Early Childhood Caries (ECC)
• Definition:
The presence of 1 or more decayed
(cavitated / non-cavitated), missing (due to caries) or filled tooth surface in any primary tooth in a child 71 months of age or younger.
Severe early childhood caries (S-ECC)
Severe early childhood caries (S-ECC)
• Any sign of smooth surface caries in a child younger than 3 years of age
• A dmf score of ≥ 4 in a 3 year old
• “ “ “ “ ≥ 5 in a 4 year old
• “ “ “ “ ≥ 6 in a 5 year old
Early Childhood Caries (ECC)
Risk factors:
Risk factors:
- Frequent nocturnal bottle feeding
- Breast feeding on demand (non-nutritive)
- Poor feeding / snacking habits
- Poor oral hygiene habits
- Chronically ill children on sweetened syrup medications
What is rampant caries?
• In older children and young adults
• Carious lesion of acute onset, involving many or all erupted teeth, rapidly destroying coronal tissue, often on surfaces normally immune to decay, and leading to early involvement of the dental pulp
Aetiology of rampant caries
Aetiology
Poor dietary/snacking habits
-Poor oral hygiene
-Following irradiation, due to reduced saliva productn
-Xerostomia - salivary gland aplasia,
Sjogren’s syndrome, sarcoidosis
Consequences of rampant caries
Consequences
• Lost school hours
• Lost work hours (for parents)
• Early loss of teeth - malocclusion If not treated,
• can lead to poor aesthetics, inability to eat properly
Management of rampant caries
• Early recognition
• Preventive measures: first give dietary chart
• Diet modification
For prevent measures what can be done?
• OH, prophylaxis
Preventive measures
Tilt the brush at a 45° angle against the gum line and sweep or roll the brush away from the gumline.
Gently brush the outside, inside and chewing surface of each tooth using
short back - and - forthstrokes .
Gently brush your tongue to remove bacteria and freshen-breath.
Other preventive measures
Fissure sealants
Fluoride therapy
For management what do you do?
• Emergency treatment - if required??
• Definitive treatment - anterior & posterior resin restorations
Pulp therapy, SSC or preformed metal crowns, resin crowns for ant teeth
Space maintainer
• Saliva stimulants - Pilocarpine 5mg qid,
————-Cevimeline 30mg tid
• Saliva substitutes - Carboxymethyl
cellulose (0.5% aqueous soln)
• Topical fluoride concentrate - Neutral
NaFl gel 1.1% (Prevident); Stannous Fl
0.4% (Gel-Kam) - brush on for 2 mins and expectorate.
What do you do at regular appointments?
• reinforce OH mea s u r e s ,
• review dietary habits,
• review restorations,
• monitor closely
