Early childhood caries:

Dental caries has not disappeared and still remains a major health problem for many children, especially among children disadvantaged by low income, minority and immigrant status (ref).

Applying the medical model to this population is especially beneficial since early caries detection and diagnosis allows for a non-invasive approach to treatment and prevents cavitation of the tooth.  

The overall approach for this type of patient is very similar to that applied to the adult patient with some modifications that we will discuss.

The patient is assessed and classified into a risk category (low, moderate or high) as previously outlined in other sections of this site. See main outline

-Some special factors requiring evaluation in this population.

-Proactive and preventive treatment should involve treating and controlling dental caries in the mother and even other members of the family.  This will reduce the reservoir of caries producing bacteria and reduce transmission. For more information.

-The treatment goals of this population is similar to that outlined in the adult population.

-Use bacterial testing for ms levels to determine caries active and not active status.

-Just as in white spot lesions of the adult enamel, if the lesion is non-cavitated and a demineralization has occurred, a  remineralization protocol should be used.

-In patients with cavitated lesions, proceed to control the patient's ms level to below 100,000 cfu and use glass ionomer restorations for caries control procedures.  Once the infection is under control, a more permanent restoration may be used.