Care early for dental caries in kids

What is dental caries?
It’s a multifactorial microbial infectious diseases characterized by demineralization of the inorganic and destruction of the organic substances of the tooth.
What causes dental caries?
* Host – tooth itself
* Bacteria – streptococcus mutant
* Diet – carbohydrates containing diet
How to identify it
* Development of white spot on enamel
* Followed by cavitation on enamel
* Early caries is brown
* As it grows bigger, it darkens, almost black
Associated problems
* Symptoms of caries differ from child to child. Cavities do not usually result in symptoms
* Children complain of pain
* If caries enters the pulp (inner cavity of tooth), severe pain with development of abscess in vicinity of involved tooth
* Pain can be associated with hot /cold/sweet food, beverages or may be spontaneous
* Abscess might be associated with swelling of the involved region which can extend to the eyes if caries associated with upper teeth
How to avoid tooth decay?
* Begin brushing your child’s teeth as soon as they appear
* Use only a small amount of toothpaste, around the size of a grain of rice, on children under 3
* Use pea-sized amount of toothpaste for as early as 3 years of age
* Brush twice a day
* After 15-18 months avoid mid-night feeding
* Avoid sticky and heavily-sugared snacks
* Rinsing after snacking
* Do not share eating utensils with kids
* If your child uses a bottle at bedtime, only fill it with water
* If you reside in a region lacking fluoridated water, talk to your child’s healthcare professional or dentist about utilizing a fluoride supplement
* Inquire about tooth sealants and fluoride varnish as well. Both are applied to the teeth
* Schedule your child’s dental cleanings and exams every 6 months
Treatment options at GDCH
Preventive
* Fluoride treatment: To treat decay in its early stages
* Pit and fissure sealant: Oral decay prevention by applying a sealant over the pits and fissures of teeth once the permanent teeth erupt into oral cavity
Therapeutic treatment
* Fillings: If the caries involves enamel and dentin, restorations can be done such as glass ionomer restoration, composite filling, silver amalgam filling
* If caries involves pulp, then pulptomy or pulpectomy (popularly known as root canal treatment) can be done
* If root canal treatment is not possible then extraction is done
* After extraction of milk teeth, make sure that space maintainer is given (if indicated)
* Treatment for dental caries of disabled can be carried out under general anaesthesia
EXPERT SPEAK
In children, newly-erupted teeth are weak. So, they are more susceptible for dental caries. Excessive consumption of carbohydrates such as chocolate, biscuit, junk food (any sugar containing product) is fermented by bacteria (streptococcus mutants) leading to production of acetic acid which leads to demineralization of tooth structure. Initially, white spot lesion is developed on the enamel surface which is called incipient caries. Incipient caries is reversible if nutrition supply to bacteria is reduced by way of reducing the sweet intake. Slowly, this incipient caries leads to catch formation (hole on enamel surface), once cavity on tooth surfaces, it becomes irreversible and spreads to dentin and pulp
Dr Ritesh Kalaskar | HoD, dept of pediatric & preventive dentistry, GDCH Ngp
Text: Sarfaraz Ahmed