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Reasons For Decayed Tooth in Toddlers

By Dr. Beena J.P
| Reviewed By Beeena J P

Early childhood caries (ECC) is an infectious microbiological disease which spreads rapidly involving multiple teeth of young children.Once the teeth erupt through the gums, decay can occur. Tooth decay can occur when the baby is put to bed with a bottle, or when a bottle is used as a pacifier for a fussy baby. The same thing can happen as your child grows and uses a training (Sippy) cup.

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The sugars in these liquids combine with bacteria, primarily mutans streptococci,combination of cariogenic semisolid or solid food and lack of oral hygiene run a great risk(demineralization) of suffering from ECC. Caries is perceived to be a prolonged imbalance in the oral cavity such that factors favoring demineralization devastate factors that favour remineralisation or healing of tissues.

The tooth surfaces are mainly composed of crystals that are arranged in a repeating pattern in a crystal lattice structure. When these crystals are subjected to the change in pH of its surrounding(sugars), demineralization occurs and its solubility is greatly affected, thus, causing tooth decay or caries. Hence, caries occurs due to the interaction between teeth, microorganism and diet over a period of time.

Early Childhood Caries

ECC or baby bottle tooth decay begins as white chalky lines along gum lines and progresses to destroy the complete tooth structure.

'Lift the lip' and examine at least once in a month and make sure the teeth are dried before you look for white spots. If seen, take your baby to the Pediatric dentist right away before the cavities get worse.

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The complex knowledge of dental caries allows us to appreciate it with a comprehensive analysis of dental caries and detection of tooth demineralization sites. It, thus, is followed by comprehensive treatment of dental caries which includes abolition of cariogenic bacteria, reduction of plaque acidogenecity and enrichment of tooth mineralization.

As dental caries is now considered as a disease process, the concept of 'Primordial prevention' comes into play. The prevention of a disease not only includes methods to prevent the occurrence of the disease but also includes assessment of risk factors as also the prevention of progression of the disease.

This concept is relatively new and is gaining much importance for treatment of chronic diseases. As caries is considered as a chronic disease, the primordial prevention can be applied to dental caries as well. Primordial prevention begins in early childhood when health risk behavior begins. Thus, the pediatric dentist has a major role to play in primordial prevention of dental caries.

Early Childhood Caries

PREVENTION OF ECC
Dental decay is a preventable disease, and it can be stopped and even potentially reversed during its early stages.Pediatricdentists usually advice cleaning your child's teeth to prevent cavities. Perhaps the most recognized and effective method in the prevention of caries is the regular use of fluoride. It has become so essential in the maintaining the health of teeth that certain foods, toothpastes, mouthwashes, and even tap water are fluoridated.

ENVIRONMENTAL SOURCE OF FLOURIDE

FLOURIDE AND THEIR ROLE IN DENTAL CARIES PREVENTION
Fluoride present in the oral fluid bonds with enamel, the tooth's outer surface. Fluoride ions (F-) replace hydroxyl groups (OH-) in hydroxyapatiteto formflourapatite crystallattice via ion exchange thus, making the tooth more resistant to sugars and plaque or invading bacteria colonies that lead to decay. Using topical fluoride applications, for example fluoride toothpastes, or fluoride rinses, can also aid in remineralization.

Early Childhood Caries

PROFESSIONAL CARE:
Fluoride varnish is a highly concentrated form of fluoride which is applied to the tooth's surface, as a type of topical fluoride therapy. Fluoride varnish treatments are shown to reduce the number of the cariogenic bacteria by over ten-folds. Fluoride varnishes are available in different flavors which can be advantageous when treating younger patients.

Casein phosphopeptide -Amorphous calcium phosphate, or CPP-ACP, is a milk-derived product that remineralises teeth and prevent dental caries. Casein phosphopeptides (CPP) from the major protein of milk have the ability to stabilize calcium, phosphate and fluoride ions as water soluble amorphous complexes that provide bioavailable calcium, phosphate and fluoride ions to the tooth.

These complexes of amorphous calcium phosphate and amorphous calcium fluoride phosphate stabilized by the CPP repair early stages of tooth decay by replacing the calcium and phosphate ions lost due to decay.

Under the strict supervision of a Pediatric dentist these techniques are considered as a safe and painless method can be applied to baby teeth to prevent and stop ECC.

Early Childhood Caries

CONSEQUENCES
These white spots when left untreated, may lead to dental pain, abscess formation, fever, lack of appetite and lethargy which effects the everyday activities leading to insufficient physical development (especially in height/weight).At this stage complex treatment involves fillings, root canal treatment and steel or veneer crowns.

CONCLUSION
Presentevidence on the dynamic nature of the carious process and risk assessment allows increased importance on patient-specific approaches that include disease monitoring and prevention as well as restorative therapies.Regular dental check-up,six months after the first tooth is through or when your child reaches the age of one, the Pediatric dentist can counsel you on how to prevent dental diseases.

Beeena J PDental Sciences
Asst Professor
Beeena J P

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