Early Childhood Caries

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Early Childhood Caries

• Deb Fancher, RN, s-FNP

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Who?WHO?American Indians (AI)Alaska
Natives (AN)Children in these populations lt 6
years old
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What?

• Early Childhood Caries (ECC)
• Severe Early Childhood Caries (S-ECC)
• Some require general anesthesia to rehabilitate
  restorations or extractions
• (Schroth, r. et al, 2009)

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Where?

• Rural and remote indigenous citizens
• Alaskan native populations
• American Indian populations

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When?

• 1999 Indian Health Services Survey
• 2663 AI-AN preschool children examined
• 79 ECC (Schroth,R. et al, 2009)
• WWII sucrose largely unavailable, caries
  decreased in all populations
• (YoungDentist, date unavail.)

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Why?

• Multifactorial
• Access to dental care (geographical isol.)
• Socioeconomic status
• Increased intake sucrose
• Incidence of caries has increased at about same
  rate as rising sucrose consumption
• (YoungDentist, date unavail.)

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Why? (cont)

• Oral health literacy
• Oral hygeine
• Environmental factors
• Fluoride exposure
• Water fluoridation
• Community support
• Social determinantscritical role in
  susceptibility
• (Schroth, R. et al, 2009)

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How Much?

• 2-4 y.o. 5 x general population
• Untreated caries 3 x general population
• Minor percentage access dental care offered by
  Indian Health Services (HIS)
• (Schroth, R. et al., 2009)

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How does this relate to us?

• Holistic
• Possible correlation dental caries and failure
  to thrive
• ECC children with otitis media (OM)
• Higher incidence of OM
• Chewing/eating behaviors
• Quality of life Sleep? Pain? Behavior?
• (Schroth, R. et al., 2009)

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How does this relate to us? (cont.)

• Anticipatory Guidance change behaviour no baby
  bottles after age 12 months
• Adopt new behavior regular tooth brushing
• Encourage remineralization of tooth
  enamelfluoride
• Encourage expectant moms in healthy diet and oral
  hygeine
• Voice of leaders within communities will more
  likely lead to change
• (Schroth, R.et al., 2009)

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Primary Care Providers

• Screen
• Refer
• Encourage dental home by 12 months
• Counsel fluoride interventions, varnish (Crane,
  M, 2011)
• Lobby for greater dental care access in remote
  regions (Schroth, R. et al, 2009)

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References

• Crane, M. (2011). Improving kids teeth their
  goal. Columbus Dispatch newspaper, May 22, 2011.
• Schroth, R., Dahl, P., Haque, M., Kliewer, E.
  (2009). Early childhood caries among Hutterite
  preschool children in Manitoba, Canada. Rural
  Remote Health. 10(4), 1-11.
• YoungDentist (n.d.). The most common disease that
  causes loss of teeth-Dental caries part 5.
  Retrieved June 10, 2011 from http//www.sanedentis
  t.com/the-most-common-disease-that-causes-loss-of-
  teeth-dental-caries.html.