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Childhood Caries

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Date added: 19-03-13


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Introduction

Early childhood caries is not only a problem in underdeveloped countries, but in many well-developed countries as well. It is a world-wide problem. There are many influences that could increase the likelihood of early childhood caries. Childhood caries could be influenced by diet, genetics, exposure, and oral hygiene. Caries have no limitations and will affect any child no matter age, gender, or race. This is a significant health issue because children do not understand the importance of oral hygiene and need to be taught by their parents or guardian. However, parents often feel because they are baby teeth and will be lost anyway they are not as important to take care of.

Early Childhood Caries

Early childhood caries (ECC) is defined as having one or more primary teeth with decay, fillings/restorations, or missing due to decay in a child that is 3 years of age or younger. ECC remains the number one chronic disease affecting young children in the United States (cite). Although children who are part of a lower socioeconomical status or racial minority tend to have more severe dental decay it still affects all races and all socioeconomic classes. An article written by Brooke Jackson, DNP, APRN, CPNP (2015) states, despite ECC being largely preventable, it continues to be five times more common than asthma and seven times more common than hay fever in the pediatric population in the United States (p. 543). This is a huge indicator that something needs to be done in order to reduce the likelihood of ECC. Some children may have predispositions to developing caries, but they are largely preventable.

It is recommended a child should have their first dental visit by age one or when their first tooth comes in. Many parents are unaware of when to take their child to see the dentist, but they may regularly take their child in to see their primary health care provider. There is currently a disconnect between oral health care providers and primary health care providers. Primary care providers should communicate with the parent regarding dental concerns and recommend a time for them to take their child for a dental visit.

I can see this as a solution if this could become more routine amongst care providers and overtime could possibly lead to a decline in child caries. Some parents may not see the importance of regular dental visits for children because they are going to lose those teeth eventually. However, according to Kawashita, Kitamura, and Saito (2011) children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and the permanent dentitions (p. 1). It is problematic for children who develop caries in their permanent dentition at a young age because those teeth are supposed to last them a lifetime.

Many parents understand proper nutrition is important for their child to grow and develop appropriately, but they may not understand how nutrition can affect their child's teeth. Children should be brushing twice a day to remove the biofilm on their teeth especially if their diet consists of softer foods that stick to their teeth. Kawashita et. al (2011) explains the process of how decay begins, the presence of a fermentable carbohydrate (e.g., sucrose, glucose, fructose, cooked starch) and bio?¬lms on the teeth support the metabolism of acidogenic microorganisms, resulting in acidic substances, the hydrogen ions of which dissolve the carbonated hydroxyapatite crystal lattice of enamel, cementum, and dentin (p. 2).

Overtime this repeated exposure and demineralization of the tooth will lead to caries. Parents
Children who experience dental caries may also experience some nutritional deficiencies. If a child has untreated decay they could be experiencing significant pain, and this could lead to them avoiding some meals. According to Khanh et al., children with ECC may experience acute and chronic mouth pain that can adversely affect their quality of life, eating practices, nutritional status, growth, and educational and economic potential (p. 2510). If a child has decayed or missing teeth they may also experience some psychologic distress because of embarrassment or lack of confidence.

Conclusion

Early childhood caries is a chronic disease amongst all types of children no matter their race, age or socioeconomic status. Although this problem has been addressed further efforts still need to be made. Primary care providers and dental care providers need to work together to provide the best possible care for their patients. Parents need to be educated on the importance of proper nutrition, proper oral hygiene, and the possible negative affects that can be associated with poor oral care. Parents should also be informed of the psychological problems that could be associated with ECC and correlations to poor nutrition. As a dental health care provider, I have seen children with severe decay and parents not understanding the importance of taking care of primary teeth. Parents need to be educated earlier during pregnancy by their doctors to take preventative dental measures to benefit their child.

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