Please activate JavaScript!
Please install Adobe Flash Player, click here for download

Dental Tribune Middle East & Africa No. 5, 2016

Fig1.TheclinicalpictureofECCinearly(A)andadvancedstage(B)inapreschoolchild. Dental Tribune Middle East & Africa Edition | 5/2016 24 paediatric Early Childhood Caries A Continuing Epidemic Oral Health Problem in the United Arab Emirates ByDrMawloodKowash,UAE Early Childhood Caries (ECC) is a chronic, transmissible infectious disease affecting the primary (milk) teeth. The etiology of the condition is a combination of factors includ- ing frequent consumption of fer- mentable carbohydrates as liquids, especially when the baby is sleeping, with on-demand breast- or bottle- feeding. Other factors include oral colonization by cariogenic bacteria (especially mutans streptococci), poor oral hygiene and poor parent- ing. It is the most common chronic disease among children. The preva- lenceofECCininfantsandpreschool children has been reported to vary between 3% and 94% world-wide. In United Arab Emirates (UAE) the prevalence is one of the highest and reported to be over 90% in Abu Dhabiemirate.ECCcanresultincon- siderable suffering, pain, disfigure- ment and frequently compromises future (permanent) dentition. This ultimatelyleadstoareductioninthe quality of life of affected children. This paper provides an updated review of ECC covering its defini- tion, aetiology, prevalence, clinical picture, complications and manage- ment and a solution to the continu- ingproblemofECCissuggested. Introduction Cariesordentaldecayinchildrenhas beenknowntoexistformanycentu- ries [1]. Early Childhood Caries (ECC) is a chronic, transmissible infectious disease affecting the primary (milk) teeth. It is defined as the presence of one or more decayed, filled or miss- ing tooth surfaces in any primary tooth in a child 71 months of age or younger [2,3]. It can result in consid- erable suffering, pain, reduction of quality of life of affected children and disfigurement and frequently can compromise their future denti- tion. The etiology of the condition is acombinationoffrequentconsump- tion of fermentable carbohydrates as liquids, especially at night, with on-demandbreast-orbottle-feeding, oral colonization by cariogenic bac- teria (especially mutans streptococ- ci)andpoororalhygiene[4]. In most cases, the aetiology will be a combination of several of these factors. The prevalence has been reported to vary worldwide. Higher prevalence has occurred in children from lower socio-economic status families,migrantsandethnicminor- itypopulations[5]. In the United Arab Emirates (UAE), ECC is the most common childhood disease. The prevalence of ECC in the UAE has been reported as 93.8% in 5-year-oldchildren[6]. Prevention of ECC can be achieved by the education of prospective and new parents, as well as by the iden- tification of 'high risk' children [7]. Strategies have focused on the indi- vidual mother and child by prevent- ing transfer of cariogenic bacteria frommothertoherinfant,usingpre- ventive agents such as fluoride and teaching good oral hygiene practices [8]. Community-based approaches havebeenattempted.Anexampleof a successful program was reported by Kowash et al [9] which investi- gated the effect of dental health edu- cation provided by trained, non pro- fessionals (not dentists) carrying out regularhomevisitsinalowsocioeco- nomic high-caries area in Leeds, UK. The study was able to demonstrate a significantly reduced occurrence of ECCafterthreeyears. The treatment of ECC is very costly, time consuming and in most cases, requires full dental rehabilitation under general anaesthesia by a pae- diatric dentist. Unfortunately, in many countries, even in the devel- oped world, these carious teeth end upbeingextracted. This paper provides an updated ev- idence-based review of ECC. The lit- erature in regards to ECC definition and terminology, aetiology, preva- lence, clinical picture and manage- ment is discussed. A solution to the continuing problem of ECC is sug- gested. Definition and Terminology ofECC ECC has been defined as “the pres- ence of one or more decayed (non- cavitated or cavitated lesions), miss- ing (due to caries) or filled tooth surfaces” in any primary tooth in a child 71 months of age or younger [2,3]. In children younger than 3 years of age, any sign of smooth- surface caries is indicative of severe early childhood caries (S-ECC). From ages three through five, one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth or a de- ÿPage 25 KaVo PrimusTM 1058Life KaVo Dental GmbH · D 88400 Biberach/Riß · Telephone +49 7351 56-0 · Fax +49 7351 56-1488 · www.kavo.com Designed with passion. Engineered with precision. Built with perfection. Discover the new Primus 1058 Life Andreas Schweiger, Director Research and Development The Primus 1058 has been the synonym for quality and reliability in the dental world for over 15 years. Conse- quently, our development team has passionately designed the new Primus 1058 Life around these core values whilst adding a significant number of improvements and innovations including: • NEW intuitive dentist element • NEW optimised ergonomics • NEW contemporary design • NEW AC chair motor For More Information: go.kavo.com/MEA 2305_TU-Anzeige_DE.indd 1 23/05/16 13:13 KaVo Dental GmbH · D 88400 Biberach/Riß · Telephone +49735156-0 · Fax +49735156-1488 · www.kavo.com 2305_TU-Anzeige_DE.indd 123/05/1613:13

Pages Overview