Oral Rehabilitation of Severe Early Childhood Caries and Associated Challenges: Two Case Reports

Abstract

Early Childhood Caries (ECC) is defined in the Guidelines of the American Association of Paediatric Dentists as a condition in children aged between 3-5 years where there is “The occurrence of one or more decayed (not cavitated or cavitated lesions). Teeth are missing (due to decay), or restored tooth surfaces†in any primary tooth in a child 71 months and below [1]. Also, the filled smooth surfaces in primary maxillary anterior teeth, or a decayed, missing or filled a score of >4 (age 3), >5 (age 4), or >6 (age 5) surfaces constitutes Severe-ECC. ECC is a public health problem with biological, social and behavioral diet [2]. Amongst the most prevalent chronic disease childhood is dental caries [3].Caries in very young children known as Early Childhood Caries (ECC) may be defined as at least one carious lesion affecting an anterior maxillary tooth in preschool- aged children [4]. The age for ECC is defined from 3years to 5 years where there is one or more cavitated, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth. A decayed, missing or filled a score of ≥4 surfaces age three-years, ≥5 tooth surfaces for age 4years or ≥6 affected tooth surfaces for age five years constitute severe-ECC [5]. In Kenya, a prevalence of 63.5% has been reported with a mean dmft of 2.95 among 3-5-yr old children and in a different study a mean dmft of 1.35 and 1.88 for 3yr-olds and five-year-olds respectively [6,7]. Milnes [5] show that carries on maxillary anterior primary dentition has the highest prevalence in Africa [4].The risk factors which have been associated with ECC the child’s low birth weight, maternal education, and duration of feeding at infancy and toddler stage, low socioeconomic status among others [3,6] .Dental caries is an infectious disease that is modified by diet. The biological mechanisms of dental caries are well established [2].