Presentation on theme: "Dr Salome K. Ireri BDS, MSc, MCLinDent, PhD Kenyatta National Hospital."— Presentation transcript:
Dr Salome K. Ireri BDS, MSc, MCLinDent, PhD Kenyatta National Hospital
Severe decay in the teeth of infants or young children (preschool-age).. child between birth and 71 months of age.decayteethinfants children Also known as baby bottle caries, baby bottle tooth decay /nursing bottle tooth decay "Severe Early Childhood Caries" refers to "rampant" patterns of dental caries.
ECC is a significant public health problem Afflicts predominantly disadvantaged children in developed countries In Kenya –both disadvantaged & those not disadvantaged.
frequent consumption of foods containing fermentable carbohydrates (e.g., juice, milk, formula, soda) due to prolonged contact between sugars and cariogenic bacteria on the teeth. fermentablecarbohydratesjuicemilk formulasodasugarsbacteria Dental caries is preventable
Early colonization by Streptococcus mutans is a major risk factor for ECC and future dental caries.
Prevention Comprehensive program of counselling- preventing or delaying maternal transmission Oral hygiene instructions -as soon as 1 st primary tooth erupts brush X2 by parents, soft brush etc Early dental consultation-6 months -caries risk assessment, parental education including anticipatory guidance for prevention
Avoiding frequent consumption of foods/drinks containing sugar Infants should not be put to sleep with a bottle or breast in mouth Encourage infants to drink from a cup wean from the bottle between 12 to 18 months of age. Fluoride treatments Restorative care.
Costly because the cooperative capacity of babies and preschool children: usually necessitates the use of general anaesthesia. Restoration (fillings) and/or surgical removal of teeth with cavities Recommendations regarding feeding habits.
Behaviour management Non-Pharmacological - tell show & do, modelling positive and negative reinforcement, voice control, physical retrain etc Pharmacological -Sedation- (conscious) nitrous oxide, oral, iv -GA- costly and other risk factors
Children are becoming more un cooperative,.. parenting styles, failure of parents to set limits on children's behaviour. Cost of dental care is a barrier to families of lower socio-economic status. A degree of ignorance among the medium-high social class
Primary prevention has largely been restricted to counselling parents about caries; promoting feeding behaviours. Limitation; Relapse rates of approx 40% have been reported within the first year after dental surgery. Topical antimicrobial therapy appears promising- more research needed. Potential for enormous strain on healthcare system and society