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Early Childhood Caries. By: Jasmine, K ourtni , and Tracy. What is ECC?. Nursing bottle caries/Baby bottle tooth decay
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EarlyChildhoodCaries By: Jasmine, Kourtni, and Tracy
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”
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
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
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%
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
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
How ECC affects the child • Dental treatment can be a frightening experience for children with severe caries • Some treatments may include teeth extraction
Prevention of ECC • Healthy Diet • Fluorides • Oral Hygiene • Sealants • Increase Saliva flow • Xylitol • Antibacterial Mouthrinses • Only for children who can rinses and spit
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
Some Risk Factors: Oral Hygiene • Do not know proper techniques • Parents do not monitor • Parents do not help
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
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
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
Fluoride Use • Do not use fluoridated toothpaste • Drinking water not fluoridated • No fluoride supplements
Visible Plaque • Form thin sticky biofilm • Utilize sugars and carbs to produce acid • Tend to demineralize tooth enamel • Causing tooth decay
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
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
Low Socio-Economic Status • Transportation • Don’t have money for care • Have no insurance • Low income families have higher risk
Mothers Who have….. • Carious teeth • High s. mutanslevels • High rate of sugar consumption • Spread from mom to baby
Racial/Ethnic Minorities • Language barriers • Racial discrimination • Attitudes different towards • African Americans/Hispanics
Public Health Insurance • Harder access to care • Medicaid • More at risk than children with private insurance • Getting Appointments • Long waits
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.
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.
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.
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!
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.
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!
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.
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.