Early Childhood Caries (ECC)

Happy Wednesday,

Today we are going to talk about early childhood cavities. Some parents may ask why baby teeth are important.
They are important because:
1) children use them for chewing, talking and let’s not forget cute smile.
2) If they develop cavities, they would hurt. If cavities are ignored, they would hurt very badly and according to an article published in  journal of CDA volume 78 : “Dental infections have been implicated as the cause in multiple cases of brain abscesses and the recent death of a child in Boston.”
3) If they are lost prematurely due to neglect, adult teeth would lose their guidance to where to come-in. Hence causing future need for orthodontic treatment to bring them back to their rightful places.

Canadian Dental Association’s position on ECC is, according to CDA Board of Directors approved in April 2010 is:
” CDA encourages dental assessments of infants within 6 months of eruption of the first tooth and no later than 1 year of age. At the first dental visit, the infant’s risk of caries should be assessed and discussed with a parent or caregiver.”

Risk factors are, again from CDA:
” 1) The child lives in an area with a non-fluoridated water supply or low (<0.3 parts per million) natural fluoride levels. ( Contact the municipal government to determine if drinking water is fluoridated.)

2)The child has a visible defect, notch, cavity or white chalky area on a baby tooth in the front of the mouth.
3) The child regularly consumes sugar (even natural sugars) between meals. This includes use of a bottle or sippy cup filled with any liquid other than water and consumption of sweetened medications.
4) The child has special health care needs that limit his or her cooperative abilities, thus making it difficult for the parent to brush the child’s teeth.
5) The child’s teeth are brushed less often than once a day.
6) The child was born prematurely with a very low birth weight of less than 1500 grams (3 pounds).
7) The parent or caregiver has tooth decay.
8) The child has visible plaque, such as white or yellow deposits on the teeth.”

CDA continues:
” At the first dental visit…appropriate preventive interventions need to be planned to take into account any social challenges that the family may be experiencing and must be culturally appropriate…Dentists should recognize the importance of a first dental visit by 12 months of age.”

Now: ” CDA position on use of fluorides in caries prevention: Fluoridated toothpastes should be used twice a day to brush teeth. Early commencement of tooth brushing has been associated with lack of colonization by the bacteria that are primarily responsible for cavities. Because young children tend to swallow toothpaste when they are brushing, which may increase their exposure to fluoride, the following guidelines have been established to moderate their risk of developing dental fluorosis while optimizing the benefits of fluoride.

Children from birth to 3 years of age should have their teeth an gums brushed by an adult. The use of fluoridated toothpaste in this age group is determined by the level of risk. Parents should consult a health professional to determine a child up to 3 years of age is at risk of developing tooth decay. If such a risk exists, the child’s teeth should be brushed by an adult using a minimal amount (a portion the size of a grain of rice) of the fluoridated toothpaste. Use of fluoridated toothpaste in a small amount has been betermined to achievee a balance between the benefits of fluoride and the risk of dveloping fluorosis. If the child is not considered to be at risk, the teeth should be brushed by an adult using a toothbrush moistened only with water.

Early childhood tooth decay can be painful, may cause infection and is difficult and expensive to treat. Therefore, by a child’s first birthday, the parents should consult a health professional knowledgeable in the areas of early childhood decay and the benefits of fluoride. This health professional will help to determine the child’s risk of developing tooth decay and whether there would be a benefit of brushing with a minimal amount (a portion the size of a grain of rice) of fluoridated toothpaste before the age of 3 years.

Children from 3 to 6 years of age should be assisted by an adult in brushing their teeth. Only a small amount (a portion the size of a green pea) of fluoridated toothpaste should be used. All children should be supervised or assisted until they develop appropriate manual dexterity. Fluoride mouth rinses are an effective preventive measure for at risk individuals and should be used according to the specific needs of the individual. Fluoride mouth rinsing is not recommended for children under 6 years if age.”

Well you heard it from Canadian Dental Association.
I hope this helps.
To be continued…

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