ECC and Rampant Caries.3rdYear
ECC and Rampant Caries.3rdYear
ECC and Rampant Caries.3rdYear
Chai HH, Gao SS, Chen KJ, Duangthip D, Lo ECM, Chu CH. A Kindergarten-Based Oral Health
Preventive Approach for Hong Kong Preschool Children. Healthcare. 2020; 8(4):545.
https://doi.org/10.3390/healthcare8040545
Early Childhood Caries
La mélanodontie infantile
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Early Childhood Caries
•Studies have reported that early childhood caries have adverse effects
on the quality of life of children, as well as causing sleep disorders and
concentration problems.
Early Childhood
Caries
• EEC is typical for children in the 0-
3 age group and follows a
particular path.
• Primarily, the upper jaw begins in
the gingival triple part of the
labial face of the anterior teeth.
The initial lesion appears as a
white decalcification band along
the gingiva or is consistent with
plaque distribution on the
occlusal surface.
•If left untreated, the lower and upper first molars are also
affected. Caries in molars start from the pit and fissure areas
Early or the gingival area of the buccal surface.
•Caries can develop in the pits and fissures of the primary
Childhood molars and the approximal surfaces of the teeth with contact.
Caries •Canine and second molar teeth are less affected because
during the period these teeth are erupting, the child usually
quits the feeding bottle and sucking habit. The front teeth of
the lower jaw are not affected by ECC due to the cleansing
effect of the tongue.
Developmental Stages of ECC
Alshammar A, Almukrin A. Parental perceptions and acceptance of silver diamine fluoride treatment in Kingdom of Saudi Arabia. Int J Health Sci 2019; 13(2):25-29.
• The conventional approach to addressing early
childhood caries involves restoring the affected
tooth's function and appearance through fillings
after eliminating all infected tissues.
• Early childhood caries (ECC) frequently occurs in
Treatment families with lower educational attainment, and
delayed detection often necessitates more
of Early complex treatment procedures.
Childhood • Young children often face significant challenges
when it comes to adapting to lengthy and
Caries complex dental procedures. These challenges
often necessitate costly interventions like
general anesthesia and sedation. Furthermore,
studies have shown that approximately 50% of
children treated under general anesthesia
develop new instances of caries post-treatment.
Prevention and
Treatment of Early
Childhood Caries
Restorative Treatments
• Early childhood caries (ECC)
management in children varies
depending on factors such as the
severity of the lesions, the child's
age, behavioral characteristics, and
the level of parental cooperation.
• Left untreated, ECC can lead to
complications, including abscess
formation, pain, and malocclusion.
• Therefore, early intervention and
appropriate treatment are crucial to
prevent these adverse outcomes.
Treatment of Early Childhood
Caries
Restorative Treatments
• Restorative treatment for teeth affected by early childhood caries (ECC)
typically involves filling decayed teeth. In more severe cases, extraction
of decayed teeth may be necessary.
• However, even after these treatments, secondary caries and new decay
can develop in the restored teeth if the child's oral care is inadequate.
• The rate of recurrence within a year following dental treatment has been
reported to be as high as 40%. Therefore, minimal restorative procedures
should be pursued whenever possible in cases requiring treatment.
• For non-cooperative children, dental treatment may need to be
performed under sedation or general anesthesia to ensure safety and
effectiveness.
Treatment of Early Childhood Caries
Treatment of Early Childhood Caries
Restorative Treatments
• Achieving painless treatment for caries is paramount during the initial dental appointment
for pediatric patients. Various treatment options are available, including:
1.Compomer/composite restorations: These tooth-colored materials are commonly used for
restoring decayed teeth, providing both aesthetic appeal and functional restoration.
2.Glass ionomer restorations: These restorations release fluoride and are often used in
primary teeth due to their ability to bond to the tooth structure and release fluoride, aiding
in caries prevention.
3.Stainless steel crowns: These crowns are durable and commonly used for restoring
extensively decayed primary teeth, providing long-term protection and functionality.
4.Zirconia prefabricated crowns: They are esthetically pleasing and durable, making them
suitable for restoring primary teeth with extensive decay or structural damage.
5.Space maintainer applications: These devices help preserve space in the dental arch
following premature loss of primary teeth, preventing misalignment of permanent teeth.
Treatment of Early Childhood Caries
Treatment of Early Childhood Caries
Restorative Treatments
Total coronal restoration of primary incisors is required when:
•When caries are found on many surfaces
•When the incisal edge is involved in caries
•When there is advanced cervical decalcification
•When pulp treatments are required
•When the decay is small but oral hygiene is poor (in high-risk patients)
•Where the child's behavior makes it challenging to perform a Class II
restoration
Treatment of Early Childhood Caries
Treatment of Early Childhood Caries
Treatment of Early Childhood Caries
Treatment of Early Childhood Caries
Restorative Treatments:
• Crowns applied to teeth reduce the number of surfaces at risk of
secondary caries formation, decreasing the need for retreatment over
time compared to other treatment options.
• While crown restorations offer good aesthetics, their application is
challenging due to the required time and patient cooperation. This
makes them less satisfactory for families with high aesthetic
expectations.
• Despite various treatments, secondary or new caries may still be
observed during children's 6-month to 1-year follow-up visits.
• Therefore, it is essential not only to address the symptoms of the disease
but also to prioritize oral hygiene to prevent further decay and maintain
dental health.
Rampant Caries
Rampant caries are characterized by:
• sudden onset
• affecting multiple teeth simultaneously and