Abstract
Severe Early Childhood Caries (S-ECC) is a public health care problem affecting toddlers and preschool children worldwide. S-ECC is an infectious disease most frequently characterized by an overwhelming mutans streptococci infection. The current community standard of care for S-ECC calls for the removal and restoration of carious teeth, application of topical fluoride agents, oral hygiene instruction, and counseling regarding decay-promoting feeding behaviors. Dental surgery alone has minimal impact on oral mutans streptococci reservoirs in the setting of S-ECC and counseling regarding feeding behaviors by dental professionals has largely been unsuccessful. Not surprisingly, clinical outcomes for S-ECC treated under sedation or general anesthesia are poor. Improved clinical outcomes for S-ECC may be realized through treatment strategies that focus on the infectious basis of this disease. Suppression of oral mutans streptococci reservoirs to non-pathogenic levels with a topical anti-microbial agent shows promise as the approach of choice. Preliminary studies using a one time intra-operative application of 10% povidone iodine solution to the dentition in the setting of S-ECC has produced persistent suppression of salivary mutans streptococci reservoirs for 3 months post dental surgery. This paper reviews the relevant literature focusing on this important pediatric health care issue.
Keywords: Mutans streptococci, early childhood caries, povidone iodine, general anesthesia
Current Pediatric Reviews
Title: Clinical Outcomes for Severe Early Childhood Caries
Volume: 4 Issue: 3
Author(s): Jeffrey M. Karp and Robert J. Berkowitz
Affiliation:
Keywords: Mutans streptococci, early childhood caries, povidone iodine, general anesthesia
Abstract: Severe Early Childhood Caries (S-ECC) is a public health care problem affecting toddlers and preschool children worldwide. S-ECC is an infectious disease most frequently characterized by an overwhelming mutans streptococci infection. The current community standard of care for S-ECC calls for the removal and restoration of carious teeth, application of topical fluoride agents, oral hygiene instruction, and counseling regarding decay-promoting feeding behaviors. Dental surgery alone has minimal impact on oral mutans streptococci reservoirs in the setting of S-ECC and counseling regarding feeding behaviors by dental professionals has largely been unsuccessful. Not surprisingly, clinical outcomes for S-ECC treated under sedation or general anesthesia are poor. Improved clinical outcomes for S-ECC may be realized through treatment strategies that focus on the infectious basis of this disease. Suppression of oral mutans streptococci reservoirs to non-pathogenic levels with a topical anti-microbial agent shows promise as the approach of choice. Preliminary studies using a one time intra-operative application of 10% povidone iodine solution to the dentition in the setting of S-ECC has produced persistent suppression of salivary mutans streptococci reservoirs for 3 months post dental surgery. This paper reviews the relevant literature focusing on this important pediatric health care issue.
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Cite this article as:
Karp M. Jeffrey and Berkowitz J. Robert, Clinical Outcomes for Severe Early Childhood Caries, Current Pediatric Reviews 2008; 4 (3) . https://dx.doi.org/10.2174/157339608785855965
DOI https://dx.doi.org/10.2174/157339608785855965 |
Print ISSN 1573-3963 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6336 |
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