Childhood Caries is a disease that is diagnosed when a child of or under 71 months of age has got his/her primary teeth with one or more caries, missing tooth surfaces or tooth surfaces with filling. Severe Early Childhood Caries (S-ECC) is the most common disease in children, affecting 60% to 90% of children worldwide. Nutritional status and S-ECC can be caused by some behavioural factors associated with poor dietary habits. Therefore, this study was aimed to determine the nutritional status of children with severe early childhood caries. This study was conducted by using a literature review method with a systematic approach and by collecting articles related to research topics on PubMed, ScienceDirect, and Google Scholar. The referenced papers which were used for the purpose of creating this study were published within the last ten years (between 2011 and 2021). The articles were selected using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). They were screened and assessed for eligibility by JBI critical appraisal tools and The Mixed Methods Appraisal Tool (MMAT). 610 studies were identified through the database search, and 16 were included in this systematic review. The studies which were included in this systematic review vary. Ten of the studies have significant results whilst six of them have non-significant results. The reason for this might be either caries being a multifactorial, varied sample population or the research methods differing in each study.

Effect of Dental Treatment Under General Anesthesia on Oral Health Related Quality of Life in Children with Severe Early Childhood Caries

Effect of Dental Treatment Under General Anesthesia on Oral Health Related Quality of Life in Children with Severe Early Childhood Caries

Impact of Severe Early Childhood Caries on General Health in a Group of Egyptian Preschool Children

Impact of Severe Early Childhood Caries on General Health in a Group of Egyptian Preschool Children

Association between Vitamin D and Dental Caries in a Sample of Canadian and American Preschool-Aged Children

Background: Inadequate vitamin D levels may increase the risk of caries during childhood. The purpose of this study was to investigate the association between 25-hydroxyvitamin D (25(OH)D) status and severe early childhood caries (S-ECC) in preschool children. Methods: Data were obtained from children <72 months of age in two case–control studies in Winnipeg, Manitoba and Richmond, Virginia. Serum analysis assessed 25(OH)D, calcium and parathyroid concentrations. Data on demographics, dental history and oral hygiene were obtained via questionnaires. Bivariate and multiple logistic regression analyses were performed to assess the relationships between demographic and biological variables and S-ECC. A p-value of ≤0.05 was significant. Results: Data were available for 200 children with S-ECC and 144 caries-free controls. Children with S-ECC had significantly lower 25(OH)D levels than those who were caries-free (p < 0.001), and children with deficient 25(OH)D levels were 10 times more likely to have S-ECC (p < 0.001). Multiple logistic regression revealed that having higher 25(OH)D and calcium concentrations (p = 0.019 and p < 0.0001, respectively), as well as being breastfed in infancy (p < 0.001), were significantly and independently associated with lower odds of S-ECC, while dental insurance (p = 0.006) was associated with higher odds of S-ECC. Conclusions: This study provides additional evidence of an association between nutritional status, specifically vitamin D and calcium levels, and S-ECC.

Correlation of Child Temperament with Severity of Early Childhood Caries in Children Aged 3-6 Years

Objective: To check the correlation of child temperament with severity of early childhood caries in children aged 3-6 years. Design of the Study: It’s a cross-sectional study. Study Settings: The study was conducted at Department of Dentistry and Oral Pathology, Bakhtawar Amin Medical and Dental College, Multan from August 2020 to August 2021. Material and Methods: Total 700 children aged between 3-6 years who fulfill the inclusion criteria were selected along with their parents/ primary caregivers. In the present study temperament was assessed using Thomas and Chess’s parent temperament questionnaire. Both intensity and frequency of occurrence of that particular behavior was considered, each entity is scored on a five (5) point scale. Rating is done on negative and positive directions in which scores of 1-5 represent the extremes of intensity and frequency of occurrence of that behavior. At the midpoint, score of 3 is average according to the parent’s insights. Results of the Study: Among the study group of, 24% belonged to the age group 3 years, 29% belonged to age group 4 years, 27% belonged to the age group 5 years and 20% belonged to the age group 6 years. Forty nine percent among the study group were male participants whereas 51% were female participants. Fifty percent of the participants among the study population had caries while 46% of the study participants were free of caries. The results showed that children with caries had lower overall temperament scores (36.49± 5.67) compared to subjects without caries (38.82± 5.43).There was a statistically significant correlation with p&lt;0.001. Conclusion: There was a significant correlation between child temperament scores of Sociability, Energy and Emotionality and Caries Severity Index scores. No correlation could be established with Attentivity and Rhythmicity scores. It can be concluded that in early childhood caries child temperament is a risk factor. Keywords: Temperament, Early Childhood Caries

Feeding practices and early childhood caries among children with primary dentition

Background: Early childhood caries (ECC) is major oral health problem of young children. Risk factors for ECC are poor oral hygiene and feeding practices. Prevalence and severity of ECC is increasing with change in lifestyle and diet pattern in developing countries. Objectives: To assess the association between feeding practices and severity of early childhood caries in preschool children. Methods: An analytical cross-sectional study was conducted with convenient sample of 96 children up to six years age in Peoples Dental College from July to December 2020. Clinical examination included the recording of dental caries (dmft) using WHO criteria. The self-validated questionnaire consisting seven questions about feeding practices was asked to mothers. The Chi-square test was performed to determine association between severity of ECC and feeding pattern. Results: Mean dmft was 6.77 ± 5.91. Prevalence of severe-ECC (S-ECC) was highest in youngest age group. Caries experience was similar in breast fed, bottle fed, and mixed. There was no significant difference in non-severe ECC and ECC in relation to duration of breast or bottle feeding but frequency of night feeding was associated with S-ECC. Children given ready-made infant formula solid food had more S-ECC (13, 92%) compared to non-severe ECC (1, 7.1%) which was statistically significant. Children given homemade gram flour food were noted to have less of S-ECC (5, 27.5%) than nonsevere ECC (13, 72.5%) which was statistically significant. Conclusion: Present study revealed that multiple night feeding and weaning with readymade food are significant factors for S-ECC.

Posts in Primary Teeth-Past to Present: A Review of Literature.

ABSTRACTEarly childhood caries is indeed a devastative situation for both patients’ parents and pediatric dentists. The primary goal in treating severe early childhood caries is to restore normal function such as maintenance of mesiodistal and vertical dimension, prevention of alteration of mastication, phonetics (due to premature loss), development of parafunctional habits, and prevention of psychological problems affecting the self-esteem of a child. The restoration of primary dentition with extensive carious lesions is a complex clinical challenge of several dimensions. The severity of this condition in maxillary anterior teeth has prompted the extraction of teeth due to inadequate esthetic treatment options. The only concern with the severely destructed primary incisors is a lack of crown structure, which fails to support and adhere to a composite crown. Clinicians have preferred many restorative modalities for esthetic rehabilitation of badly decayed anterior primary teeth with numerous root canal retentive post and core systems with appropriate techniques to preserve those teeth until they are replaced by permanent teeth. This review highlights the various posts, their indications, principles, ideal properties, and the current concepts on their use in pediatric dentistry.How to cite this articleMartin AG, Shivashakarappa PG, Arumugam S, et al. Posts in Primary Teeth–Past to Present: A Review of Literature. Int J Clin Pediatr Dent 2021;14(5):705–710.

Oral Mycobiome Differences in Various Spatial Niches With and Without Severe Early Childhood Caries.

Purpose: Severe early childhood caries (S-ECC) is a microbe-mediated disease with tooth hard tissue destruction. However, the role of the fungal community in various ecological niches of deciduous dental caries has not been fully elucidated. This study aimed to analyze the differences of mycobiome in diverse spatial niches with and without S-ECC.Method: A total of 48 samples were obtained from 8 S-ECC children (SE group) and 8 caries-free children (CF group) aged 4–5 years. Unstimulated saliva (S), healthy supragingival plaque (FMIX), mixed plaque from decayed teeth (SMIX) and carious lesion (DMIX) samples were collected. The ITS2 region of the fungi was amplified and sequenced using the Ion S5™XL platform.Results: A total of 281 species were identified. Candida albicans showed relatively higher abundance in S-ECC children, while Alternaria alternata and Bipolaris sorokiniana were more enriched in CF group. In this study, the relative abundance of C. albicans in CF.FMIX (0.4%), SE.FMIX (12.5%), SE.SMIX (24.0%), and SE.DMIX (37.2%) increased successively. Significant differences of fungal species richness and diversity were observed between SE.FMIX-SE.SMIX, SE.FMIX-SE.DMIX (P < 0.05).Conclusions: The diversity of fungal communities in S-ECC children showed significant differences in various spatial niches of primary teeth. The richness of C. albicans was closely related to the caries states and depth, suggesting that it may play a crucial role in caries pathogenicity.

Oral Health Status and Oral Health-Related Quality of Life of First Nations and Metis Children.

Objectives:To assess the oral health status and oral health–related quality of life (OHRQoL) of young First Nations and Metis children.Methods:This cross-sectional study assessed the oral health status of Indigenous children <72 mo of age while their parents/caregivers completed a questionnaire, including the Early Childhood Oral Health Impact Scale (ECOHIS), to assess OHRQoL. Analysis included descriptive statistics, bivariate analyses, and multiple regression. A P value ≤0.05 was considered significant.Results:Overall, 146 children were recruited with a mean age of 40.1 ± 21.2 (SD) months, and 49% were male. Among First Nations children, 65.4% had early childhood caries (ECC) as compared with 45.2% among Metis children (P = 0.025). However, there was no statistically significant difference in the prevalence of severe ECC (S-ECC) between First Nations and Metis children (60.6% v. 42.9%, P = 0.051). The mean decayed, missing, and filled primary teeth (dmft) score was 4.9 ± 5.3 (range 0–20), and the mean decayed, missing, and filled surfaces (dmfs) score was 14.5 ± 20.4 (range 0–80). The total mean ECOHIS score was 4.4 ± 5.9 (range 0–25), while the mean Child Impact Section and Family Impact Section scores were 2.6 ± 4.0 (range 0–10) and 1.8 ± 2.8 (range 0–8), respectively. Multiple linear regression showed S-ECC was associated with total mean ECOHIS scores (P = 0.02). Higher total mean ECOHIS scores (which indicates poorer OHRQoL) were observed in children with ECC compared with caries-free children (5.8 v. 2.4, P = 0.0001).Conclusion:Oral health disparities such as ECC and reduced OHRQoL exist among many First Nations and Metis children in Manitoba. This is the first Canadian study exploring the OHRQoL of Indigenous children in addition to their oral health status.Knowledge Transfer Statement:This study is the first to report on the oral health–related quality of life and its relationship to early childhood caries (ECC) among young Canadian First Nations and Metis children. Metis children are just as likely to suffer from severe ECC than First Nations children. The findings of this study have informed community-based and community-developed oral health promotion and ECC prevention activities.

Evaluation of salivary thiobarbituric acid reactive substances, total protein, and pH in children with various degrees of early childhood caries: a case-control study.

According to new studies, oxidative stress may play an important role in the beginning and progression of oral diseases. The aim of this study was the evaluation of thiobarbituric acid reactive substances (TBARS) as an indicator of lipid peroxidation, total protein, and pH of saliva in children with various degrees of early childhood caries in comparison with caries-free children. This case-control study was carried out on 90 children 3-5years old in three equal groups, including caries-free children (CF), early childhood caries (ECC), and severe early childhood caries (S-ECC) who were age- and sex matched. Saliva pH was measured using a paper pH meter and TBARS and total protein were measured by spectrophotometer methods and data were statistically analysed. TBARS and total protein levels in ECC and S-ECC groups were significantly higher than the CF group (p < 0.001), but pH was not significantly different between groups. There were no significant differences between ECC and S-ECC groups in any of the studied indicators. Considering the limitations of the present study, the results showing the higher salivary TBARS levels in the S-ECC and ECC groups compared to caries-free children, lead to the conclusion that oxidative stress could be considered as a risk factor for early childhood caries.

Mutans Streptococci and Lactobacilli: Colonization Patterns and Genotypic Characterization of Cariogenic Bacterial Species in American Indian Children

Aim: The purpose of this study was to investigate the presence of Streptococcus mutans, Streptococcus sobrinus, and Lactobacillus species in an American Indian population displaying a high incidence of severe early childhood caries (S-ECC) and to explore the genotypic diversity and fidelity of transmission of S. sobrinus in this population.Methods: We report here on the microbial profiles of 71 children compiled from birth to 36 months of age and initial exploration of genotypic diversity in a subset of 40 mother/child dyads. Whole mouth plaque samples were collected from mother/child dyads in a Northern Plains American Indian cohort. Mutans streptococci (MS) and Lactobacillus counts were recorded and presence/absence of S. mutans, S. sobrinus, and Lactobacillus was noted for each child. S. sobrinus was isolated and genotyped via arbitrarily primed-polymerase chain reaction (AP-PCR).Results: The children in this study were divided into caries active (CA) and caries free (CF) groups. S. mutans, S. sobrinus, and Lactobacillus species were detected more frequently in CA groups. Distribution of MS and Lactobacillus counts was significantly different between the two groups, as was the distribution of three species colonization profiles. Twelve S. sobrinus genotypes were detected in the subset of mother/child dyads. Individual participants displayed a range of 0–3 distinct genotypes while mother/child pairs displayed a range of 1–5 genotypes. Eighty-three percent of children shared at least one genotype with his/her mother.Conclusion: Caries active children in this population display different microbial profiles than the caries free children in this cohort. A small number of S. sobrinus genotypes appear to be very common in this population. A high rate of vertical transmission of S. sobrinus from mother to child is seen in these mother/child dyads.

A Cross-Sectional Study on the Oral Health of the Infants and Toddlers at the National Guard, Jeddah, Saudi Arabia

Background: The high prevalence of dental caries among preschool children had been reported in literature. However, studies on dental caries and related problems among infants and toddlers in Saudi Arabia are lacking. Aim: This study assessed the oral health status of the infants and toddlers in the Iskan Primary Health Care (PHC) Center for the National Guard in Jeddah, Saudi Arabia. Settings and Design: The assessment included 151 children between the ages of 5 to 36 months during 2015 to 2016. Materials and Methods: The caregivers were provided with a structured questionnaire. Oral examinations on the children were based on the WHO’s assessment form and criteria. Statistical Analysis: Frequency, mean, standard deviation, and regression analysis were used for the risk assessment of the caries. Results: Dental caries was reported in 9% of the children in the Center, and 95.5% of them were categorized as severe early childhood caries (S-ECC). More than half of the children were bottle-fed. About 70% of the caregivers never cleaned their children’s mouth. The caries among the children was highly associated with bottle-feeding during their sleep. Conclusions: Nocturnal bottle-feeding, failure to clean the children’s mouths, and the use of cleaning materials other than toothpaste were identified as the risk factors that promoted the development of caries among the children. With these findings, we recommend that the mothers and the medical professionals should be trained on necessary oral health practices. Early preventive dental health services within the National Guard health services should be initiated.

Trends, Characteristics, and Success Rates of Treatment for Severe Early Childhood Caries Under General Anesthesia: A Retrospective Study in Northwest China.

To retrospectively analyze the characteristics, tendencies, and success rates of dental treatments for severe early childhood caries (SECC) under general anesthesia (GA) in in northwest China. Children diagnosed with SECC were included in this retrospective study. From January 2015 to December 2018, they received dental treatment under GA at Affiliated Stomatology Hospital of Xi'an Jiaotong University. Demographic information, caries status and treatment characteristics were collected from electronic medical record system. Success rates of different treatments at 6-month and 12-month follow up were also analyzed. A total of 846 children (477 male, 369 female) received dental treatment under GA. The case number was increased from 148 in 2015 to 278 in 2018. There were 81.2% and 70.8% of the children participated the 6-month and 12-month follow up. SSC and pulpotomy was the most successful restorations and pulp therapy, with the success rate of 97.09% and 93.98% in 12-month follow up, respectively. The use of crown restorations (including composite resin crown and stainless steel crown) and pulp reservation therapies (including indirect pulp therapy and pulpotomy) were significantly increased while composite resin filling and pulpectomy decreased during 2015 to 2018. There has been an increasing demand for dental treatment under GA for children with SECC in northwest China, with a trend toward younger ages. With better clinical outcomes, crown restorations and pulp reservation therapies were the fastest-growing treatments under GA.

Prospective study of the caries recurrence risks after severe early childhood caries treatments under general anesthesia

Objective: To study prospectively the caries characteristics of the children who suffered severe early childhood caries (S-ECC) and received dental caries treatment under general anesthesia and to explore the related risk factors of caries recurrence after treatment. Methods: During December 2012 to August 2014, eighty-three children aged 2-4 years with S-ECC who underwent one caries treatment session under general anesthesia in Peking University School and Hospital of Stomatology participated in this study. Data of demographics, clinical characteristics, dietary and oral hygiene habits of the participants were collected before the treatment and 1-, 7- and 13-months after the treatment. All data were then analyzed to find out whether the factors were related to caries relapse. Results: Among the 70 children who completed 7-13 months follow-up, twenty-nine children (41%) remained caries-free and 41 children (59%) had a few caries recurrence during the observation period. All the teeth suffered different variation of caries recurrence except mandibular deciduous incisors. As for the types of caries recurrence after caries treatment under general anesthesia, the maxillary deciduous incisors usually showed secondary caries (new caries/secondary caries numbers were 1/12), the canines and first deciduous molars occurred both secondary and new caries (new caries/secondary caries numbers in canines were 12/6, in first deciduous molars were 16/12) and the second deciduous molars usually presented new caries (new caries/secondary caries numbers were 19/5). After treatment, the prone tooth surfaces of caries recurrence from high to low were: adjacent surfaces of deciduous molars (37 surfaces), occlusal surface of deciduous molars (28 surfaces), adjacent surfaces of deciduous canines (13 surfaces), buccal and lingual surfaces of deciduous molars (12 surfaces), labial and lingual surfaces of deciduous incisors (10 surfaces), labial and lingual surfaces of deciduous canines (8 surfaces) and adjacent surfaces of deciduous incisors (5 surfaces). There were no significant differences in the children's demographics and clinical characteristics between relapse and non-relapse groups (P>0.05). Patients in the relapse group had higher sugar intake frequencies than those in the non-relapse group at both 7- and 13-month follow-ups (P<0.05). Conclusions: Children of 2-4 years old with S-ECC have a high risk of caries recurrence after caries treatment under general anesthesia and need to recieve regular oral examination. During the follow-ups, the prevention and treatment of new and secondary caries of deciduous molars and secondary caries of deciduous incisors should be focused on. High frequency of sugar intake is an important risk factor of recurrent caries for children with S-ECC after caries treatment.