Table of Contents    
REVIEW ARTICLE
Year : 2013  |  Volume : 4  |  Issue : 1  |  Page : 29-38  

Early childhood caries update: A review of causes, diagnoses, and treatments


1 Kirikkale University Dental Faculty, Department of Restorative Dentistry, Kirikkale, Turkey
2 Department of Restorative Dentistry, Dicle University Dental, Diyarbakir, Turkey

Date of Web Publication20-Feb-2013

Correspondence Address:
Çoruh T Dülgergil
Department of Restorative Dentistry, Kirikkale University Dental Faculty, Kirikkale
Turkey
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0976-9668.107257

Rights and Permissions
   Abstract 

Dental caries (decay) is an international public health challenge, especially amongst young children. Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. Its consequences can affect the immediate and long-term quality of life of the child's family and can have significant social and economic consequences beyond the immediate family as well. ECC can be a particularly virulent form of caries, beginning soon after dental eruption, developing on smooth surfaces, progressing rapidly, and having a lasting detrimental impact on the dentition. Children experiencing caries as infants or toddlers have a much greater probability of subsequent caries in both the primary and permanent dentitions. The relationship between breastfeeding and ECC is likely to be complex and confounded by many biological variables, such as mutans streptococci, enamel hypoplasia, intake of sugars, as well as social variables, such as parental education and socioeconomic status, which may affect oral health. Unlike other infectious diseases, tooth decay is not self-limiting. Decayed teeth require professional treatment to remove infection and restore tooth function. In this review, we give detailed information about ECC, from its diagnosis to management.

Keywords: Early childhood caries, etiology, feeding, fluoride


How to cite this article:
Çolak H, Dülgergil ÇT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sc Biol Med 2013;4:29-38

How to cite this URL:
Çolak H, Dülgergil ÇT, Dalli M, Hamidi MM. Early childhood caries update: A review of causes, diagnoses, and treatments. J Nat Sc Biol Med [serial online] 2013 [cited 2018 Nov 12];4:29-38. Available from: http://www.jnsbm.org/text.asp?2013/4/1/29/107257


   Introduction Top


Dental caries is the most common chronic infectious disease of childhood, caused by the interaction of bacteria, mainly Streptococcus mutans, and sugary foods on tooth enamel. S. mutans can spread from mother to baby during infancy and can inoculate even pre-dentate infants. These bacteria break down sugars for energy, causing an acidic environment in the mouth and result in demineralization of the enamel of the teeth and dental caries. [1] Early childhood caries (ECC) is a serious public health problem in both developing and industrialized countries. [2] ECC can begin early in life, progresses rapidly in those who are at high risk, and often goes untreated. [3],[4] Its consequences can affect the immediate and long-term quality of life of the child and family, and can have significant social and economic consequences beyond the immediate family as well. [5]


   Description Top


Dental caries in toddlers and infants has a distinctive pattern. Different names and terminology have been used to refer to the presence of dental caries among very young children. [6] The definitions first used to describe this condition were related to etiology, with the focus on inappropriate use of nursing practices. The following terms are used interchangeably: Early childhood tooth decay, early childhood caries, baby bottle-fed tooth decay, early childhood dental decay, comforter caries, nursing caries, maxillary anterior caries, rampant caries, and many more. [7],[8] Some of these terms indicate the causes of dental caries in pre-school children. [8] Baby bottle-fed tooth decay refers to decay in an infant's teeth, associated with what the baby drinks. [9] However, some authors use the term "nursing caries" because it designates inappropriate bottle use and nursing practices as the causal factors. [7],[10] However, the term "early childhood caries" is becoming increasingly popular with dentists and dental researchers alike. [8],[11]

The term "early childhood caries" was suggested at a 1994 workshop sponsored by the Centers for Disease Control and Prevention in an attempt to focus attention on the multiple factors (i.e. socioeconomic, behavioral, and psycho-social) that contribute to caries at such early ages, rather than ascribing sole causation to inappropriate feeding methods. [12] ECC is defined as "the presence of one or more decayed (non-cavitated or cavitated lesions), missing teeth (due to caries), or filled tooth surfaces in any primary tooth in a child 72 of months age or younger. In children younger than 3 years of age, any sign of smooth-surface caries is indicative of severe early childhood caries (S-ECC). From ages 3 through 5, one or more cavitated, missing teeth (due to caries), or filled smooth surfaces in primary maxillary anterior teeth, or decayed, missing, or filled score of ≥4 (age 3), ≥5 (age 4), or ≥6 (age 5) surfaces constitutes S-ECC. [13]

In the initial phase, ECC is recognized as a dull, white demineralized enamel that quickly advances to obvious decay along the gingival margin. [14] Primary maxillary incisors are generally affected earlier than the four maxillary anterior teeth which are often involved concurrently. [15] Carious lesions may be found on either the labial or lingual surfaces of the teeth and, in some cases, on both. [16] The decayed hard tissue is clinically evident as a yellow or brown cavitated area. In older children, whose entire primary dentition is fully erupted, it is not unusual to see considerable advancement of the dental damage.


   Epidemiology Top


Despite the decline in the prevalence of dental caries in children in the western countries, caries in pre-school children remains a problem in both developed and developing countries. ECC has been considered to be at epidemic proportions in the developing countries. [4],[17]

A comprehensive review of the occurrence of the caries on maxillary anterior teeth in children, including numerous studies from Europe, Africa, Asia, the Middle East, and North America, found the highest caries prevalence in Africa and South-East Asia. [18] The prevalence of ECC is estimated to range from 1 to 12% in infants from developed countries. [19]

Prevalence of ECC is a not a common finding relative to some European countries (England, Sweden, and Finland), with the available prevalence data ranging from below 1% to 32%. [20],[21] However, this figure is rising by as much as 56% in some eastern European countries. [22] In US, pre-school children data from a more recent study indicate that the prevalence of dental caries of children 2-5 years of age had increased from 24% in 1988-1994 to 28% in 1999-2004. Overall, considering all 2-5-year olds, the 1999-2004 survey indicates that 72% of decayed or filled tooth surfaces remain untreated. [14],[23],[24] The prevalence of ECC children in the general population of Canada is less than 5%; but in high-risk population, 50-80% are affected. [25],[26],[27] Studies reveal that the prevalence percentage of ECC in 25- to 36-month olds [28] is 46% and the reported prevalence in Native Canadian 3-year-olds [29] has been as high as 65%.

Published studies show higher prevalence figures for 3-year-olds, which ranges from 36 to 85% [30],[31],[32] in Far East Asia region, whereas this figure is 44% for 8- to 48-month olds [33] reported in Indian studies. ECC has been considered at epidemic proportions in the developing countries. [34] Studies conducted in the Middle East have shown that the prevalence of dental caries in 3-year-olds is between 22% and 61% [35],[36],[37] and in Africa it is between 38% and 45%. [38],[39]


   Etiology Top


The etiology of ECC is multifactorial and has been well established. ECC is frequently associated with a poor diet [40] and bad oral health [14] habits.

Microbiological risk factors

S. mutans and Streptococcus sobrinus are the main cariogenic micro-organisms. [41],[42] These acid-producing pathogens inhabiting the mouth cause damage by dissolving tooth structures in the presence of fermentable carbohydrates such as sucrose, fructose, and glucose. [43],[44] Most of the investigations [15],[45],[46] have shown that in children with ECC, S. mutans has regularly exceeded 30% of the cultivable plaque flora. These bacterial masses are often associated with carious lesions, white spot lesions, and sound tooth surfaces near the lesions. Conversely, S. mutans typically constitutes less than 0.1% of the plaque flora in children with negligible to no caries activity. [47] It is well known that initial acquisition of mutans streptococci (MS) by infants occurs during a well-delineated age range that is being designated as the window of infectivity. [48] Most of the long-term studies also demonstrated that the individuals with low infection levels in this period are less likely to be infected with MS, and subsequently have the lowest level of risk of developing caries. [49],[50] This may be explained by the competition between the oral bacteria, resulting in the invasion of the niches, where MS can easily colonize, by less pathogenic species. [51]

Vertical transmission, also known as mother-to-child transmission, is the transmission of an infection or other disease from caregiver to child. The major reservoir from which infants acquire MS is their mothers. The early evidence for this concept comes from bacteriocin typing studies [52],[53],[54] where MS isolated from mothers and their infants demonstrated identical bacteriocin typing patterns. More advanced technology that utilized chromosomal DNA patterns or identical plasmids provided more compelling evidence to substantiate the concept of vertical transmission. [55],[56],[57],[58]

Feeding practices

Inappropriate use of baby bottle has a central role in the etiology and severity of ECC. The rationale is the prolonged bedtime use of bottles with sweet content, especially lactose. Most of the studies have shown significant correlation between ECC and bottle-feeding and sleeping with a bottle. [59],[60],[61] Breastfeeding provides the perfect nutrition for infant, and there are a number of health benefits to the breastfed child, including a reduced risk of gastrointestinal and respiratory infections. [62] However, frequent and prolonged contact of enamel with human milk has been shown to result in acidiogenic conditions and softening of enamel. Increasing the time per day that fermentable carbohydrates are available is the most significant factor in shifting the re-mineralization equilibrium toward de-mineralization. [63] There appears to be a clinical consensus amongst dental practitioners that prolonged and nocturnal breastfeeding is associated with an increased risk of ECC, especially after the age of 12 months. These conditions explained by less saliva production at night result in higher levels of lactose in the resting saliva and dental plaque for longer than would be expected during the day. Thereby, balance is shifted toward de-mineralization rather than re-mineralization during the night because of the insufficient protection caused by reduced nocturnal salivary flow. [64],[65]

Sugars

In general, perspective dental caries is accepted as primarily a microbial disease, but few would disagree that dietary features play a crucial and a secondary role. Numerous worldwide epidemiologic studies, laboratory and animal experiments, as well as human investigations after the World War II have contributed to much of the knowledge on the etiology and natural history of caries. [66]

Fermentable carbohydrates are a factor in the development of caries. The small size of sugar molecules allows salivary amylase to split the molecules into components that can be easily metabolized by plaque bacteria. [67] This process leads to bacteria producing acidic end products with subsequent de-mineralization of teeth [68],[69] and increased risk for caries on susceptible teeth. Some authors [70],[71] found a positive relationship between sugar intake and the incidence of dental caries where fluoridation was minimal and dental hygiene was poor. The length of time of exposure of the teeth to sugar is the principal factor in the etiology of dental caries; it is known that acids produced by bacteria after sugar intake persist for 20-40 min. Some authors [72] studied the clearance of glucose, fructose, sucrose, maltose, and sorbitol rinses, as well as chocolate bars, white bread, and bananas, from the oral cavity. Sucrose is removed the quickest, while sorbitol and food residues stay in the mouth longer. Retentiveness of the food and the presence of protective factors in foods (calcium, phosphates, fluoride) are considered as other factors that contribute to de-mineralization.

The best available evidence indicates that the level of dental caries is low in countries where the consumption of free sugars is below 40-55 g per person per day. [73] Caries risk is greatest if sugars are consumed at high frequency and are in a form that is retained in the mouth for long periods. [74] Non-milk extrinsic sugars (NMES) have also been widely implicated as the cause of caries, while milk sugars are not. [75] However, consumption of milk-based formulas for infant feeding, even without sucrose in their formulation, proved to be cariogenic. [76] The relationship between diet and dental caries has become weaker in contemporary society and this has been attributed to the widespread use of fluoride. [77] There is evidence to show that many groups of people with habitually high consumption of sugars also have levels of caries higher than the population averages.

Socioeconomic factors

Association between ECC and the socioeconomic status (SES) has been well documented. Studies suggested that ECC is more commonly found in children who live in poverty or in poor economic conditions, [35],[40],[44],[78],[79] who belong to ethnic and racial minorities, [80] who are born to single mothers, [81] whose parents have low educational level, especially those of illiterate mothers. [35],[82],[83] In these populations, due to the prenatal and perinatal malnutrition or undernourishment, these children have an increased risk for enamel hypoplasia and exposure to fluorine is probably insufficient, [80] and there is a greater preference for sugary foods. [84]

The possible influence of SES on dental health may also be a consequence of differences in dietary habits and the role of sugar in the diet. [85] In their review on inequalities in oral health, Sheiham and Watt indicated that the main causes of inequalities in oral health are differences in patterns of consumption of non-milk sugars and fluoride toothpaste. [86] Weinstein [4] emphasizes the discrepancy in ECC prevalence rate: 1-12% in developed countries, whereas it as high as 70% in developing countries or within select immigrant or ethnic minority populations. Authors in Ref. [23] confirm that children with parents in the lowest income group had mean Decayed, Missing, and Filled Teeth (dmft) scores four times as high as children with parents in the highest income group.


   Diagnosis Top


ECC is initially recognized as a dull, white hand of de-mineralized enamel that quickly advances to obvious decay along the gingival margin. [31] The decay is generally first seen on the primary maxillary incisors, and the four maxillary anterior teeth are often involved concurrently. [87] Carious lesions may be found on either the labial or lingual surfaces of the teeth and, in some cases, on both. [40] The decayed hard tissue is clinically evident as a yellow or brown cavitated area. In the older child whose entire primary dentition is fully erupted, it is not unusual to see considerable advancement of the dental damage.

Furthermore, the expression S-ECC was adopted in lieu of rampant caries in the presence of at least one of the following criteria:

  • Any sign of caries on a smooth surface in children younger than 3 years.
  • Any smooth surface of an antero-posterior deciduous tooth that is decayed, missing (due to caries), or filled in children between 3 and 5 years old.
  • The dmft index equal to or greater than 4 at the age of 3 years, 5 at the age of 4 years, and 6 at the age of 5 years. [88]



   Consequences of Untreated Dental Caries in Children Top


Although largely preventable by early examination, identification of individual risk factors, parental counseling and education, and initiation of preventive care procedures such as topical fluoride application, the progressive nature of dental disease can quickly diminish the general health and quality of life for the affected infants, toddlers, and children. [89] Failure to identify and prevent dental disease has consequential and costly long-term adverse effects [Table 1]. As treatment for ECC is delayed, the child's condition worsens and becomes more difficult to treat, the cost of treatment increases, and the number of clinicians who can perform the more complicated procedures diminishes.
Table 1: A summary of the consequences of leaving untreated carious primary teeth

Click here to view


Oral health means more than just healthy teeth. Oral health affects people physically and psychologically, and influences how they grow, look, speak, chew, taste food, and socialize, as well as their feelings of social well-being. [90] Children's quality of life can be seriously affected by severe caries because of pain and discomfort which could lead to disfigurement, acute and chronic infections, and altered eating and sleeping habits, as well as risk of hospitalization, high treatment costs, and loss of school days with the consequent diminished ability to learn. [91] In most small children, ECC is associated with reduced growth and reduced weight gain due to insufficient food consumption to meet the metabolic and growth needs of children less than 2 years old. [91] Children of 3 years of age with nursing caries weighed about 1 kg less than control children [92] because toothache and infection alter eating and sleeping habits, dietary intake, and metabolic processes. Disturbed sleep affects glucosteroid production. In addition, there is suppression of hemoglobin from depressed erythrocyte production. Early tooth loss caused by dental decay has been associated with the failure to thrive, impaired speech development, absence from and inability to concentrate in school, and reduced self-esteem. [92],[93],[94]

At the level of family consequences, there is a troubling association between ECC and child maltreatment. Sheller and colleagues [95],[96] concluded that a dysfunctional family or social situation can lead to a recurrence of ECC, often with emotional outbursts and the threat of or actual violence. The relationship between ECC and neglect is well established, but only recently have child maltreatment experts included dental caries in their list of health conditions that predispose children to maltreatment. [97],[98]

Untreated oral disease can exacerbate the already fragile conditions of many children with special health care needs [99] because of the prevalence of chronic medical conditions such as seizure disorders or severe emotional disturbances. For example, it can complicate the treatment of organ and bone marrow transplants (sometimes resulting in death); it can result in severe complications (e.g., pneumonia, urinary tract infections, fever, and generalized infections of the entire body); and it can cause infection of a defective heart valve (resulting in death 50% of the time). [99]

A third possible mechanism of how untreated severe caries with pulpitis affects growth is that pulpitis and chronic dental abscesses affect growth by causing chronic inflammation that affects metabolic pathways where cytokines affect erythropoiesis. [100] For example, interleukin-1 (IL-1), which has a wide variety of actions in inflammation, can induce inhibition of erythropoiesis. This suppression of hemoglobin can lead to anemia of chronic disease, as a result of depressed erythrocyte production in the bone marrow. [101],[102] One of the best predictors of future caries is previous caries experience. [103],[104] Children under the age of 5 with a history of dental caries should automatically be classified as being at high risk for future decay. However, the absence of caries is not a useful caries risk predictor for infants and toddlers because even if these children are at high risk, there may not have been enough time for carious lesion development. [105] Since white spot lesions are the precursors to cavitated lesions, they will be apparent before cavitations. These white spot lesions are most often found on enamel smooth surfaces close to the gingiva. Although only a few studies have examined staining of pits and fissures [106] or white spot lesions [107] as a caries risk variable, such lesions should be considered equivalent to caries when determining caries risk in young children.

Tooth extraction is a common and necessary treatment for advanced caries. Premature loss of molars is likely to result in future orthodontic problems. [96] Therefore, children affected by ECC are likely to continue having oral health problems for which treatment is often financially out of reach for their parents. Furthermore, caries in the early years has been associated with caries in late childhood. [108],[109]


   Prevention of Early Childhood Caries Top


There are three general approaches that have been used to prevent ECC [Figure 1]. All three approaches include training of mothers or caregivers to follow healthy dietary and feeding habits in order to prevent the development of ECC.
Figure 1: Strategies for the prevention of ECC

Click here to view


Prevention of maternal bacterial transmission to the child

The strategy to combat the early transmission of cariogenic bacteria from parents to their offsprings is often named primary-primary prevention. The preventive intervention is most often directed to pregnant women and/or mothers of newborn babies. This includes the following.

A. Reduce the bacteria in the mouth of the mother or primary caregiver. Earlier studies suggest that infants acquire MS from their mothers and only after the eruption of primary teeth. [49],[50] Preventive interventions for the purpose of reducing the transmission of bacteria from mothers to children improve the likelihood of better oral health for the child. [110] Effective approach in the prevention of dental caries is the suppression of S. mutans in the mouth of the child's primary caregiver (usually the mother). Chemical suppression by use of chlorhexidine gluconate in the form of mouth rinses, gels, and dentifrices has been shown to reduce oral microorganisms. [111],[112]

B. Minimize the transmission of bacteria that cause tooth decay. Minimizing saliva-sharing activities between children and parents/caregivers limits bacterial transmission. Examples include avoiding the sharing of utensils, food, and drinks, discouraging a child from putting his/her hand in the caregiver's mouth, not licking a pacifier before giving it to the child, and not sharing toothbrushes. The goal is to prevent or delay children as long as possible from acquiring the bacteria that cause tooth decay.

Oral health education

Dental caries cannot occur without the substrate component of sugar. Therefore, much of the professional advice and practical research has focused on modification of the infant diet and feeding habits through education of the parents. [113],[114] Child health professionals, including but not limited to physicians, physician assistants, nurse practitioners, and nurses, can play a significant role in reducing the burden of this disease. While most children do not visit a dentist until the age of 3 years, children have visited a child health professional up to 11 times for well-child visits by this age. [113] Oral health education is a designed package of information, learning activities, or experiences that are intended to produce improved oral health. [115] With the primary goal of disease prevention, its purpose is to facilitate decision-making for oral health practices and to encourage appropriate choices for these behaviors.

Effective health education may thus [116]

  • produce changes in knowledge;
  • induce or clarify values;
  • bring about some shift in belief or attitudes;
  • facilitate the achievement of skills; and
  • bring about change in behaviors or lifestyles.


Health promotion programs to stimulate tooth brushing have been among the most successful educational programs. [117],[118] Cross-sectional surveys, clinical trials, and experiments for tooth brushing research studies involving populations of 1450-1545 children have found that tooth brushing with flossing twice a day resulted in increased tooth retention. [117]

The American Academy of Pediatric Dentistry (AAPD) has given recommendations on anticipatory guidance, bottle-feeding habits to prevent ECC, and infant/toddler oral hygiene care. [88]

Avoiding caries-promoting feeding behaviors

  1. Infants should not be put to sleep with a bottle containing fermentable carbohydrates.
  2. Ad libitum breastfeeding should be avoided after the first primary tooth begins to erupt and other dietary carbohydrates are introduced.
  3. Parents should be encouraged to have infants drink from a cup as they approach their first birthday. Infants should be weaned from the bottle at 12-14 months of age.
  4. Repetitive consumption of any liquid containing fermentable carbohydrates from a bottle or no-spill training cup should be avoided.
  5. Between-meal snacks and prolonged exposures to foods and juice or other beverages containing fermentable carbohydrates should be avoided.


Fluoride

The use of fluorides for dental purposes began in the 19 th century. Fluorides are found naturally throughout the world. [119] They are present to some extent in all foods and water, so that all humans ingest some fluoride on a daily basis. In addition, fluorides are used by communities as a public health measure to adjust the concentration of fluoride in drinking water to an optimum level (water fluoridation); by individuals in the form of toothpastes, rinses, lozenges, chewable tablets, drops; and by the dental professionals in the professional application of gels, foams, and varnishes.

Fluoride varnish is a concentrated topical fluoride with a resin or synthetic base. At least 19 fluoride varnish reviews, [120] including a systematic review [121] and three meta-analyses, [122],[123],[124] have been published in English. In the last three decade, a great deal of research published that evaluated fluoride varnish efficacy in the permanent teeth of school-aged children, [125] regarding fluoride varnish differed for permanent and primary teeth. All of these studies stated, "The evidence for the benefit of applying fluoride varnish to permanent teeth is generally positive." Fluoride varnish works by increasing the concentration of fluoride in the outer surface of teeth, thereby enhancing fluoride uptake during early stages of de-mineralization. The varnish hardens on the tooth as soon as it contacts saliva, allowing the high concentration of fluoride to be in contact with tooth enamel for an extended period of time (about 1-7 days). This is a much longer exposure compared to that of other high-dose topical fluorides such as gels or foams, which is typically 10-15 minutes. The amount of fluoride deposited in the tooth surface is considerably greater in de-mineralized versus sound tooth surfaces. [126],[127] Thus, the benefits of fluoride varnish are greatest for individuals at moderate risk or high risk for de-mineralization or tooth decay. [128]

There is a global consensus that regular use of fluoride (F) toothpaste constitutes a cornerstone in child dental health. In fact, a global survey revealed that most experts addressed F toothpaste as the main reason for the dramatic decline in caries during the last decade of the 20 th century. [129] Moreover, toothpaste is probably the most readily available form of F and tooth brushing is a convenient and approved habit in most cultures. [130] Working groups within national Health Technology Agencies have independently and in parallel presented strong scientific evidence that daily tooth brushing with F toothpaste is the most cost-effective, self-applied method to prevent caries at practically all ages. [131],[132],[133],[134] Because small children usually swallow 30% of the paste, it is important to limit the amount of toothpaste to a pea size or less. [135] According to Douglass et al. [1] the amount of toothpaste should not exceed the size of a rice grain or the tip of a pencil eraser for children as young as 6-12 months of age. Fluoride products such as toothpaste, mouth rinse, and dental office topicals have been shown to reduce caries between 30% and 70% compared with no fluoride therapy. [136],[137] Because young children tend to swallow toothpaste when they are brushing, which may increase their exposure to fluoride, guidelines [Table 2] have been established to moderate their risk of developing dental fluorosis while optimizing the benefits of fluoride, by the American Dental Association (ADA) (2008) [138]
Table 2: Recommended dosages for fluoride supplementation chart

Click here to view


The most common method for systematically applied fluoride is fluoridated drinking water shown to be effective in reducing the severity of dental decay in entire populations. Fluoridation of community drinking water is the precise adjustment of the existing natural fluoride concentration in drinking water to a safe level that is recommended for caries prevention. The United States Public Health Service has established the optimum concentration for fluoride in the water in the range of 0.7-1.2 mg/L. [139] Reductions in childhood dental caries attributable to fluoridation were approximately from 40 to 60% from 1949 to 1979, but in the next decade, the estimates were lower: from 18% to 40%. [113],[134],[139] This is likely caused by the increasing use of fluoride from other sources, with the widespread use of fluoride toothpaste probably being the most important factor. [113],[133]


   Treatment Top


Treatment of ECC can be accomplished through different types of intervention, depending on the progression of the disease, the child's age, as well as the social, behavioral, and medical history of the child. Examining a child by his or her first birthday is ideal in the prevention and intervention of ECC. [88] During this initial visit, conducting a risk assessment can provide baseline data necessary to counsel the parent on the prevention of dental decay. Children at low risk may not need any restorative therapy. Children at moderate risk may require restoration of progressing and cavitated lesions, while white spot and enamel proximal lesions should be treated by preventive techniques and monitored for progression. Children at high risk, however, may require earlier restorative intervention of enamel proximal lesions, as well as intervention of progressing and cavitated lesions to minimize continual caries development. [140]

The current standard of care for treatment of S-ECC usually necessitates general anesthesia with all of its potential complications because the level of co-operative behavior of babies and pre-school children is less than ideal.

Stainless steel (preformed) crowns are pre-fabricated crown forms which can be adapted to individual primary molars and cemented in place to provide a definitive restoration. [141] They have been indicated for the restoration of primary and permanent teeth with caries, cervical decalcification, and/or developmental defects (e.g., hypoplasia, hypocalcification), when failure of other available restorative materials is likely (e.g., interproxima caries extending beyond line angles, patients with bruxism), following pulpotomy or pulpectomy, for restoring a primary tooth that is to be used as an abutment for a space maintainer, or for the intermediate restoration of fractured teeth.

Another approach of treating dental caries in young children is Atraumatic Restorative Treatment (ART). The ART is a procedure based on removing carious tooth tissues using hand instruments alone and restoring the cavity with an adhesive restorative material. [142],[143],[144] At present, the restorative material is glass ionomer. ART is a simple technique with many advantages, such as it reduces pain and fear during dental treatment, [145] it does not require electricity; [146] and it is more cost-effective than the traditional approach using amalgam. [147] It is an alternative treatment available to a large part of the world's population. [148] In addition, it is mostly indicated for use in children, as it is reportedly atraumatic because no rotary instruments are used and in most cases no local anesthesia is needed. [149]

 
   References Top

1.Douglass JM, Douglass AB, Silk HJ. A practical guide to infant oral health. Am Fam Physician 2004;70:2113-20.  Back to cited text no. 1
[PUBMED]    
2.Livny A, Assali R, Sgan-Cohen H. Early Childhood Caries among a Bedouin community residing in the eastern outskirts of Jerusalem. BMC Public Health 2007;7:167.  Back to cited text no. 2
    
3.Grindefjord M, Dahllof G, Modeer T. Caries development in children from 2.5 to 3.5 years of age: A longitudinal study. Caries Res 1995;29:449-54.  Back to cited text no. 3
    
4.Weinstein P, Domoto P, Koday M, Leroux B. Results of a promising open trial to prevent baby bottle tooth decay: A fluoride varnish study. ASDC J Dent Child 1994;61:338-41.  Back to cited text no. 4
    
5.Inglehart MR, Filstrup SL, Wandera A. Oral health and quality of life in children. In: Inglehart M, Bagramian R, editors. Oral health-related quality of life. Chicago: Quintessence Publishing Co., 2002. p. 79-88.  Back to cited text no. 5
    
6.Tinanoff N. Introduction to the Early Childhood Caries Conference: Initial description and current understanding. Community Dent Oral Epidemiol 1998;26:5-7.  Back to cited text no. 6
[PUBMED]    
7.Dilley GJ, Dilley DH, Machen JB. Prolonged nursing habit: A profile of patients and their families. ASDC J Dent Child 1980;47:102-8.  Back to cited text no. 7
[PUBMED]    
8.Ismail AI, Sohn W. A systematic review of clinical diagnostic criteria of early childhood caries. J Public Health Dent 1999;59:171-91.  Back to cited text no. 8
[PUBMED]    
9.Lacroix I, Buithieu H, Kandelman D. La carie du biberon. J dentaire du Québec 1997;34:360-74.  Back to cited text no. 9
    
10.Ripa LW. Nursing caries: A comprehensive review. Pediatr Dent 1988;10:268-82.  Back to cited text no. 10
[PUBMED]    
11.Drury TF, Horowitz AM, Ismail AI, Maertens MP, Rozier RG, Selwitz RH. Diagnosing and reporting early childhood caries for research purposes. A report of a workshop sponsored by the National Institute of Dental and Craniofacial Research, the Health Resources and Services Administration, and the Health Care Financing Administration. J Public Health Dent 1999;59:192-7.  Back to cited text no. 11
[PUBMED]    
12.Schroth RJ, Brothwell DJ, Moffatt ME. Caregiver knowledge and attitudes of preschool oral health and early childhood caries (ECC). Int J Circumpolar Health 2007;66:153-67.  Back to cited text no. 12
[PUBMED]    
13.Suzuki N, Yoneda M, Naito T, Iwamoto T, Hirofuji T. Relationship between halitosis and psychologic status. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2008;106:542-7.  Back to cited text no. 13
[PUBMED]    
14.Berkowitz RJ. Causes, treatment and prevention of early childhood caries: A microbiologic perspective. J Can Dent Assoc 2003;69:304-7.  Back to cited text no. 14
[PUBMED]    
15.van Houte J, Gibbs G, Butera C. Oral flora of children with "nursing bottle caries". J Dent Res 1982;61:382-5.  Back to cited text no. 15
[PUBMED]    
16.Kelly M, Bruerd B. The prevalence of baby bottle tooth decay among two native American populations. J Public Health Dent 1987;47:94-7.  Back to cited text no. 16
[PUBMED]    
17.Vadiakas G. Case definition, aetiology and risk assessment of early childhood caries (ECC): A revisited review. Eur Arch Paediatr Dent 2008;9:114-25.  Back to cited text no. 17
[PUBMED]    
18.Milnes AR. Description and epidemiology of nursing caries. J Public Health Dent 1996;56:38-50.  Back to cited text no. 18
[PUBMED]    
19.Burt BA, Eklund SA. Dentistry, dental practice, and the community. 5 th ed. Philadelphia: Saunders; 1999.  Back to cited text no. 19
    
20.Douglass JM, Tinanoff N, Tang JM, Altman DS. Dental caries patterns and oral health behaviors in Arizona infants and toddlers. Community Dent Oral Epidemiol 2001;29:14-22.  Back to cited text no. 20
[PUBMED]    
21.Davies GM, Blinkhorn FA, Duxbury JT. Caries among 3-year-olds in greater Manchester. Br Dent J 2001;190:381-4.  Back to cited text no. 21
[PUBMED]    
22.Szatko F, Wierzbicka M, Dybizbanska E, Struzycka I, Iwanicka-Frankowska E. Oral health of Polish three-year-olds and mothers' oral health-related knowledge. Community Dent Health 2004;21:175-80.  Back to cited text no. 22
[PUBMED]    
23.Tang JM, Altman DS, Robertson DC, O'Sullivan DM, Douglass JM, Tinanoff N. Dental caries prevalence and treatment levels in Arizona preschool children. Public Health Rep 1997;112:319-29;30-1.  Back to cited text no. 23
[PUBMED]    
24.Reisine S, Douglass JM. Psychosocial and behavioral issues in early childhood caries. Community Dent Oral Epidemiol 1998;26:32-44.  Back to cited text no. 24
[PUBMED]    
25.Harrison R, Wong T, Ewan C, Contreras B, Phung Y. Feeding practices and dental caries in an urban Canadian population of Vietnamese preschool children. ASDC J Dent Child 1997;64:112-7.  Back to cited text no. 25
[PUBMED]    
26.Albert RJ, Cantin RY, Cross HG, Castaldi CR. Nursing caries in the Inuit children of the Keewatin. J Can Dent Assoc 1988;54:751-8.  Back to cited text no. 26
[PUBMED]    
27.Harrison R, White L. A community-based approach to infant and child oral health promotion in a British Columbia First Nations community. Can J Community Dent 1997;12:7-14.  Back to cited text no. 27
    
28.Rosenblatt A, Zarzar P. The prevalence of early childhood caries in 12- to 36-month-old children in Recife, Brazil. ASDC J Dent Child 2002;69:319-24,236.  Back to cited text no. 28
[PUBMED]    
29.Peressini S, Leake JL, Mayhall JT, Maar M, Trudeau R. Prevalence of early childhood caries among First Nations children, District of Manitoulin, Ontario. Int J Paediatr Dent 2004;14:101-10.  Back to cited text no. 29
[PUBMED]    
30.Tsai AI, Chen CY, Li LA, Hsiang CL, Hsu KH. Risk indicators for early childhood caries in Taiwan. Community Dent Oral Epidemiol 2006;34:437-45.  Back to cited text no. 30
[PUBMED]    
31.Carino KM, Shinada K, Kawaguchi Y. Early childhood caries in northern Philippines. Community Dent Oral Epidemiol 2003;31:81-9.  Back to cited text no. 31
    
32.Jin BH, Ma DS, Moon HS, Paik DI, Hahn SH, Horowitz AM. Early childhood caries: Prevalence and risk factors in Seoul, Korea. J Public Health Dent 2003;63:183-8.  Back to cited text no. 32
[PUBMED]    
33.Jose B, King NM. Early childhood caries lesions in preschool children in Kerala, India. Pediatr Dent 2003;25:594-600.  Back to cited text no. 33
[PUBMED]    
34.Weinstein P, Harrison R, Benton T. Motivating parents to prevent caries in their young children: One-year findings. J Am Dent Assoc 2004;135:731-8.  Back to cited text no. 34
[PUBMED]    
35.Rajab LD, Hamdan MA. Early childhood caries and risk factors in Jordan. Community Dent Health 2002;19:224-9.  Back to cited text no. 35
[PUBMED]    
36.Al-Malik MI, Holt RD, Bedi R. The relationship between erosion, caries and rampant caries and dietary habits in preschool children in Saudi Arabia. Int J Paediatr Dent 2001;11:430-9.  Back to cited text no. 36
[PUBMED]    
37.Al-Hosani E, Rugg-Gunn A. Combination of low parental educational attainment and high parental income related to high caries experience in pre-school children in Abu Dhabi. Community Dent Oral Epidemiol 1998;26:31-6.  Back to cited text no. 37
[PUBMED]    
38.Kiwanuka SN, Astrom AN, Trovik TA. Dental caries experience and its relationship to social and behavioural factors among 3-5-year-old children in Uganda. Int J Paediatr Dent 2004;14:336-46.  Back to cited text no. 38
    
39.Masiga MA, Holt RD. The prevalence of dental caries and gingivitis and their relationship to social class amongst nursery-school children in Nairobi, Kenya. Int J Paediatr Dent 1993;3:135-40.  Back to cited text no. 39
[PUBMED]    
40.Davies GN. Early childhood caries--a synopsis. Community Dent Oral Epidemiol 1998;26:106-16.  Back to cited text no. 40
[PUBMED]    
41.Tanzer JM, Livingston J, Thompson AM. The microbiology of primary dental caries in humans. J Dent Educ 2001;65:1028-37.  Back to cited text no. 41
[PUBMED]    
42.Nurelhuda NM, Al-Haroni M, Trovik TA, Bakken V. Caries experience and quantification of Streptococcus mutans and Streptococcus sobrinus in saliva of Sudanese schoolchildren. Caries Res 2010;44:402-7.  Back to cited text no. 42
[PUBMED]    
43.Schafer TE, Adair SM. Prevention of dental disease. The role of the pediatrician. Pediatr Clin North Am 2000;47:1021-42, v-vi.  Back to cited text no. 43
[PUBMED]    
44.Caufield PW, Griffen AL. Dental caries. An infectious and transmissible disease. Pediatr Clin North Am 2000;47:1001-19, v.  Back to cited text no. 44
[PUBMED]    
45.Berkowitz RJ, Turner J, Hughes C. Microbial characteristics of the human dental caries associated with prolonged bottle-feeding. Arch Oral Biol 1984;29:949-51.  Back to cited text no. 45
[PUBMED]    
46.Milnes AR, Bowden GH. The microflora associated with developing lesions of nursing caries. Caries Res 1985;19:289-97.  Back to cited text no. 46
[PUBMED]    
47.Loesche WJ. Nutrition and dental decay in infants. Am J Clin Nutr 1985;41:423-35.  Back to cited text no. 47
[PUBMED]    
48.Caufield PW, Cutter GR, Dasanayake AP. Initial Acquisition of Mutans Streptococci by Infants: Evidence for a Discrete Window of Infectivity. J Dent Res 1993;72:37-45.  Back to cited text no. 48
[PUBMED]    
49.Ercan E, Dulgergil CT, Yildirim I, Dalli M. Prevention of maternal bacterial transmission on children's dental-caries-development: 4-year results of a pilot study in a rural-child population. Arch Oral Biol 2007;52:748-52.  Back to cited text no. 49
    
50.Turksel Dulgergil C, Satici O, Yildirim I, Yavuz I. Prevention of caries in children by preventive and operative dental care for mothers in rural Anatolia, Turkey. Acta Odontol Scand 2004;62:251-7.  Back to cited text no. 50
    
51.Köhler B, Andréen I, Jonsson B. The earlier the colonization by mutans streptococci, the higher the caries prevalence at 4 years of age. Oral Microbiol Immunol 1988;3:14-7.  Back to cited text no. 51
    
52.Davey AL, Rogers AH. Multiple types of the bacterium Streptococcus mutans in the human mouth and their intra-family transmission. Arch Oral Biol 1984;29:453-60.  Back to cited text no. 52
    
53.Berkowitz RJ, Jordan HV. Similarity of bacteriocins of Streptococcus mutans from mother and infant. Arch Oral Biol 1975;20:725-30.  Back to cited text no. 53
    
54.Berkowitz RJ, Jones P. Mouth-to-mouth transmission of the bacterium Streptococcus mutans between mother and child. Arch Oral Biol 1985;30:377-9.  Back to cited text no. 54
    
55.Caufield PW, Childers NK, Allen DN, Hansen JB. Distinct bacteriocin groups correlate with different groups of Streptococcus mutans plasmids. Infect Immun 1985;48:51-6.  Back to cited text no. 55
    
56.Caufield PW, Ratanapridakul K, Allen DN, Cutter GR. Plasmid-containing strains of Streptococcus mutans cluster within family and racial cohorts: Implications for natural transmission. Infect Immun 1988;56:3216-20.  Back to cited text no. 56
    
57.Kulkarni GV, Chan KH, Sandham HJ. An investigation into the use of restriction endonuclease analysis for the study of transmission of mutans streptococci. J Dent Res 1989;68:1155-61.  Back to cited text no. 57
    
58.Caufield PW, Childers NK. Plasmids in Streptococcus mutans: Usefulness as epidemiological markers and association with mutacins. In: Hamada S, Michaelek S, editors. Proceedings of an International Conference on Cellular, Molecular, and Clinical Aspects of Streptococcus Mutans. Birmingham, Ala: Elsevier Science Publishers; 1985. p. 217-23.  Back to cited text no. 58
    
59.Azevedo TD, Bezerra AC, de Toledo OA. Feeding habits and severe early childhood caries in Brazilian preschool children. Pediatr Dent 2005;27:28-33.  Back to cited text no. 59
    
60.Hallett KB, O'Rourke PK. Early childhood caries and infant feeding practice. Community Dent Health 2002;19:237-42.  Back to cited text no. 60
    
61.Oulis CJ, Berdouses ED, Vadiakas G, Lygidakis NA. Feeding practices of Greek children with and without nursing caries. Pediatr Dent 1999;21:409-16.  Back to cited text no. 61
    
62.Kramer MS, Kakuma R. Optimal duration of exclusive breastfeeding. Cochrane Database Syst Rev 2002;1:CD003517.  Back to cited text no. 62
    
63.Ramos-Gomez F, Crystal YO, Ng MW, Tinanoff N, Featherstone JD. Caries risk assessment, prevention, and management in pediatric dental care. Gen Dent 2010;58:505-17;quiz 18-9.  Back to cited text no. 63
    
64.Van Loveren C. Sugar alcohols: What is the evidence for caries-preventive and caries-therapeutic effects? Caries Res 2004;38:286-93.  Back to cited text no. 64
    
65.van Palenstein Helderman WH, Soe W, van 't Hof MA. Risk factors of early childhood caries in a Southeast Asian population. J Dent Res 2006;85:85-8.  Back to cited text no. 65
    
66.Naylor MN. Diet and the prevention of dental caries. J R Soc Med 1986;79 Suppl 14:11-4.  Back to cited text no. 66
    
67.Jensen ME. Diet and dental caries. Dent Clin North Am 1999;43:615-33.  Back to cited text no. 67
    
68.Birkhed D. Sugar substitutes--one consequence of the Vipeholm Study? Scand J Dent Res 1989;97:126-9.  Back to cited text no. 68
    
69.Harel-Raviv M, Laskaris M, Chu KS. Dental caries and sugar consumption into the 21 st century. Am J Dent 1996;9:184-90.  Back to cited text no. 69
    
70.Marrs JA, Trumbley S, Malik G. Early childhood caries: Determining the risk factors and assessing the prevention strategies for nursing intervention. Pediatr Nurs 2011;37:9-15;quiz 6.  Back to cited text no. 70
    
71.Sanders TA. Diet and general health: Dietary counselling. Caries Res 2004;38 Suppl 1:3-8.  Back to cited text no. 71
    
72.Luke GA, Gough H, Beeley JA, Geddes DA. Human salivary sugar clearance after sugar rinses and intake of foodstuffs. Caries Res 1999;33:123-9.  Back to cited text no. 72
    
73.Diet, nutrition and the prevention of chronic diseases. World Health Organ Tech Rep Ser 2003;916:i-viii,1-149, backcover.  Back to cited text no. 73
    
74.Misra S, Tahmassebi JF, Brosnan M. Early childhood caries: A review. Dent Update 2007;34:556-8,61-2,64.  Back to cited text no. 74
    
75.Moynihan PJ. Update on the nomenclature of carbohydrates and their dental effects. J Dent 1998;26:209-18.  Back to cited text no. 75
    
76.Erickson PR, McClintock KL, Green N, LaFleur J. Estimation of the caries-related risk associated with infant formulas. Pediatr Dent 1998;20:395-403.  Back to cited text no. 76
    
77.Zero DT. Sugars - the arch criminal? Caries Res 2004;38:277-85.  Back to cited text no. 77
    
78.Slavkin HC. Streptococcus mutans, early childhood caries and new opportunities. J Am Dent Assoc 1999;130:1787-92.  Back to cited text no. 78
    
79.Weerheijm KL, Uyttendaele-Speybrouck BF, Euwe HC, Groen HJ. Prolonged demand breast-feeding and nursing caries. Caries Res 1998;32:46-50.  Back to cited text no. 79
    
80.Ramos-Gomez FJ, Tomar SL, Ellison J, Artiga N, Sintes J, Vicuna G. Assessment of early childhood caries and dietary habits in a population of migrant Hispanic children in Stockton, California. ASDC J Dent Child 1999;66:395-403,366.  Back to cited text no. 80
    
81.Quinonez RB, Keels MA, Vann WF Jr, McIver FT, Heller K, Whitt JK. Early childhood caries: Analysis of psychosocial and biological factors in a high-risk population. Caries Res 2001;35:376-83.  Back to cited text no. 81
    
82.Dini EL, Holt RD, Bedi R. Caries and its association with infant feeding and oral health-related behaviours in 3-4-year-old Brazilian children. Community Dent Oral Epidemiol 2000;28:241-8.  Back to cited text no. 82
    
83.Wendt LK, Hallonsten AL, Koch G, Birkhed D. Analysis of caries-related factors in infants and toddlers living in Sweden. Acta Odontol Scand 1996;54:131-7.  Back to cited text no. 83
    
84.Ruottinen S, Karjalainen S, Pienihakkinen K, Lagstrom H, Niinikoski H, Salminen M, et al. Sucrose intake since infancy and dental health in 10-year-old children. Caries Res 2004;38:142-8.  Back to cited text no. 84
    
85.Ismail AI, Tanzer JM, Dingle JL. Current trends of sugar consumption in developing societies. Community Dent Oral Epidemiol 1997;25:438-43.  Back to cited text no. 85
    
86.Sheiham A, Watt RG. The common risk factor approach: A rational basis for promoting oral health. Community Dent Oral Epidemiol 2000;28:399-406.  Back to cited text no. 86
    
87.Petti S, Cairella G, Tarsitani G. Rampant early childhood dental decay: An example from Italy. J Public Health Dent 2000;60:159-66.  Back to cited text no. 87
    
88.Policy on early childhood caries (ECC): Classifications, consequences, and preventive strategies. Pediatr Dent 2008;30:40-3.  Back to cited text no. 88
    
89.Colak H, Dülgergil ÇT, Serdaroðlu Ý. Aðýz ve Diþ Hastalýklarýnýn Medikal, Psikososyal ve Ekonomik Etkilerinin Deðerlendirilmesi. Saðlýkta Performans ve Kalite Dergisi 2010;1:63-89.  Back to cited text no. 89
    
90.Locker D. Concepts of oral health, disease and the quality of life. In: Slade GD, editor. Measuring oral health and quality of life. Chapel Hill: University of North Carolina, Dental Ecology; 1997. p. 11-23.  Back to cited text no. 90
    
91.Petersen PE, Estupinan-Day S, Ndiaye C. WHO's action for continuous improvement in oral health. Bull World Health Organ 2005;83:642.  Back to cited text no. 91
    
92.Acs G, Lodolini G, Kaminsky S, Cisneros GJ. Effect of nursing caries on body weight in a pediatric population. Pediatr Dent 1992;14:302-5.  Back to cited text no. 92
    
93.Acs G, Shulman R, Ng MW, Chussid S. The effect of dental rehabilitation on the body weight of children with early childhood caries. Pediatr Dent 1999;21:109-13.  Back to cited text no. 93
    
94.Acs G, Lodolini G, Shulman R, Chussid S. The effect of dental rehabilitation on the body weight of children with failure to thrive: Case reports. Compend Contin Educ Dent 1998;19:164-8,70-1.  Back to cited text no. 94
    
95.Sheller B, Williams BJ, Hays K, Mancl L. Reasons for repeat dental treatment under general anesthesia for the healthy child. Pediatr Dent 2003;25:546-52.  Back to cited text no. 95
    
96.Casamassimo PS, Thikkurissy S, Edelstein BL, Maiorini E. Beyond the dmft: The human and economic cost of early childhood caries. J Am Dent Assoc 2009;140:650-7.  Back to cited text no. 96
    
97.Friedlaender EY, Rubin DM, Alpern ER, Mandell DS, Christian CW, Alessandrini EA. Patterns of health care use that may identify young children who are at risk for maltreatment. Pediatrics 2005;116:1303-8.  Back to cited text no. 97
    
98.Valencia-Rojas N, Lawrence HP, Goodman D. Prevalence of early childhood caries in a population of children with history of maltreatment. J Public Health Dent 2008;68:94-101.  Back to cited text no. 98
    
99.Foundation TDH. California children and families first initiative (Proposition 10). Why should there be a dental component? White Paper available from the Dental Health Foundation, 520 Third Street, Suite 205, Oakland, CA 94607, 1999.  Back to cited text no. 99
    
100.Sheiham A. Dental caries affects body weight, growth and quality of life in pre-school children. Br Dent J 2006;201:625-6.  Back to cited text no. 100
    
101.Means RT Jr. Recent developments in the anemia of chronic disease. Curr Hematol Rep 2003;2:116-21.  Back to cited text no. 101
    
102.Means RT Jr, Krantz SB. Progress in understanding the pathogenesis of the anemia of chronic disease. Blood 1992;80:1639-47.  Back to cited text no. 102
    
103.Reisine S, Litt M, Tinanoff N. A biopsychosocial model to predict caries in preschool children. Pediatr Dent 1994;16:413-8.  Back to cited text no. 103
    
104.Birkeland JM, Broch L, Jorkjend L. Caries experience as predictor for caries incidence. Community Dent Oral Epidemiol 1976;4:66-9.  Back to cited text no. 104
    
105.Tinanoff N, Reisine S. Update on early childhood caries since the Surgeon General's Report. Acad Pediatr 2009;9:396-403.  Back to cited text no. 105
    
106.Steiner M, Helfenstein U, Marthaler TM. Dental predictors of high caries increment in children. J Dent Res 1992;71:1926-33.  Back to cited text no. 106
    
107.van Palenstein Helderman WH, van't Hof MA, van Loveren C. Prognosis of caries increment with past caries experience variables. Caries Res 2001;35:186-92.  Back to cited text no. 107
    
108.O'Sullivan DM, Tinanoff N. The association of early dental caries patterns with caries incidence in preschool children. J Public Health Dent 1996;56:81-3.  Back to cited text no. 108
    
109.Johnsen DC, Gerstenmaier JH, DiSantis TA, Berkowitz RJ. Susceptibility of nursing-caries children to future approximal molar decay. Pediatr Dent 1986;8:168-70.  Back to cited text no. 109
    
110.Kishi M, Abe A, Kishi K, Ohara-Nemoto Y, Kimura S, Yonemitsu M. Relationship of quantitative salivary levels of Streptococcus mutans and S. sobrinus in mothers to caries status and colonization of mutans streptococci in plaque in their 2.5-year-old children. Community Dent Oral Epidemiol 2009;37:241-9.  Back to cited text no. 110
    
111.King N, Anthonappa R, Itthagarun A. The importance of the primary dentition to children - Part 1: Consequences of not treating carious teeth. Hong Kong Pract 2007;29:52-61.  Back to cited text no. 111
    
112.Kohler B, Andreen I. Mutans streptococci and caries prevalence in children after early maternal caries prevention: A follow-up at eleven and fifteen years of age. Caries Res 2010;44:453-8.  Back to cited text no. 112
    
113.Ismail AI. Prevention of early childhood caries. Community Dent Oral Epidemiol 1998;26:49-61.  Back to cited text no. 113
    
114.Dülgergil ÇT, Colak H. Rural Dentistry: Is it an imagination or obligation in Community Dental Health Education. Niger Med J 2012;53:1-8 [Epub ahead of print]  Back to cited text no. 114
    
115.Overton DA. Community oral health education. In: Mason J, editor. Concepts in Dental Public Health. Philadelphia: Lippincott Williams and Wilkin; 2005. p. 139-57.  Back to cited text no. 115
    
116.Adair P, Ashcroft A. Theory-based approaches to the planning and evaluation of oral health education programmes. In: Pine CM, Harris R, editors. Community Oral Health. Berlin: Quintessence; 2007. p. 307-31.  Back to cited text no. 116
    
117.Curnow MM, Pine CM, Burnside G, Nicholson JA, Chesters RK, Huntington E. A randomised controlled trial of the efficacy of supervised toothbrushing in high-caries-risk children. Caries Res 2002;36:294-300.  Back to cited text no. 117
    
118.de Almeida CM, Petersen PE, Andre SJ, Toscano A. Changing oral health status of 6- and 12-year-old schoolchildren in Portugal. Community Dent Health 2003;20:211-6.  Back to cited text no. 118
    
119.Ercan E, Baðlar S, Colak H. Topical Fluoride Application Methods in Dentistry. Cumhuriyet Dent J 2010;13:27-33.  Back to cited text no. 119
    
120.Weintraub JA. Fluoride varnish for caries prevention: Comparisons with other preventive agents and recommendations for a community-based protocol. Spec Care Dentist 2003;23:180-6.  Back to cited text no. 120
    
121.Bader JD, Shugars DA, Bonito AJ. Systematic reviews of selected dental caries diagnostic and management methods. J Dent Educ 2001;65:960-8.  Back to cited text no. 121
    
122.Helfenstein U, Steiner M. Fluoride varnishes (Duraphat): A meta-analysis. Community Dent Oral Epidemiol 1994;22:1-5.  Back to cited text no. 122
    
123.Strohmenger L, Brambilla E. The use of fluoride varnishes in the prevention of dental caries: A short review. Oral Dis 2001;7:71-80.  Back to cited text no. 123
    
124.Marinho VC, Higgins JP, Logan S, Sheiham A. Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2002;3:CD002279.  Back to cited text no. 124
    
125.Diagnosis and management of dental caries throughout life. National Institutes of Health Consensus Development Conference statement, March 26-28, 2001. J Dent Educ 2001;65:1162-8.  Back to cited text no. 125
    
126.Skold-Larsson K, Modeer T, Twetman S. Fluoride concentration in plaque in adolescents after topical application of different fluoride varnishes. Clin Oral Investig 2000;4:31-4.  Back to cited text no. 126
    
127.ten Cate JM, Featherstone JD. Mechanistic aspects of the interactions between fluoride and dental enamel. Crit Rev Oral Biol Med 1991;2:283-96.  Back to cited text no. 127
    
128.Marinho VC, Higgins JP, Sheiham A, Logan S. Combinations of topical fluoride (toothpastes, mouthrinses, gels, varnishes) versus single topical fluoride for preventing dental caries in children and adolescents. Cochrane Database Syst Rev 2004;1:CD002781.  Back to cited text no. 128
    
129.Bratthall D, Hansel-Petersson G, Sundberg H. Reasons for the caries decline: What do the experts believe? Eur J Oral Sci 1996;104:416-22;discussion 23-5,30-2.  Back to cited text no. 129
    
130.Marinho VC. Evidence-based effectiveness of topical fluorides. Adv Dent Res 2008;20:3-7.  Back to cited text no. 130
    
131.Twetman S, Axelsson S, Dahlgren H, Holm AK, Kallestal C, Lagerlof F, et al. Caries-preventive effect of fluoride toothpaste: A systematic review. Acta Odontol Scand 2003;61:347-55.  Back to cited text no. 131
    
132.Jones S, Burt BA, Petersen PE, Lennon MA. The effective use of fluorides in public health. Bull World Health Organ 2005;83:670-6.  Back to cited text no. 132
    
133.Seppa L. The future of preventive programs in countries with different systems for dental care. Caries Res 2001;35 Suppl 1:26-9.  Back to cited text no. 133
    
134.Twetman S, Garcia-Godoy F, Goepferd SJ. Infant oral health. Dent Clin North Am 2000;44:487-505.  Back to cited text no. 134
    
135.Gussy MG, Waters EG, Walsh O, Kilpatrick NM. Early childhood caries: Current evidence for aetiology and prevention. J Paediatr Child Health 2006;42:37-43.  Back to cited text no. 135
    
136.Featherstone JDB. The Continuum of Dental Caries-Evidence for a Dynamic Disease Process. J Dent Res 2004;83:C39-42.  Back to cited text no. 136
    
137.Jenkins GN. Recent changes in dental caries. Br Med J (Clin Res Ed) 1985;291:1297-8.  Back to cited text no. 137
    
138.American Dental Association (ADA). (2008). Fluoridation facts. Retrieved September 1, from http://www.ada.org/sections/newsAndEvents/pdfs/fluoridation_facts. pdf.  Back to cited text no. 138
    
139.Populations receiving optimally fluoridated public drinking water: United States, 1992-2006. MMWR Morb Mortal Wkly Rep 2008;57:737-41.  Back to cited text no. 139
    
140.Tinanoff N, Douglass JM. Clinical decision-making for caries management in primary teeth. J Dent Educ 2001;65:1133-42.  Back to cited text no. 140
    
141.Kindelan SA, Day P, Nichol R, Willmott N, Fayle SA. UK National Clinical Guidelines in Paediatric Dentistry: Stainless steel preformed crowns for primary molars. Int J Paediatr Dent 2008;18 Suppl 1:20-8.  Back to cited text no. 141
    
142.Dulgergil CT, Soyman M, Civelek A. Atraumatic restorative treatment with resin-modified glass ionomer material: Short-term results of a pilot study. Med Princ Pract 2005;14:277-80.  Back to cited text no. 142
    
143.Ercan E, Dülgergil ÇT, Dalli M, Yildirim I, Ince B, Çolak H. Anticaries effect of atraumatic restorative treatment with fissure sealants in suburban districts of Turkey. J Dent Sci 2009;4:55-60.  Back to cited text no. 143
    
144.Dallý M, Çolak H, Mustafa Hamidi M. Minimal intervention concept: A new paradigm for operative dentistry. J Investig Clin Dent. 2012 Feb 8. doi: 10.1111/j.2041-1626.2012.00117.x. [Epub ahead of print]  Back to cited text no. 144
    
145.Ercan E, Dulgergil CT, Soyman M, Dalli M, Yildirim I. A field-trial of two restorative materials used with atraumatic restorative treatment in rural Turkey: 24-month results. J Appl Oral Sci 2009;17:307-14.  Back to cited text no. 145
    
146.Frencken JE, Pilot T, Songpaisan Y, Phantumvanit P. Atraumatic restorative treatment (ART): Rationale, technique, and development. J Public Health Dent 1996;56:135-40;discussion 61-3.  Back to cited text no. 146
    
147.Seale NS, Casamassimo PS. Access to dental care for children in the United States: A survey of general practitioners. J Am Dent Assoc 2003;134:1630-40.  Back to cited text no. 147
    
148.Da Franca C, Colares V, Van Amerongen E. Two-year evaluation of the atraumatic restorative treatment approach in primary molars class I and II restorations. Int J Paediatr Dent 2011;21:249-53.  Back to cited text no. 148
    
149.Schriks MC, van Amerongen WE. Atraumatic perspectives of ART: Psychological and physiological aspects of treatment with and without rotary instruments. Community Dent Oral Epidemiol 2003;31:15-20.  Back to cited text no. 149
    


    Figures

  [Figure 1]
 
 
    Tables

  [Table 1], [Table 2]


This article has been cited by
1 Young children and snacks - is tooth brushing alone not enough to prevent tooth decay?
H. Gibson-Moore,B. Benelam
Nutrition Bulletin. 2018; 43(3): 248
[Pubmed] | [DOI]
2 Comparative Analysis of the Microbial Profiles in Supragingival Plaque Samples Obtained From Twins With Discordant Caries Phenotypes and Their Mothers
Yuqiao Zheng,Meng Zhang,Jin Li,Yuhong Li,Fei Teng,Han Jiang,Minquan Du
Frontiers in Cellular and Infection Microbiology. 2018; 8
[Pubmed] | [DOI]
3 Homecare protective and risk factors for early childhood caries in Japan
Ritsuko Nishide,Mayumi Mizutani,Susumu Tanimura,Noriko Kudo,Takayuki Nishii,Hiroyo Hatashita
Environmental Health and Preventive Medicine. 2018; 23(1)
[Pubmed] | [DOI]
4 The impact of anticipatory guidance on early childhood caries: a quasi-experimental study
Azhani Ismail,Ishak A. Razak,Norintan Ab-Murat
BMC Oral Health. 2018; 18(1)
[Pubmed] | [DOI]
5 The importance of dental health
Amy Noakes
Journal of Health Visiting. 2018; 6(10): 482
[Pubmed] | [DOI]
6 Association between sickle cell disease and the oral health condition of children and adolescents
Carla Figueiredo Brandão,Viviane Maia Barreto Oliveira,Ada Rocha Ramony Martins Santos,Taísa Midlej Martins da Silva,Verônica Queiroz Cruz Vilella,Gleice Glenda Prata Pimentel Simas,Laura Regina Santos Carvalho,Raissa Aires Costa Carvalho,Ana Marice Teixeira Ladeia
BMC Oral Health. 2018; 18(1)
[Pubmed] | [DOI]
7 Process evaluation of the midwifery initiated oral health-dental service program: Perceptions of midwives in Greater Western Sydney, Australia
Hannah G. Dahlen,Maree Johnson,Julia Hoolsema,Tiffany Patterson Norrie,Shilpi Ajwani,Anthony Blinkhorn,Sameer Bhole,Sharon Ellis,Ravi Srinivas,Albert Yaacoub,Andrew Milat,John Skinner,Ajesh George
Women and Birth. 2018;
[Pubmed] | [DOI]
8 Perinatal HIV Infection and Exposure and Their Association With Dental Caries in Nigerian Children
Modupe Coker,Samer S. El-Kamary,Cyril Enwonwu,William Blattner,Patricia Langenberg,Emmanuel Mongodin,Paul Akhigbe,Ozo Obuekwe,Austin Omoigberale,Manhattan Charurat
The Pediatric Infectious Disease Journal. 2018; 37(1): 59
[Pubmed] | [DOI]
9 Infant Oral Health
Erica A. Brecher,Charlotte W. Lewis
Pediatric Clinics of North America. 2018; 65(5): 909
[Pubmed] | [DOI]
10 Parental Attitudes and Beliefs About Preschooler Preventive Oral Health Behaviors: Implications for Health Promotion
Rachel Clarke,Mary Shaw-Ridley
Journal of Immigrant and Minority Health. 2018;
[Pubmed] | [DOI]
11 A Modified Pretreatment with Deproteinization for Resin Infiltration in Early Childhood Caries
Siyeon Nam,Jonghyun Shin,Taesung Jeong,Shin Kim,Jiyeon Kim
THE JOURNAL OF THE KOREAN ACADEMY OF PEDTATRIC DENTISTRY. 2018; 45(3): 290
[Pubmed] | [DOI]
12 The role of parental anxiety, depression, and psychological stress level on the development of early-childhood caries in children
Lidia Gavic,Antonija Tadin,Ina Mihanovic,Kristina Gorseta,Livia Cigic
International Journal of Paediatric Dentistry. 2018;
[Pubmed] | [DOI]
13 Oral health-related quality of life changes in children following dental treatment under general anaesthesia: a meta-analysis
Joon Soo Park,Robert P. Anthonappa,Rana Yawary,Nigel M. King,Luc C. Martens
Clinical Oral Investigations. 2018;
[Pubmed] | [DOI]
14 Evaluation of a Comprehensive Oral Health Services Program in School-Based Health Centers
Tara Trudnak Fowler,Gregory Matthews,Cydny Black,Hendi Crosby Kowal,Pamella Vodicka,Elizabeth Edgerton
Maternal and Child Health Journal. 2018;
[Pubmed] | [DOI]
15 Effects of nutrition and hygiene education on oral health and growth among toddlers in rural Uganda: follow-up of a cluster-randomised controlled trial
Grace K. M. Muhoozi,Prudence Atukunda,Anne B. Skaare,Tiril Willumsen,Lien My Diep,Ane C. Westerberg,Per Ole Iversen
Tropical Medicine & International Health. 2018;
[Pubmed] | [DOI]
16 Pulpotomy versus pulpectomy in the treatment of vital pulp exposure in primary incisors. A systematic review and meta-analysis.
Lamia Gadallah,Mahmoud Hamdy,Adel El Bardissy,Mohamed Abou El Yazeed
F1000Research. 2018; 7: 1560
[Pubmed] | [DOI]
17 Candida albicans and Early Childhood Caries: A Systematic Review and Meta-Analysis
Jin Xiao,Xuelian Huang,Naemah Alkhers,Hassan Alzamil,Sari Alzoubi,Tong Tong Wu,Daniel A. Castillo,Frank Campbell,Joseph Davis,Karli Herzog,Ronald Billings,Dorota T. Kopycka-Kedzierawski,Evlambia Hajishengallis,Hyun Koo
Caries Research. 2018; : 102
[Pubmed] | [DOI]
18 Research roundup: April 2018
Sheila Lally,Judy Brook,Angela Willis
Journal of Health Visiting. 2018; 6(4): 162
[Pubmed] | [DOI]
19 Failure Rate of Pediatric Dental Treatment under General Anesthesia
Effat Khodadadi,Mehrnaz Mohammadpour,Saeed Motamedian,Farnaz Kouhestani
Dentistry Journal. 2018; 6(3): 25
[Pubmed] | [DOI]
20 The oral health behaviours and fluid consumption practices of young urban aboriginal preschool children in south-western Sydney, New South Wales, Australia
Ajesh George,Rebekah Grace,Emma Elcombe,Amy R. Villarosa,Holly A. Mack,Lynn Kemp,Shilpi Ajwani,Darryl C. Wright,Cheryl Anderson,Natasha Bucknall,Elizabeth Comino
Health Promotion Journal of Australia. 2018;
[Pubmed] | [DOI]
21 Dental caries prevention in children and adolescents: a systematic quality assessment of clinical practice guidelines
Andrea Seiffert,Carlos Zaror,Claudia Atala-Acevedo,Andrea Ormeño,María José Martínez-Zapata,Pablo Alonso-Coello
Clinical Oral Investigations. 2018;
[Pubmed] | [DOI]
22 Evaluation of determinant factors for the presence and activity of dental caries in five-year-old children: study with decision tree
Monalisa Cesarino Gomes,Matheus França Perazzo,Erick Tássio Neves,Maria Betânia Lins Dantas Siqueira,Edja Maria Melo de Brito Costa,Ane Polline Lacerda Protasio,Adriana Freitas Lins Pimentel Silva,Kátia Virgínia Guerra Botelho,Ana Flávia Granville-Garcia
Journal of Public Health. 2018;
[Pubmed] | [DOI]
23 Survival Rates of Stainless Steel Crowns and Multi-Surface Composite Restorations Placed by Dental Students in a Pediatric Clinic
Badia A Zahdan,Aniko Szabo,Cesar D Gonzalez,Elaye M Okunseri,Christopher E Okunseri
Journal of Clinical Pediatric Dentistry. 2018;
[Pubmed] | [DOI]
24 Dental caries and their association with socioeconomic characteristics, oral hygiene practices and eating habits among preschool children in Abu Dhabi, United Arab Emirates — the NOPLAS project
Amal Elamin,Malin Garemo,Andrew Gardner
BMC Oral Health. 2018; 18(1)
[Pubmed] | [DOI]
25 Early Childhood Caries: Epidemiology, Aetiology, and Prevention
F. Meyer,J. Enax
International Journal of Dentistry. 2018; 2018: 1
[Pubmed] | [DOI]
26 Epidemiological profile of patients utilising public oral health services in Limpopo province, South Africa
Lawrence K. Thema,Shenuka Singh
African Journal of Primary Health Care & Family Medicine. 2017; 9(1)
[Pubmed] | [DOI]
27 Association Between Severe Dental Caries and Child Abuse and Neglect
Henk Sillevis Smitt,Jenny de Leeuw,Tjalling de Vries
Journal of Oral and Maxillofacial Surgery. 2017;
[Pubmed] | [DOI]
28 Salivary proteins and microbiota as biomarkers for early childhood caries risk assessment
Abdullah S Hemadi,Ruijie Huang,Yuan Zhou,Jing Zou
International Journal of Oral Science. 2017; 9(11): e1
[Pubmed] | [DOI]
29 Factors Associated with Dental Caries in Primary Dentition in a Non-Fluoridated Rural Community of New South Wales, Australia
Amit Arora,Narendar Manohar,James Rufus John
International Journal of Environmental Research and Public Health. 2017; 14(12): 1444
[Pubmed] | [DOI]
30 Oral and Dental Health Considerations in Feeding Toddlers
Carole A. Palmer
Nutrition Today. 2017; 52(Supplement): S69
[Pubmed] | [DOI]
31 Nutritional aspects of commercially prepared infant foods in developed countries: a narrative review
Kate Maslin,Carina Venter
Nutrition Research Reviews. 2017; : 1
[Pubmed] | [DOI]
32 Prevalence of early childhood caries and its related risk factors in preschoolers: Result from a cross sectional study in Vietnam
Do Minh Huong,Le Thi Thu Hang,Vo Truong Nhu Ngoc,Le Quynh Anh,Le Hoang Son,Dinh-Toi Chu,Duc-Hau Le
Pediatric Dental Journal. 2017;
[Pubmed] | [DOI]
33 Maternal identification of dental caries lesions in their children aged 1–3 years
I. B. Fernandes,A. C. Sá-Pinto,L. Silva Marques,J. Ramos-Jorge,M. L. Ramos-Jorge
European Archives of Paediatric Dentistry. 2017;
[Pubmed] | [DOI]
34 Finite Element Analysis of Mechanical Behavior of Restored Maxillary and Mandibular Deciduous Incisors
Florin Baciu,Aurelia Rusu-Casandra,Claudia Bratosin
Key Engineering Materials. 2017; 752: 11
[Pubmed] | [DOI]
35 Factors determining access to oral health services among children aged less than 12 years in Peru
Diego Azañedo,Akram Hernández-Vásquez,Mixsi Casas-Bendezú,César Gutiérrez,Andrés A. Agudelo-Suárez,Sandra Cortés
F1000Research. 2017; 6: 1680
[Pubmed] | [DOI]
36 Quantitative assessment of salivary oral bacteria according to the severity of dental caries in childhood
Natália H. Colombo,Paula F. Kreling,Laís F.F. Ribas,Jesse A. Pereira,Christine A. Kressirer,Marlise I. Klein,Anne C.R. Tanner,Cristiane Duque
Archives of Oral Biology. 2017; 83: 282
[Pubmed] | [DOI]
37 Sociodemographic determinants of spatial disparities in early childhood caries: An ecological analysis in Braunschweig, Germany
Frederic Meyer,André Karch,Kristin Maria Schlinkmann,Johannes Dreesman,Johannes Horn,Nicole Rübsamen,Henny Sudradjat,Rainer Schubert,Rafael Mikolajczyk
Community Dentistry and Oral Epidemiology. 2017;
[Pubmed] | [DOI]
38 Immediate Postoperative Pain and Recovery Time after Pulpotomy Performed under General Anaesthesia in Young Children
Sultan Keles,Ozlem Kocaturk
Pain Research and Management. 2017; 2017: 1
[Pubmed] | [DOI]
39 Scardovia wiggsiae and its potential role as a caries pathogen
Christine A. Kressirer,Daniel J. Smith,William F. King,Justine M. Dobeck,Jacqueline R. Starr,Anne C.R. Tanner
Journal of Oral Biosciences. 2017;
[Pubmed] | [DOI]
40 Karmienie piersia a próchnica wczesnego dziecinstwa – systematyczny przeglad pismiennictwa
Angelika Kobylinska,Piotr Rozniatowski,Dorota Olczak-Kowalczyk
Pediatria Polska. 2017;
[Pubmed] | [DOI]
41 Management of dental caries among children: a look at the cost-effectiveness
Nathalia Miranda Ladewig,Lucila Basto Camargo,Tamara Kerber Tedesco,Isabela Floriano,Thais Gimenez,José Carlos P Imparato,Fausto Medeiros Mendes,Mariana Minatel Braga,Daniela Prócida Raggio
Expert Review of Pharmacoeconomics & Outcomes Research. 2017; : 1
[Pubmed] | [DOI]
42 Effectiveness of oral examination for infants and toddlers: effects on subsequent utilization and costs
Eunsuk Ahn,Hosung Shin
Journal of Korean Academy of Oral Health. 2017; 41(2): 73
[Pubmed] | [DOI]
43 Asociación de caries de infancia temprana con factores de riesgo en hogares comunitarios del Instituto Colombiano de Bienestar Familiar en Zipaquirá, Colombia
Carmenza Macías,Diana Díaz,Marta Caycedo,Francisco Lamus,Carlos Rincón
Revista Facultad de Odontología. 2016; 28(1): 123
[Pubmed] | [DOI]
44 Community-based assessment and intervention for early childhood caries in rural El Salvador
Darya Dabiri,Margherita Fontana,Yvonne Kapila,George Eckert,Karen Sokal-Gutierrez
International Dental Journal. 2016;
[Pubmed] | [DOI]
45 Salivary peptidome profiling for diagnosis of severe early childhood caries
Xiangyu Sun,Xin Huang,Xu Tan,Yan Si,Xiaozhe Wang,Feng Chen,Shuguo Zheng
Journal of Translational Medicine. 2016; 14(1)
[Pubmed] | [DOI]
46 Ernährung und Bewegung von Säuglingen und stillenden Frauen
B. Koletzko,C.-P. Bauer,M. Cierpka,M. Cremer,M. Flothkötter,C. Graf,I. Heindl,C. Hellmers,M. Kersting,M. Krawinkel,H. Przyrembel,K. Vetter,A. Weißenborn,A. Wöckel
Monatsschrift Kinderheilkunde. 2016;
[Pubmed] | [DOI]
47 The early childhood oral health program: a qualitative study of the perceptions of child and family health nurses in South Western Sydney, Australia
Maxine Veale,Shilpi Ajwani,Maree Johnson,Linda Nash,Tiffany Patterson,Ajesh George
BMC Oral Health. 2016; 16(1)
[Pubmed] | [DOI]
48 Doctoral dental hygiene education would prepare scholars and leaders to improve population health through changes in oral health policy and delivery
JoAnn R. Gurenlian,Ellen J. Rogo,Ann Eshenaur Spolarich
Journal of Evidence Based Dental Practice. 2016;
[Pubmed] | [DOI]
49 Emerging Early Actions to Bend the Curve in Sub-Saharan Africa’s Nutrition Transition
Steven Haggblade,Kwaku G. Duodu,John D. Kabasa,Amanda Minnaar,Nelson K. O. Ojijo,John R. N. Taylor
Food and Nutrition Bulletin. 2016; 37(2): 219
[Pubmed] | [DOI]
50 Factors Associated With Parents’ Perceptions of Their Infants’ Oral Health Care
Jeanette M. Daly,Steven M. Levy,Yinghui Xu,Richard D. Jackson,George J. Eckert,Barcey T. Levy,Margherita Fontana
Journal of Primary Care & Community Health. 2016; 7(3): 180
[Pubmed] | [DOI]
51 Candida albicans Carriage in Children with Severe Early Childhood Caries (S-ECC) and Maternal Relatedness
Jin Xiao,Yonghwi Moon,Lihua Li,Elena Rustchenko,Hironao Wakabayashi,Xiaoyi Zhao,Changyong Feng,Steven R. Gill,Sean McLaren,Hans Malmstrom,Yanfang Ren,Robert Quivey,Hyun Koo,Dorota T. Kopycka-Kedzierawski,Marcelle Nascimento
PLOS ONE. 2016; 11(10): e0164242
[Pubmed] | [DOI]
52 Prevalence of early childhood caries in non-fluoridated rural areas of Chile.
Gerardo Espinoza-Espinoza,Patricia Muñoz-Millán,Carolina Vergara-González,Claudia Atala-Acevedo,Carlos Zaror.
Journal of Oral Research. 2016; 5(8)
[Pubmed] | [DOI]
53 Evaluation of a regional German interdisciplinary oral health programme for children from birth to 5 years of age
Y Wagner,R Heinrich-Weltzien
Clinical Oral Investigations. 2016;
[Pubmed] | [DOI]
54 Who attends a Childrenæs Hospital Emergency Department for dental reasons? A two-step cluster analysis approach
Z. Marshman,T. Broomhead,H. D. Rodd,K. Jones,D. Burke,S. R. Baker
Community Dentistry and Oral Epidemiology. 2016;
[Pubmed] | [DOI]
55 Factors associated with caries: a survey of students from southern Brazil
Tássia Silvana Borges,Natalí Lippert Schwanke,Cézane Priscila Reuter,Léo Kraether Neto,Miria Suzana Burgos
Revista Paulista de Pediatria (English Edition). 2016;
[Pubmed] | [DOI]
56 Fatores associados à cárie: pesquisa de estudantes do sul do Brasil
Tássia Silvana Borges,Natalí Lippert Schwanke,Cézane Priscila Reuter,Léo Kraether Neto,Miria Suzana Burgos
Revista Paulista de Pediatria. 2016;
[Pubmed] | [DOI]
57 Framing Young Childrens Oral Health: A Participatory Action Research Project
Chimere C. Collins,Laura Villa-Torres,Lattice D. Sams,Leslie P. Zeldin,Kimon Divaris,Susan R. Rittling
PLOS ONE. 2016; 11(8): e0161728
[Pubmed] | [DOI]
58 Dentin caries risk indicators in 1-year-olds. A two year follow-up study
Ann Ingemansson Hultquist,Mats Bågesund
Acta Odontologica Scandinavica. 2016; : 1
[Pubmed] | [DOI]
59 Ernährung und Bewegung von Säuglingen und stillenden Frauen
B. Koletzko,C.-P. Bauer,M. Cierpka,M. Cremer,M. Flothkötter,C. Graf,I. Heindl,C. Hellmers,M. Kersting,M. Krawinkel,H. Przyrembel,K. Vetter,A. Weißenborn,A. Wöckel
Monatsschrift Kinderheilkunde. 2016; 164(S5): 433
[Pubmed] | [DOI]
60 A Three-Dimensional Finite Element Analysis of Restored Deciduous Canine
Florin Baciu,Claudia Bratosin,Aurelia Rusu-Casandra
Key Engineering Materials. 2015; 638: 123
[Pubmed] | [DOI]
61 An assessment of dental caries among young Aboriginal children in New South Wales, Australia: a cross-sectional study
Leanne Smith,Anthony Blinkhorn,Rachael Moir,Ngiare Brown,Fiona Blinkhorn
BMC Public Health. 2015; 15(1)
[Pubmed] | [DOI]
62 Socio-behavioural risk factors for early childhood caries (ECC) in Cambodian preschool children: a pilot study
B. Turton,C. Durward,D. Manton,K. Bach,C. Yos
European Archives of Paediatric Dentistry. 2015;
[Pubmed] | [DOI]
63 Immigrant Caregivers of Young Children: Oral Health Beliefs, Attitudes, and Early Childhood Caries Knowledge
Deborah A. Finnegan,Lori Rainchuso,Susan Jenkins,Erin Kierce,Andrew Rothman
Journal of Community Health. 2015;
[Pubmed] | [DOI]
64 Early childhood caries in Switzerland: a marker of social inequalities
Stéphanie Baggio,Marcelo Abarca,Patrick Bodenmann,Mario Gehri,Carlos Madrid
BMC Oral Health. 2015; 15(1)
[Pubmed] | [DOI]
65 Prevalence, and early childhood caries risk indicators in preschool children in suburban Nigeria
Morenike O Folayan,Kikelomo A Kolawole,Elizabeth O Oziegbe,Titus Oyedele,Olusegun V Oshomoji,Nneka M Chukwumah,Nneka Onyejaka
BMC Oral Health. 2015; 15(1)
[Pubmed] | [DOI]
66 Oral health status in Navajo Nation Head Start children
Terrence Batliner,Anne R. Wilson,Tamanna Tiwari,Deborah Glueck,William Henderson,Jacob Thomas,Patricia Braun,Diana Cudeii,David Quissell,Judith Albino
Journal of Public Health Dentistry. 2014; 74(4): 317
[Pubmed] | [DOI]
67 Risk factors for early colonization of mutans streptococci – a multiple logistic regression analysis in Swedish 1-year-olds
Ann Ingemansson Hultquist,Peter Lingström,Mats Bågesund
BMC Oral Health. 2014; 14(1): 147
[Pubmed] | [DOI]
68 Informing a culturally appropriate approach to oral health and dental care for pre-school refugee children: a community participatory study
Pam Nicol,Arwa Al-Hanbali,Nigel King,Linda Slack-Smith,Sarah Cherian
BMC Oral Health. 2014; 14(1): 69
[Pubmed] | [DOI]
69 Dental caries and associated factors among primary school children in Bahir Dar city: a cross-sectional study
Wondemagegn Mulu,Tazebew Demilie,Mulat Yimer,Kassaw Meshesha,Bayeh Abera
BMC Research Notes. 2014; 7(1): 949
[Pubmed] | [DOI]
70 Recruitment for Health Disparities Preventive Intervention Trials: The Early Childhood Caries Collaborating Centers
Tamanna Tiwari,Alana Casciello,Stuart A. Gansky,Michelle Henshaw,Francisco Ramos-Gomez,Margaret Rasmussen,Raul I. Garcia,Judith Albino,Terrence S. Batliner
Preventing Chronic Disease. 2014; 11
[Pubmed] | [DOI]
71 Propolis - based chitosan varnish: drug delivery, controlled release and antimicrobial activity against oral pathogen bacteria
Juçara R Franca,Mariana P De Luca,Tatiana G Ribeiro,Rachel O Castilho,Allyson N Moreira,Vagner R Santos,André AG Faraco
BMC Complementary and Alternative Medicine. 2014; 14(1): 478
[Pubmed] | [DOI]
72 Effect of changing the kilovoltage peak on radiographic caries assessment in digital and conventional radiography
Mohamed Khalifa Zayet,Yara Rabee Helaly,Salma Belal Eiid
Imaging Science in Dentistry. 2014; 44(3): 199
[Pubmed] | [DOI]
73 Barriers to adopting and implementing an oral health programme for managing early childhood caries through primary health care providers in Lima, Peru
Eraldo Pesaressi,Rita S Villena,Wil JM van der Sanden,Jan Mulder,Jo E Frencken
BMC Oral Health. 2014; 14(1): 17
[Pubmed] | [DOI]
74 Effectiveness of an oral health program for mothers and their infants
Patrícia B. V. Medeiros,Simone A. M. Otero,Jo E. Frencken,Ewald M. Bronkhorst,Soraya C. Leal
International Journal of Paediatric Dentistry. 2014; : n/a
[Pubmed] | [DOI]
75 Casein phosphopeptide–amorphous calcium phosphate remineralization of primary teeth early enamel lesions
Chunhua Zhou,Dongliang Zhang,Yuxing Bai,Song Li
Journal of Dentistry. 2014; 42(1): 21
[Pubmed] | [DOI]



 

Top
  
 
  Search
 
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Access Statistics
    Email Alert *
    Add to My List *
* Registration required (free)  

 
  In this article
    Abstract
   Introduction
   Description
   Epidemiology
   Etiology
   Diagnosis
    Consequences of ...
    Prevention of Ea...
   Treatment
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed13232    
    Printed208    
    Emailed7    
    PDF Downloaded2275    
    Comments [Add]    
    Cited by others 75    

Recommend this journal