Sunday, October 5, 2008

EARLY CHILDHOOD CARIES

EARLY CHILDHOOD CARIES (ECC):
ECC is a specific form of severe dental caries that affects infants and young children. It is defines as the presence of more than one decayed(n0n-cavitated or cavitated lesions), missing (due to decay), or filled tooth surface in any primary tooth in a child 71months are younger. This was formerly termed as "baby bottle tooth decay" and "nursing bottle caries". Any sign of smooth surface caries in child younger than 3years is indicative of ECC. Between the ages of 3 and 5, severe ECC defined as one or more cavitated missing , missing due to caries or filled smooth surface in primary maxillary teeth or a decayed, missing or filled surface score of greater than 4(age 3) , 5 (age 4). 6(age 5) .
ECC is a result of interaction of the factors involved in other types of dental caries. However the dietary factors include frequent consumption of liquids containing fermentable carbohydrates, particularly through a nursing bottle at sleep times. When taken via nursing bottle the liquids pool around the maxillary incisors and cause rapidly progressive, severe destruction of tooth structure .
The AAPD recommends that infants not to be put to sleep with a bottle and that unrestricted nocturnal breast feeding be avoided after the eruption of the first primary tooth. Parents should encourage the infant the drink from the cup as the infant approaches the first birthday; weaning from the bottle should be done at 12-14months. Oral hygiene measures should be in place at the time of eruption of first primary tooth. The child's first oral health consultation should occur within 6months after the eruption of the first tooth but no later than 12months of age.

DENTAL HOME

The concept of DENTAL HOME originated from MEDICAL HOME. The dental home could increase the oppurtunities for preventive oral health services for children that can reduce disease disparities.
THE MEDICAL HOME CONCEPT
The health care of children of all ages is best managed when there is an established relationship between a practitioner who is familiar with the child and the child's family. The medical home becomes the place where a child receives preventive instruction, immunization, counseling and anticipatory guidance.
HOW A DENTAL HOME WOULD AFFECT CARE:
In 1999, Nowak described the term in relation to the desired recurrence of of preventive oral health supervisory services as propagated by the AMERICAN ACADEMY OF PEDIATRIC DENTISTRY .
CHARACTERISTICS OF THE DENTAL HOME:
Although a dental home most often connotes to be a philosophy embraced by the dental practise. A practise that embraces a child early and continues to follow them periodically through life would be the ideal. The dental home begins in the office of the pediatric dentist and then move to that of a family dentist, once the child has matured and is more comfortable being treated by parents dentist. dental home should also provide a place for children to be treated in case of emergency, where parents can feel comfortable and not to have worry that the management of their child's oral emergencies would be minimal.