Early childhood caries- Etiology, prevention and management: A Review

Abstract

Early Childhood Caries (ECC) is a severe debilitating disease affecting the primary dentition of young children in both developing and industrialized countries. Historically, the management of ECC has a global scenario showing operative management of the disease. The contemporary method of preventing the carious process mainly focuses on dietary factors, host factors and removal of plaque biofilm. Enamel demineralization is caused by acidogenic and aciduric bacteria. Colonization of microorganisms in the mouth of children can occur via horizontal or vertical transmission or both. The bacteria present in dental plaque metabolize sugars and starches to produce acids, which lowers the pH in the mouth and promotes loss of minerals from the tooth surface. Sucrose is the most common sugar and when metabolized, produces dextrans which promote superior bacterial adhesion to teeth. Visible plaque on the labial surfaces of the maxillary incisors were strongly associated with the caries development. Saliva buffers plaque acids, aids in oral clearance and acts as a reservoir for minerals to assist in the mineralization of enamel. Most studies have put forward a correlation between bed time use of bottles with sweetened contents especially lactose. One of the factors included by Newbrun in factors causing dental caries is time. The CPP-ACP complex, an effective remineralizing complex preventing the acidic environment reduce incidence of caries. Conventional probiotics comprised of lactobacilli and bifidobacterium which were mainly of intestinal origin; the contemporary probiotic research has brought forward that oral diseases like dental caries, periodontal problems and candida infections have direct link with oral microbial disequilibria. A promising new approach towards primary prevention of the disease is to target the infectious component of Early Childhood Caries by preventing or delaying acquisition of Streptococcus mutans at an early age.