DENTAL CARIES IN PRESCHOOL CHILDREN – BOTTLE CARIES

Dental caries is a chronic and multifactorial disease that is common all over the world and has the potential to affect individuals throughout their lifetime. Tooth decay occurs through a complex interaction over time between many major factors, including acid-producing bacteria in the mouth, simple carbohydrates, and dental and salivary factors. Bacteria in the mouth metabolize carbohydrates and produce weak organic acids as a by-product. These organic acids create an acidic environment in the mouth, causing mineral loss in dental hard tissues and subsequent caries formation. (Caufield and Griffen 2000; Selwitz et al. 2007).

Dental caries seen in the teeth of preschool children has become an important problem in terms of pediatric dentistry (pedodontics) due to its rapid progression and the small age group it affects. Researchers first described dental caries in infants and young children in the 1930s. In 1978, the American Pediatric Association and the American Pediatric Dental Association associated severe form of dental caries with bottle feeding and used the term “Nursing Bottle Caries” (Beltrami and Romieu 1939; AAPD 2014c). “Bottle caries” is still an accepted term among physicians and the public.

However, it was concluded that this common dental caries seen in infants and children is not only a result of malnutrition with bottle or breast milk, but is a multifactorial infectious disease. In 1999, the National Institute of Dental and Craniofacial Research’s workshop report adopted a general definition of “Early Childhood Caries (ECC)” for this severe form of dental caries that affects young children. The classification system made in this workshop was also accepted by “AAPD (The American Academy of Pediatric Dentistry)” (AAPD 2014). “EAPD (The European Academy of Paediatric Dentistry)” means EÇÇ; defined as the appearance of any sign associated with dental caries on any tooth surface during the first 3 years of life, and reported that it is a public health problem affected by biological, social and behavioral determinants (EAPD 2008).

ECC is an important public health problem affecting infants and preschool children all over the world. According to the data of the United States of America in 2000; Tooth decay is the single most common chronic childhood disease. It is observed 5 times more frequently than asthma and 14 times more frequently than chronic bronchitis. According to the 2004 data of Turkey, the rate of dental caries in 5-year-old children is 70% and it fell far behind the World Health Organization’s 2000 targets (Filstrup et al. 2003; Topaloglu et al. 2009).

ECC first begins as white spot lesions along the gingival margin of the upper primary incisors. Since the lower milk incisors are cleaned with the effect of tongue and saliva, they are affected later by caries. If the caries factor is not eliminated, cavitation is observed on the tooth surface and the caries rapidly progresses from the incisors to the milk molars. Studies have shown that; Children with caries experience in infancy and early childhood are more likely to have caries in both their primary and permanent teeth.(Kagihara et al. 2009; Kawashita et al. 2011).

ECC not only affects teeth, the consequences of this disease can lead to more widespread health problems. Children affected by ECC may lose their daily activities and school days due to delayed physical growth and development, pain and other complications due to nutritional problems. A decrease in the quality of life of the child is observed due to oral health problems. In addition, the fact that the group of children affected by ECC is young and has difficulty in cooperation may necessitate complicated and expensive dental treatments under general anesthesia or sedation (AAPD 2014c; Kawashita et al. 2011).

Factors Influencing Early Childhood Caries

Although simple carbohydrates, caries-causing microorganisms in the oral environment and the individual sensitive to caries are the primary factors in the etiology of ECC; oral hygiene habits, dietary patterns, and socioeconomic status were identified as associated risk factors in the ECC (Fisher-Owens 2007; Zafar et al. 2009; AAPD 2014c).

Simple carbohydrates: Studies have shown that; Sugar consumption plays an important role in the formation of dental caries. In addition to simple sugars such as sucrose, fructose and glucose, highly refined complex carbohydrates such as flour, glucose syrup, high fructose corn syrup, synthetic oligosaccharides are also effective in the initiation and development of dental caries (Bradshaw and Lynch 2013). Foodstuffs such as crackers, bread, sweetened breakfast cereals, cake, cookies, dried fruit, potato chips, high-sugar baby foods, acidic or sugary drinks have a high cavities potential. Nutrients such as milk, cheese, meat, eggs, peanuts and some vegetable varieties that contain high levels of protein, moderate fat, minimal carbohydrates, high concentrations of calcium and phosphate and activate salivation have a very low potential to cause tooth decay. (Peker and Bermek 2008).

Caries-causing microorganisms : The oral cavity of babies is sterile until the moment of birth. Although the baby is exposed to many microorganisms during birth, most of these microorganisms cannot settle in the baby’s mouth permanently. With the eruption of the baby’s teeth 19–31. months are critical periods for the colonization of caries-causing microorganisms (Caufield et al. 1993). As the number of teeth in the child’s mouth increases, so does the diversity of microorganisms in the mouth. Caries-causing microorganisms are first passed to the baby from their mother. It can happen directly by mixing the saliva during the mother and baby’s kiss, or indirectly by placing objects such as spoons, pacifiers, and baby’s fingers first in the parent’s mouth and then in the baby’s mouth. Caries-causing microorganisms are transmitted from other family members or the social environment other than the mother (Berkowitz 2003; Law et al. 2007).

person susceptible to caries :Immature enamel in newly erupted teeth, the presence of enamel defects mostly characterized by hypomineralization, immunological factors, decreased salivation and genetic characteristics of teeth may play a role in increasing the risk of caries (Zafar et al. 2009).

Oral hygiene habits: To prevent caries in preschool children; Pregnant women, families, teachers, health workers and other segments of the society should be trained to apply oral hygiene methods correctly. In infancy, the teeth should be cleaned by the family from the first month and the child should be supported in oral care until the school period (AAPD 2014).

Socioeconomic status: Recent studies have shown that; Dental caries in children are seen in all segments of society, regardless of family education and income level. .However, it is observed that the incidence of dental caries is increased in children of nomadic and divorced families (Hooley et al. 2012).

Dear readers, dear parents; In this article, I wanted to briefly describe the Male Childhood Caries and explain its causes. I will talk about ways of protection in our next article. Love and respect.

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