Treatment Of Early Childhood Caries Research Articles

Interventions Targeting Bottle and Formula Feeding in the Prevention and Treatment of Early Childhood Caries, Overweight and Obesity: An Integrative Review.

Overweight, obesity and early childhood caries (ECC) are preventable conditions affecting infants and young children, with increased prevalence in those formula-fed. Previous research has focused on distinct outcomes for oral health and healthy weight gain. However, the aetiology may be linked through overlapping obesogenic and cariogenic feeding behaviours, such as increased sugar exposure through bottle propping and overfeeding. Best-practice bottle feeding and transition to cup use may concurrently reduce overweight, obesity and ECC. This integrative review aimed to identify interventions supporting best-practice formula feeding or bottle cessation and examine the intervention effects on feeding, oral health and weight outcomes. The reviewers searched nine databases and found 27 studies that met the predetermined inclusion criteria. Eighteen studies focused on populations vulnerable to ECC or unhealthy weight gain. All studies focused on carer education; however, only 10 studies utilised behaviour change techniques or theories addressing antecedents to obesogenic or cariogenic behaviours. The outcomes varied: 16 studies reported mixed outcomes, and eight reported worsened post-intervention outcomes. While some studies reported improvements, these were not maintained long-term. Many study designs were at risk of bias. Effective intervention strategies for preventing ECC and child obesity require the holistic use of interdisciplinary approaches, consumer co-design and the use of behavioural change theory.

Trends in repeat general anaesthesia for treatment of dental caries at a children's hospital in Toronto, Canada: a 10-year retrospective investigation.

Treatment of early childhood caries (ECC) under general anaesthesia (GA) was the most common day surgical procedure performed for preschool children in Canada. Evidence with regard to the rate of repeat GA for dental care for Canadian Children is limited. To determine the rate of repeat dental caries treatment performed under GA over a 10-year period and to assess the relationship between the frequency of repeat dental treatment under GA and medical comorbidities. This was a retrospective assessment of the dental records of 973 children who required repeat dental treatment under GA over a 10-year period. The rate of repeat dental treatment under GA was calculated. A Chi-square analysis was performed to determine associations between medical comorbidities and the frequency of repeat dental treatment under GA. The rate of repeat dental treatment under GA over a 10-year period was 10.8%. The yearly repeat rate and simple moving 5-year rate of repeat dental treatment under GA increased. Having a medical comorbidity was not associated with repeat dental treatment under GA. The rate of repeat dental treatment under GA was consistent with the rates reported in the dental literature and increased over the 10-year period.

Assessment and correction of the daily diet in the treatment of severe early childhood caries

Relevance. The high prevalence and intensity of early childhood caries (ECC) require a detailed analysis of the influence of the nutritional status on the course of the carious process and possible ways to treat severe caries and control certain markers of calcium and phosphorus metabolism. Purpose – to identify correlation between the nutrient composition of the diet, calcium and phosphorus metabolism markers and severe childhood caries. Materials and methods. The study involved 46 children aged 12-36 months with severe ECC which had been treated under the general anesthesia. In all patients, the nutrient composition of the diet was studied and certain markers of calcium and phosphorus metabolism were determined. ECC comprehensive treatment plan with further evaluation of the effectiveness of the treatment was developed accordingly, based on the patients’ allocation to the main and comparison groups.Results. The dynamics of the content of excreted calcium in the main group of study participants indicates an increase in the consumed calcium entering the child's body with food. 24 months after the implementation of pathogenetic therapy, the increase in the intensity of caries in the main group was significantly reduced.Conclusions. The correlation analysis revealed a strong correlation between the frequency of consumption of the basic food products and caries intensity in the primary teeth. Patient-based ECC treatment protocols can reduce caries progression in primary dentition by 42.8 % in the long run.

Analysis of the Cost Associated with the Treatment of Early Childhood Caries in Children Aged 2-6 Years

One cannot deny that cost factor plays an important role in the treatment phase of any disease and thus canwidely affect the patient’s acceptance to treatment. Overall cost of treatment gives an idea of the approximatecost differences that can be expected by patients. In this given study we aim to analyse the overall cost fortreatment procedures done for children suffering from early childhood caries in the state of Tamil Nadu. Thisis a hospital based retrospective study. All data of the patients visiting Saveetha Dental College and hospitalsfrom June 2019 to March 2020 located in Chennai were retrieved manually. Children who were diagnosedwith early childhood caries between 2-6 years who had at least one procedure done were included. A totalof 1210 patients were included in the study out of which 660 were males (54.55%), and 550 were females(46.45%). Out of 1210 patients: average costs for 1 to 5 procedures: Rs 231/-, 6 to 10 procedures: Rs 698/-,11 to 15 procedures: Rs 1222/-, 16 to 20 procedures: Rs 1783/-, 21 to 25 procedures: Rs 2419/-, 26 to 30procedures: Rs 2765/-, 31 to 35 procedures: Rs 3261/-, 36 to 40 procedures: Rs 3713/-, 41 to 45 procedures:Rs 3893/-. Out of total procedures the patient count for 1 to 5 procedures: 715, 6 to 10 procedures: 232,11 to 15 procedures: 98, 16 to 20 procedures: 47, 21 to 25 procedures: 40, 26 to 30 procedures: 30, 31 to35 procedures: 25, 36 to 40 procedures: 12, 41 to 45 procedures: 4. We can conclude that the most of thepatients required 1 - 5 dental procedures with the frequency being highest at 5 years and mostly in malechildren and the overall cost had a gradual linear increase with the increase in the number of procedures.

Longevity of posterior composite restorations in children suffering from early childhood caries-results from a retrospective study.

This retrospective study aimed to evaluate health status as a new patient risk factor and analyze its influence on the survival of posterior composite restorations in patients with early childhood caries (ECC). Patients who received dental treatment of ECC under general anesthesia (GA) and attended at least one follow-up visit were included in this study. A total of 907 patient records were evaluated retrospectively through patient examination forms and panoramic radiographs. Kaplan-Meier survival probability analysis with log-rank test was used to assess the posterior composite restorations' longevity up to 24 months. Furthermore, risk factors were determined using Cox regression multivariate analysis. A total of 5063 posterior composite restorations were assessed. Following the Cox regression analysis to determine the effect of risk factors on longevity of composite restorations, findings revealed that the survival probability of composite fillings was significantly lower in patients with systemic disease (p = 0.00). Filling materials were compared based on the survival probabilities and results were further discussed. There was no significant relationship between age, gender, and the survival of the restoration; however, the child's health status (p = 0.00) and caries risk status (p = 0.05) significantly affected survival. Moreover, the type of arch and pulp intervention influenced the restoration's survival. Systemic disease has a detrimental influence over longevity of composite restorations. Therefore, considering the reduced survival rates of the composite restorations for children who have systemic disease, alternative non-invasive treatment options should be considered. This study's novelty is the observation of drastically reduced survival of composite restorations in children with systemic disease.

Composite core-supported stainless steel crowns enhance fracture resistance of severely damaged primary posterior teeth

Extraction of severely damaged primary teeth has been the common treatment for early childhood caries. The early loss of primary teeth results in poor oral and general health in children. To assess fracture resistance of severely damaged primary molars restored with intracoronal core with and without stainless steel crown (SSC). Eighty extracted primary molars were divided into 4 groups: Group 1 MOD cavity; Group 2 MOLi cavity; Group 3 MODLi and Group 4 MODBLi. Pulpectomy and core build-up with and without SSC placement were carried out and subjected to fracture resistance testing to examine the load to fracture and type of fracture. Fracture loads of 870–950 N were observed in the fabrication of intracoronal composite core in teeth with 1–2 remaining tooth walls whereas higher fracture load of teeth with extensive loss of all the surrounding wall following intracoronal composite core build-up was 1270 N. Following SSC placement, all groups had higher fracture load, with Group 4 being resisted to the highest force at 5500 N. Without SSC, Group 1 and Group 2 appeared to be restorable whereas Group 3 and Group 4 were non-restorable when fractured. Following SSC placement, all groups showed non-restorable fracture at the root furcation. Combined intracoronal core and SSC significantly strengthen the restored severely damaged primary molars with severe loss of coronal tooth structures. This proposed restoration method provided resistance to occlusal load that is much higher than the physiologic chewing force in children.

Long-Term Treatment of Early Childhood Caries (ECC)

Early childhood caries (ECC) is an infectious disease affecting the primary dentition in infants and children younger than 6 years of age...

A review of the use of general anaesthesia in the treatment of early childhood caries

A review of the use of general anaesthesia in the treatment of early childhood caries

How Much Country Economy Influences ECC Profile in Serbian Children-A Macro-Level Factor Analysis.

Introduction: Serbia has universal health coverage (UHC) for pediatric dental care and similar country distribution for dentists and physicians per 1,000 inhabitants. However, a high prevalence of early childhood caries (ECC) with wide variation across the country was observed in previous studies. This paper aimed to analyze the association between economic and healthcare country macro-level factors with ECC prevalence and treatment.Method: The outcome variables were ECC prevalence and frequency of untreated ECC in 36- to 71-month-olds. Cross-sectional pathfinder survey on a nationally representative sample of children was conducted in order to obtain data. Independent variables included the following: gross domestic product (GDP), social and health care budget beneficiaries' expenditures, local self-government budget, unemployment rate, population density and density of physicians and dentists. Guided by the WHO's Basic Methods for Oral Health Surveys stratified cluster sample, 17 sites were randomly chosen to obtain adequate distribution of data regarding urban, peri-urban and rural areas in each analyzed statistical territorial unit. The variables were analyzed using the independent t-test or Mann–Whitney U test. A probability value of <0.05 was considered significant.Results: The final sample included 864 children aged 36 to 71 months. Observed prevalence of ECC was 41.1%. Although no statistically significant difference was found, children with ECC compared to healthy children were living in parts of the country with averages of ≈122€ lower GDP per capita, ≈4€ lower social and health care expenditures per capita, 9 inhabitants per km2 lower population density, almost 7€ per capita lower local self-government budget and a 0.6% higher unemployment rate. Furthermore, although without a statistically significant difference, untreated ECC was associated with ≈302€ lower GDP per capita, ≈12€ lower social and health care expenditures per capita, 34 inhabitants per km2 lower population density, almost 20€ per capita lower local self-government budget and a 1.7% higher unemployment rate.Conclusions: This study, performed in a nationally representative sample of preschool children, revealed the association of economic macro-level factors with ECC prevalence and its (non-) treatment. Further research on a larger sample is necessary to confirm the results. These findings suggest that most of the public-health efforts regarding prevention and early treatment of ECC should be directed at regions with lower economic performance.

Effects of dental general anaesthesia treatment on early childhood caries: a prospective cohort study in China

ObjectivesTo evaluate the success rates of dental procedures, the recurrence rates of caries and changes in oral health-related quality of life (OHRQoL) in children following treatment for early childhood caries...

OHRQoL changes among Chinese preschool children following dental treatment under general anesthesia.

To assess dental treatment under dental general anesthesia (DGA) among Chinese preschool children by investigating changes in their oral health-related quality of life (OHRQoL), the incidence of postoperative complications, and parental satisfaction. A single-center prospective cohort study was conducted. A total of 190 children who received treatment for early childhood caries (ECC) under DGA were included. The primary outcome was a change in the children's OHRQoL at 1month after the operation compared to that at baseline, which was measured by the Early Childhood Oral Health Impact Scale (ECOHIS). The secondary outcomes were the incidence of complications within 1day after treatment and parental satisfaction with the DGA treatment. In total, 180 participants were successfully reevaluated after the operation, yielding a 94.7% follow-up response rate. The total ECOHIS score decreased by 76.3% (P < 0.01) after treatment, demonstrating a large effect. Approximately 74.4% of the children complained of at least one complication, including sleepiness (43.3%), emergence agitation (38.9%), nausea/vomiting (13.9%), dizziness (10.6%), and fever (3.3%), on the first day. Approximately 85.5% of the parents were satisfied with the DGA treatment. DGA treatment has a positive effect on Chinese preschool children's OHRQoL and is evaluated highly by their parents. Dental treatment under general anesthesia improved the OHRQoL of Chinese preschool children.

KUALITAS HIDUP ANAK USIA 3-5 TAHUN DENGAN EARLY CHILHOOD CARIES YANG TIDAK DITANGANI

Early childhood caries (ECC), dental caries affecting the primary teeth in preschool aged children, is prevalent, especially among low social economic groups in developing countries. Treatment of ECC in developing country is almost nonexistent, so that it can cause more serious complications ((pulpitis, ulceration, fistula, and abscess). Untreated ECC can affect on quality of life in preschool aged children. This cross-sectional study aim was to evaluate association between untreated ECC and quality of life of preschool children (aged 3-5 years). This study was conducted on September until October 2018 in playgroups or kindergartens in Ilir Barat I Subdistrict, Palembang and consisted of 334 preschool children–parent pairs.Untreated ECC was assessed by PUFA/pufa index and preschool children’s quality of life by ECOHIS instrument. Association between untreated ECC and preschool children’s quality of life were analyzed using the Fisher’s exact test with 95% CI. The result showed that ECC prevalence was 84.1% dan more than 90% was untreated ECC. The pufa was developed in 39.1% untreated ECC. There wasa significant association between untreated ECC and preschool children’s quality of life (p&lt;0,05).

Use of principles of pathogenetic treatment of decompensated form of early childhood caries in preschool children

Aim. To ground the individualized pathogenetic approach to treatment of dental caries in preschool children.&#x0D; Materials and methods. We carried out the controlled randomized retrospective study, which included 111 children aged 12 to 72 months with decompensated form of caries course. Patients of the main group received pathogenetic treatment of dental caries, patients of the comparison group received symptomatic treatment and a complex of preventive measures. Patients of both groups were monitored after 6, 12 and 24 months.&#x0D; Results. The analyzed changes in caries intensity from the onset of performing individualized pathogenetic treatment of early childhood caries detected that 6 months later, a mean quantity of newly damaged surfaces was thrice as less in patients of the main group than in the comparison group. The data received one year after the onset of treatment, demonstrate a significant decrease in the growth of caries intensity of surfaces on average by one surface in persons of the main group compared to the comparison group (0.35 ± 0.12 and 1.57 ± 0.87, respectively, p = 0.05).&#x0D; Conclusions. The choice of rational approaches to the treatment of early childhood caries should be substantiated by histomorphological status of temporary teeth hard tissues, physicochemical parameters of oral fluid and pathogenetic protocols, adapted to specificity of early childhood caries course.

Prevalencija karijesa ranog detinjstva u dece Kosovskog Pomoravlja i mogući faktori rizika za njegov nastanak

Background/Aim. Early childhood caries (ECC) is an infectious multifactorial disease, which involves the presence of caries on any deciduous teeth in children up to the age of 71 months, and begins through a complex process involving the transmission of infectious bacteria, eating habits, and oral hygiene. The purpose of this paper was to examine the prevalence and possible risk factors for the emergence of caries in early childhood. Methods. The research was carried out as an analytical cross-sectional study, including 239 children aged 13-71 months, of both genders living in rural areas of the Kosovo Pomoravlje region. All selected children from the sample were examined with standard dental diagnostic tools (dental mirrors, dental probe) under artificial lighting in a dental chair. Klein-Palmer's DMFT system (d-decayed, m-missing, f-filling) was used to identify caries. Data on social status, attitudes, habits, and behavior of the parents of the examined children are recorded in questionnaires specially designed for this study. Results. Prevalence of caries in the study sample was 56.5%. The average number of diseased teeth per respondent for all children tested was 4.0. In analyzing the received data, the following seven possible ECC predictors with a significance level of p <0.05 were found to be of statistical relevance: the age of the mother (p = 0.004), visits to the dentist (p = 0.026) the reason for visiting the dentist (p = 0.038), use of a bottle in nursing (p = 0.001), child's age (p <0.001), child's birth order (p = 0.007), and the child's teeth brushing habits (p = 0.003). Conclusion. The data obtained in the study indicated a high prevalence of deciduous teeth caries in the examined children, which indicates the need for intensive preventive efforts, both with children and the parents, as well as early diagnosis and treatment for early childhood caries.

Knowledge and awareness regarding various aspects of early childhood caries among general dental practitioners of Gujarat, India: A questionnaire study

Aim: The aim of this study was to evaluate the amount of knowledge and awareness regarding early childhood caries (ECC) among general dental practitioners of Gujarat state. Materials and Methods: A list of inquiries by means of questionnaires for gauging the knowledge regarding ECC was sent via E-mail to 500 general dental practitioners utilizing Google online survey form. Results: The results were based on the answers given by the participants according to their own perception and were quantified accordingly with the help of a pie chart. Conclusion: Although Dental Practitioners have good awareness regarding ECC, there is a need to update their knowledge in order to contribute towards the prevention and treatment of ECC.

Pediatricians' view on early childhood caries and oral health in a north region of India: A cross-sectional study.

Background:The majority of oral diseases in children are preventable. The pediatricians owing to the unique position they occupy in child care are invaluable in achieving standard oral and dental healthcare in children. This study was aimed to assess pediatrician's knowledge, attitude, and awareness toward early childhood caries (ECC), oral health, and treatment needs of their patients.Methods:A total of 65 pediatricians were randomly selected for the study and were requested to fill out an objective questionnaire pertaining to individual details, approach toward pediatric dentistry, and knowledge level of oral health, without providing any oral health information.Results:About 58.5% of pediatricians acknowledged the importance of pediatric dentistry. About 72.7% of pediatricians perform oral examination regularly. Around 17% of pediatricians have knowledge of the ECC. Only 32.3% of pediatricians acknowledged the cariogenicity of medicated syrups.Conclusion:This study shows those pediatricians who were surveyed had poor knowledge regarding ECC, oral health, and dental treatment need in children. Pediatricians need to update themselves on recent recommendations.

Dojenje iz ugla dečjeg stomatologa

Current recommendations by the European Academy of Paediatric Dentistry, American Academy of Paediatric Dentistry, and International Association of Paediatric Dentistry advocate weaning from breast milk and avoiding unrestricted breastfeeding after the eruption of primary teeth in order to lower the risk of early childhood caries (ECC). However, World Health Organization, American Academy of Paediatrics and nutritional recommendations support exclusive breastfeeding up to six months of age, following continued breastfeeding along with appropriate complementary foods, favouring unrestricted and prolonged breastfeeding even beyond the age of two. The purpose of this review is to discuss current data in the literature regarding the association between breastfeeding and ECC in order to address this problem and to provide consistent recommendations. PubMed search revealed possible link between breastfeeding and ECC, however without evidence strong enough to establish the appropriate oral health preventive recommendation. Having in mind known benefits of breastfeeding, it is advisable to adhere to current paediatric guidelines which promote unrestricted breastfeeding as long as it is mutually desired by mother and child. This recommendation doesn't exclude but complements the prevention and timely treatment of ECC. Furthermore, there is a need to highlight the importance of education of parents and health care providers about the ECC risk factors, identification of initial lesions and consequences. Further research regarding this issue is needed.

Responsiveness to change of the Malay-ECOHIS following treatment of early childhood caries under general anaesthesia.

To evaluate the sensitivity and responsiveness of the Malay version of Early Childhood Oral Health Impact Scale (Malay-ECOHIS) to dental treatment of early childhood caries (ECC) under general anaesthesia (GA) and determine the minimally important difference (MID) for the Malay-ECOHIS. A sample of 158 preschool children with ECC awaiting dental treatment under GA was recruited over an 8-month period. Parents self-completed the Malay-ECOHIS before and 4weeks after their child's dental treatment. At 4weeks follow-up, parents also responded to a global health transition judgement item. Data were analysed using independent and paired samples t tests, ANOVA and Pearson correlation coefficients. The response rate was 87.3%. The final sample comprised 76 male (55.1%) and 62 female (44.9%) preschool children with mean age of 4.5 (SD=1.0) years. Following treatment, there were significant reductions in mean scores for total Malay-ECOHIS, child impact section (CIS), family impact section (FIS) and all domains, respectively (P<0.001). The effect size (ES) for the Malay-ECOHIS was +1.0; across the domains, it ranged from +0.4 to +1.9. There was a weak, positive correlation for Malay-ECOHIS change scores (r=0.165) and CIS change scores (r=0.175) with the number of decayed teeth (dt), respectively. Similar correlation was also observed between Malay-ECOHIS change scores and the number of extracted teeth (r=0.129). Based on the global health transition judgement, 62.3% of parents reported their child's oral condition to be "a little improved" while 37.7% reported it to be "much improved" following treatment, with Malay-ECOHIS mean change scores of 6.7 (ES=+1.1) and 9.6 (ES=+1.2), respectively. There was an observed gradient in the Malay-ECOHIS change scores and ES in relation to parents' perception of their child's oral health improvement after treatment, supporting the responsiveness of the measure. The Malay-ECOHIS MID was found to be 7 scale points. The Malay-ECOHIS is empirically shown to be sensitive and responsiveness to dental treatment of ECC under GA.

Acid-resistant genes of oral plaque microbiome from the functional metagenomics

ABSTRACT Acid resistance is one of key properties assisting the survival of cariogenic bacteria in a dental caries environment, but only a few genes conferring acid resistance have been identified to data. Functional metagenomics provides a systematic method for investigating commensal DNA to identify genes that encode target functions. Here, the host strain Escherichia coli DH10B and a constructed bidirectional transcription vector pSKII+-lacZ contributed to the construction of a metagenomic library, and 46.6 Mb of metagenomic DNA was cloned from carious supragingival plaque of 8children along with screening for lethal functionality. The screen identified 2 positive clones that exhibited a similar aciduric phenotype to that of the positive controls. Bioinformatic analysis revealed that these two genes encoded an ATP/GTP-binding protein and a malate dehydrogenase. Moreover, we also performed functional screening of Streptococcus mutans, since it is one of the predominant cariogenic strains but was not identified in our initial screening. Five positive clones were retrieved. In conclusion, our improved functional metagenomics screening method helped in the identification of important acid resistance genes, thereby providing new insights into the mechanism underlying caries formation as well as in the prevention and treatment of early childhood caries (ECC).

Barriers in the Treatment of Early Childhood Caries amongst the General Dentists - A Cross Sectional Study in Bhubaneswar, Odisha, India

Objective: To find out the barriers in treating Early Childhood Caries in children by general dentists. Material and Methods: A cross sectional descriptive study was undertaken among fifty general dentists in Bhubaneswar, Odisha, India, following a simple random sampling. Each selected candidate was given a barrier in childhood caries treatment (BaCCT) questionnaire. Descriptive statistics were used to calculate the absolute and relative frequencies, mean, median and standard deviation. Results: The general dentists exhibited quite a few barriers in providing treatment for Early Childhood Caries. The children don’t like to sit on dental chair (74%), they don’t like the sound of drill (78%) and they are fearful of dental treatment (86%). Providing care for children can be stressful and troublesome for the dentist (80%) and that they feel time constrained, i.e they do not spend much time with children (70%). Training in the field of management of child behaviour enhances their ability to handle early childhood caries. Conclusion: The general dentists should be given proper training in handling children in their curriculum or through continuing education programmes so that they can act as a larger workforce to be able to treat Early Childhood Caries effectively and efficiently for the benefit of society.