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Early Childhood Caries
Formerly referred to as baby bottle caries, currently is diagnosed as one or more caries or missing primary teeth in children under 6 years of age. The factors are feeding frequency, timing, tooth brushing and oral care behaviors, but risk factors can be listed as parent-caregiver socioeconomic level-education level, host factors (chronic diseases, medication use, special care needs, immune system, dental structure-development anomalies). In the development of early childhood caries, nutritional behaviors include frequent, on-demand or night-time breastfeeding, which continues after the teeth begin to erupt into the mouth, or bottle use, and long-term consumption of beverages containing sugar in the bottle (cow's milk - milk sugar is present), fruit juice, and sugar-added drinks. Not starting tooth brushing even after the teeth come out and supplementary food is started is a common mistake.
When early childhood caries are detected, it is essential to regulate the nutrition and oral hygiene regime, which are the main factors. Feeding behaviors such as night feeding and feeding on demand, feeding the bottle immediately before going to bed and putting the child to sleep should be corrected. Even if feeding is done before sleep, teeth should be brushed and put to sleep, and breastfeeding should not be on demand. Tooth brushing should start after the baby teeth erupt into the mouth, teeth should be brushed twice a day, and fluoride children's toothpaste should be used by the parent in small amounts by wiping the residue from the mouth after brushing.
Early childhood caries may not be noticed in the teeth at an early stage without careful examination by a trained eye. Since it is one of the most common diseases of children in our country and in the world, the subject of the first examination in pediatric dentistry mainly includes identifying caries risk factors and informing parents about nutrition and oral hygiene. Therefore, the first child dental examination should be performed until the age of 1, after the first primary tooth has erupted.
How is early childhood caries treated?
It is not possible to give general age limits to forsee compliance because cognitive and social development is not completed in the age group where early childhood caries are seen and dental treatment needs varies widely among children. However, children who have a short attention span, fear of strangers, do not allow interference with their physical integrity, and cannot cooperate with a strange adult are not good candidates for conscious interventions.
Depending on the severity of the cases, parents and physicians may decide to postpone the treatment with additional care products that will slow down the rate of caries progression in early stage caries. Fillings, crowns (hall technique, zircon, prefabricated stainless steel crowns), primary tooth canal treatments (pulp coatings, amputations, root canal treatments) can be applied to children who can comply with conscious treatment. Children who are consciously unable to have dental treatments in the clinic despite needing treatment can be treated for early childhood caries under general anesthesia.
