Early Childhood Caries

1. EarlyChildhoodCaries By: Jasmine, Kourtni, and Tracy

2. What is ECC? • Nursing bottle caries/Baby bottle tooth decay • It is “defined as the presence of one or more decayed (that is cavitated or noncavitated lesions), missing (due to caries), or filled surfaces in any primary tooth in a child age 6 or younger”

3. What is ECC? • It is a highly transmissible infectious disease • It can easily be spread from the mother or caregiver to the child from saliva exchange • Ex) sharing the same spoon, cup, or even kissing on the mouth

4. Some causes of ECC • Children who snack frequently throughout the day • Going to sleep with a bottle containing anything other than water will greatly increase their risk for caries

5. Early Childhood Caries • Most prevalent childhood disease in the U.S. • 5 times more common than asthma • 7 times more common than hay fever • Caries rate among preschoolers has increased to 28%

6. Early Childhood Caries • More common in children from low socio-economic groups • Associated with pregnant mothers who have periodontal disease or high levels of S.mutans • Eating habits with a high rate of sugar consumption

7. How ECC affects the child • It can affect a child’s speech if it is severe or if some teeth have been removed because of caries • Their ability to eat certain foods • May be painful • Can affect their self-esteem

8. How ECC affects the child • Dental treatment can be a frightening experience for children with severe caries • Some treatments may include teeth extraction

9. Prevention of ECC • Healthy Diet • Fluorides • Oral Hygiene • Sealants • Increase Saliva flow • Xylitol • Antibacterial Mouthrinses • Only for children who can rinses and spit

10. Educating Parents and Children • Establish good eating habits and oral hygiene during pregnancy • Start cleaning the child’s teeth after the first eruption • Watch the child brush their teeth

11. Some Risk Factors: Oral Hygiene • Do not know proper techniques • Parents do not monitor • Parents do not help

12. Diet • Foods/drinkshigh in sugar • Constantly having juice/soda • Not keeping the neutral pH in mouth • Starches are hydrolyzed by salivary amylase • Bacteria-producing acid • demineralization

13. Bottle Feeding vs. Breast Feeding • Breast fed children had lower risks of ECC • Breast milk is less likely to cause decay • Baby has to suck milk • Bottles worse (even formula) • Bottles easily leak

14. Sleeping Practices • Have baby bottle through night • Almost no salivary flow during sleep • Constant sugar attacks • Liquid pools in mouth • Use as pacifiers • Higher Risk

15. Fluoride Use • Do not use fluoridated toothpaste • Drinking water not fluoridated • No fluoride supplements

16. Visible Plaque • Form thin sticky biofilm • Utilize sugars and carbs to produce acid • Tend to demineralize tooth enamel • Causing tooth decay

17. White Spot Lesions • Initial stage • Reversible • If visible demineralization is occurring • If environment stays acidic area becomes larger • Can lead to small cavity • Continues to grow if nothing done

18. Special Health Needs • May cause limitations in daily maintenance • Have higher risk of vomiting from Gastro Reflux • Some rely on caregiver for oral hygiene • Common to have dry mouth

19. Low Socio-Economic Status • Transportation • Don’t have money for care • Have no insurance • Low income families have higher risk

20. Mothers Who have….. • Carious teeth • High s. mutanslevels • High rate of sugar consumption • Spread from mom to baby

21. Racial/Ethnic Minorities • Language barriers • Racial discrimination • Attitudes different towards • African Americans/Hispanics

22. Public Health Insurance • Harder access to care • Medicaid • More at risk than children with private insurance • Getting Appointments • Long waits

23. Prevention of ECC • Dental health education is one of the most important ways to prevent early childhood caries. • Parents who have more knowledge about their own oral hygiene, can help to prevent early childhood caries from ever happening to their children.

24. Fluoride Prevention

25. General anesthesia in the treatment of eCC • Since children with ECC are very young and the treatment of their teeth is very difficult, restorative treatment can be provided in an operating room with general anesthesia. • The AAPD approves the use of anesthesia for use in ECC. • It can be helpful for children who are very young, afraid of the dentist, uncooperative, anxious, or for children that might have special needs.

26. Is caries management simple????

27. Ways to Improve Parent/Patient Education • Determine who in the practice is engaging in parent education and make sure all dental professionals are engaging in parent/caregiver and patient education • Make sure all dentists are using the same educational material for patients or parents • Make sure your materials are up-to-date • When trying to explain information to a patient or parent, start by saying why it is necessary.

28. Take Home Messages-Prenatal • Baby teeth are important!!! • Parent’s oral health affects the baby’s oral health. • Parent’s should obtain regular dental check-ups and get treatment if necessary. • Schedule the child’s first dental appointment by age one. • Use fluorides, including brushing the teeth with a fluoride toothpaste, it is the MOST effective way to prevent tooth decay!

29. Take Home Messages-Birth to Age 1 • AGAIN! Baby teeth are important!!! • Parent’s should avoid sharing with their child things that have been in their mouths. • Prevention is less costly than treatment.

31. Take Home Messages- Ages 2 to 6 • Exactly the same as Prenatal through Age 1! • BABY TEETH ARE IMPORTANT! • USE FLUORIDES, INCLUDING BRUSHING THE TEETH WITH A FLUORIDE TOOTHPASTE, IT IS THE MOST EFFECTIVE WAY TO PREVENT TOOTH DECAY!

32. Conclusion: • Caries in young children need to be stopped as soon as they can and parents, as well as the child, need to understand how important their primary teeth really are. • ECC is preventable through education on what it actually is, what the risk factors for ECC are, and by patient and parent education on prevention.

33. References: • AmmariJumana B., Ashley Paul F., and BaqainZaid H. “Effects of Programs for Prevention of Early Childhood Caries.” Medical Principles and Practice. 2007. Web. 10 Nov. 2012. • “Caries Risk.” Protecting All Children’s Teeth. 2011. American Academy of Pediatrics. 24 October 2012 http://www2.aap.org/oralhealth/pact/ch7_sect2.cfm • Long, Marshall C., Rocio B. Quinonez, Heather A. Bell, Kelly Close, Larry P. Myers, William F. Vann Jr., and Gary R. Rozier “Pediatricians’ assessments of caries risk and need for a dental evaluation in preschool aged children” BMC Pediatric 12 (2012) 49. • Marrs, Jo-ann, Sharon Trumbley, and Gaurav Malik. " Early Childhood Caries: Determining the risk factors and assessing the prevention strategies for nursing intervention." Pediatric Nursing. 37.1 (2011): 9-15. Web. Nov. 2012. • Mofidi, Mahyar, Gary R. Rozier, and Rebecca S. King. „Problems with assess to Dental Care for Medicaid-Insured Children: What Caregivers Think.” American Journal of Public Health. 92 (2002) 53-58. • O. Harris, Norman, Franklin Garcia-Godoy, and Christine Nielsen Nathe. Primary Preventative Dentistry. New Jersey: Pearson Education Inc., 2009. Print. • Pantley, Elizabeth. “Baby Bottle Tooth Decay.” Pediatrics For Parents. 2012. Pediatric For Parents Inc.. 14 Novemeber 2005. http://www.pedsforparents.com/articles/2702.shtml • Ramas-Gomez, Francisco, Yasmi Crystal, Man Wai Ng, John Featherstone, and Norman Tinanoff. "Caries risk assessment, prevention, and management in pediatric dental care." General Dentistry. 58.6 (2010): 505-17. Print. Nov 2010. • Southward, Linda H., Angela Robertson, Burton L. Edelstein, Heather Hanna, Elisabeth Wells-Parker, Dorris H. Baggett, Neva P. Eklund, James J. Crall, Stephen L. Silberman, and David R. Parrish “Oral Health of Young Children in Mississippi Delta Child Care Centers: A Second Look at Early Childhood Caries Risk Assessment.” American Association of Public Health Dentistry 68 (2008) 188-195. • “Tooth Decay.” National Dental Centre. 2012. Sing Health. 14 Novemeber 2012. http://www.ndc.com.sg/ForPatientsAndVisitors/ConditionsAndTreatments/Glossary/Pages/ToothDecay.aspx • Warren, John, Karin Weber-Gasparoni, Teresa A. Marshall, David R. Drake, FaridehDehkordi-Vakil, Justine L. Kolker, and Deborah V. Dawson “Factors Associated with Dental Caries Experience in 1 Year-Old Children.” American Association of Public Health Dentistry 68 (2008): 70-75. • “What are the causes of Early Childhood Caries?.” Health Community. YGOY. 14 Novemeber 2012. http://dentalproblems.ygoy.com/2010/12/05/what-are-the-causes-of-early-childhood-caries/ • Vogell Susan L., “General Anesthesia in the Treatment of Early Childhood Caries.” Dimensions of Dental Hygiene. 2012 October. Print.