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Early Childhood Caries

Early Childhood Caries. Deb Fancher, RN, s-FNP. Who? WHO? A merican Indians (AI) Alaska Natives (AN) Children in these populations < 6 years old. What?. Early Childhood Caries (ECC) Severe Early Childhood Caries (S-ECC)

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Early Childhood Caries

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  1. Early Childhood Caries Deb Fancher, RN, s-FNP

  2. Who?WHO?American Indians (AI)Alaska Natives (AN)Children in these populations < 6 years old

  3. What? • Early Childhood Caries (ECC) • Severe Early Childhood Caries (S-ECC) Some require general anesthesia to rehabilitate: restorations or extractions (Schroth, r. et al, 2009)

  4. Where? Rural and remote indigenous citizens Alaskan native populations American Indian populations

  5. When? 1999 Indian Health Services Survey 2663 AI-AN preschool children examined 79% ECC (Schroth,R. et al, 2009) WWII: sucrose largely unavailable, caries decreased in all populations (YoungDentist, date unavail.)

  6. Multifactorial Access to dental care (geographical isol.) Socioeconomic status Increased intake sucrose Incidence of caries has increased at about same rate as rising sucrose consumption (YoungDentist, date unavail.) Why?

  7. Why? (cont) • Oral health literacy • Oral hygeine • Environmental factors • Fluoride exposure • Water fluoridation • Community support Social determinants—critical role in susceptibility (Schroth, R. et al, 2009)

  8. How Much? • 2-4 y.o. 5 x general population • Untreated caries 3 x general population Minor percentage access dental care offered by Indian Health Services (HIS) (Schroth, R. et al., 2009)

  9. How does this relate to us? • Holistic • Possible correlation: dental caries and failure to thrive • ECC children with otitis media (OM) Higher incidence of OM • Chewing/eating behaviors • Quality of life: Sleep? Pain? Behavior? (Schroth, R. et al., 2009)

  10. How does this relate to us? (cont.) • Anticipatory Guidance: change behaviour: no baby bottles after age 12 months • Adopt new behavior: regular tooth brushing • Encourage remineralization of tooth enamel—fluoride • Encourage expectant moms in healthy diet and oral hygeine • Voice of leaders within communities will more likely lead to change (Schroth, R.et al., 2009)

  11. Primary Care Providers • Screen • Refer • Encourage dental home by 12 months • Counsel: fluoride interventions, varnish (Crane, M, 2011) • Lobby for greater dental care access in remote regions (Schroth, R. et al, 2009)

  12. References Crane, M. (2011). Improving kids’ teeth their goal. Columbus Dispatch newspaper, May 22, 2011. Schroth, R., Dahl, P., Haque, M., Kliewer, E. (2009). Early childhood caries among Hutterite preschool children in Manitoba, Canada. Rural & Remote Health. 10(4), 1-11. YoungDentist (n.d.). The most common disease that causes loss of teeth-Dental caries part 5. Retrieved June 10, 2011 from http://www.sanedentist.com/the-most-common-disease-that-causes-loss-of-teeth-dental-caries.html.

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