Management of Early Childhood Caries – a comparison of different approaches
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Published:
Jun 30, 2017
Keywords:
Early childhood caries ECC Primary dentition Management of Early Childhood Caries Review of Early Childhood Caries
Main Article Content
Abstract
Early childhood caries (ECC) is a major problem in the South East Asian (SEA) region. The management of ECC in preschool children is multi-faceted and can be challenging for the child, the dental team, and the family. There is only limited evidence for the use of specific techniques in the management of ECC. The objective of this paper is to review different treatment approaches in the management of ECC. Method: a critical review of the literature was conducted in order to examine evidence for the best techniques to manage ECC. Results: three treatment approaches were examined (1) the ‘no treatment’ approach, (2) the ‘minimally invasive dentistry’ (MID) approach, and (3) the ‘conventional’ approach. Treatment of carious lesions in the primary dentition is well-justified and results in improvements in Quality-of-Life. Recommendations for conventional treatment techniques vary widely and often require general anaesthetic to be predictable for preschool children who may have difficulty accepting treatment. The minimally invasive approach appears to be promising and centres around the use of Atraumatic Restorative Technique (ART), Arrest of Caries Treatment (ACT) with silver diamine fluoride, and the Hall crown technique. Early intervention to treat early lesions and prevent caries is very important. It can be concluded that the Minimally Invasive Dentistry (MID) approach to managing ECC appears to be the most appropriate public health approach for managing ECC in the SEA region. It would be beneficial to build more evidence around this approach in order to inform the practice of caries management in preschool children.
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1.
J Turton B, Durward CS. Management of Early Childhood Caries – a comparison of different approaches. Th Dent PH J [Internet]. 2017 Jun. 30 [cited 2024 Nov. 23];22(พิเศษ):62-77. Available from: https://he02.tci-thaijo.org/index.php/ThDPHJo/article/view/149621
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References
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6. Evans RW, Dennison PJ. The Caries Management System: an evidence-based preventive strategy for dental practitioners. Application for children and adolescents. Aust Dent J. 2009;54(4):381–9.
7. Milsom KM, Tickle M, King D. Does the dental profession know how to care for the primary dentition? Br Dent J. 2003;195(6):301–3.
8. Mejàre IA, Klingberg G, Mowafi FK, Stecksén-Blicks C, Twetman SHA, Tranæus SH. A systematic map of systematic reviews in pediatric dentistry—what do we really know? PLoS ONE [Internet]. 2015 Feb 23 [cited 2015 Jun 4];10(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4338212/
9. Lingard GL, Drummond BK, Esson IA, Marshall DW, Durward CS, Wright FA. The provision of dental treatment for children under general anaesthesia. N Z Dent J. 2008;104(1):10–8.
10. Rashewsky S, Parameswaran A, Sloane C, Ferguson F, Epstein R. Time and cost analysis: pediatric dental rehabilitation with general anesthesia in the office and the hospital settings. Anesth Prog. 2012;59(4):147–53.
11. Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: the human and economic cost of early childhood caries. J Am Dent Assoc. 2009;140(6):650–7.
12. Khanh LN, Ivey SL, Sokal-Gutierrez K, Barkan H, Ngo KM, Hoang HT, et al. Early childhood caries, mouth pain, and nutritional threats in Vietnam. Am J Public Health. 2015 Oct 15;e1–8.
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15. Ferraz NKL, Nogueira LC, Pinheiro MLP, Marques LS, Ramos-Jorge ML, Ramos-Jorge J. Clinical consequences of untreated dental caries and toothache in preschool children. Pediatr Dent. 2014;36(5):389–92.
16. Levine RS, Pitts NB, Nugent ZJ. The fate of 1,587 unrestored carious deciduous teeth: a retrospective general dental practice based study from northern England. Br Dent J. 2002;193(2):99–103.
17. Oliveira LB, Sheiham A, Bönecker M. Exploring the association of dental caries with social factors and nutritional status in Brazilian preschool children. Eur J Oral Sci. 2008;116(1):37–43.
18. Malek Mohammadi T, Hossienian Z, Bakhteyar M. The association of body mass index with dental caries in an Iranian sample of children. J Oral Health Oral Epidemiol [Internet]. 2015 [cited 2016 Aug 4]; Available from: https://eprints.kmu.ac.ir/21468/
19. Finucane D. Rationale for restoration of carious primary teeth: a review. Eur Arch Paediatr Dent. 2012;13(6):281–92.
20. Laing E, Ashley P, Naini FB, Gill DS. Space maintenance. Int J Paediatr Dent. 2009;19(3):155–62.
21. Broder HL. Children’s oral health-related quality of life. Community Dent Oral Epidemiol. 2007;35(s1):5–7.
22. Arrow P, Klobas E. Minimum intervention dentistry approach to managing early childhood caries: a randomized control trial. Community Dent Oral Epidemiol. 2015; 43:511-20.
23. Featherstone JDB. Remineralization, the natural caries repair process—the need for new approaches. Adv Dent Res. 2009;21(1):4–7.
24. Featherstone JD. Caries prevention and reversal based on the caries balance. Pediatr Dent. 2006;28(2):128–32.
25. Gao X, Lo ECM, Kot SCC, Chan KCW. Motivational interviewing in improving oral health: a systematic review of randomized controlled trials. J Periodontol. 2014;85(3):426–37.
26. Harrison R, Benton T, Everson-Stewart S, Weinstein P. Effect of motivational interviewing on rates of early childhood caries: a randomized trial. Pediatr Dent. 2007 Jan 1;29(1):16–22.
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