Does inappropriate feeding practices cause any adverse effects?

·         Feeding the baby at night time causes a peculiar pattern of decay, leading to gross destruction of the tooth structure.

·         This pattern of decay is referred to as early childhood caries/ nursing caries.

·         The disease of early childhood caries is the presence of 1 or more decayed (non cavitated or cavitated lesions), missing (due to caries), or filled tooth surfaces in any primary tooth in a child under the age of 6 years.

·         It has several unique characteristics in clinical appearance such as rapid development of caries, which affects a number of teeth soon after they emerge in oral cavity.

·         These lesions involve tooth surfaces that are less prone to caries development.

·         It is most commonly seen in 3 – 4 years age and boys are mostly affected than girls.

 

The various factors which predispose to early childhood caries are:

•         Frequent nursing & snacking

v  Foods which contain higher amounts of sugars, sticky foods, snacks in between meals are the main causative factors for early childhood caries.

•         Early colonization with mutans streptococci.

v  Higher amount of caries in the mother and improper oral hygiene practices cause colonization of caries causing bacteria.

•         Presence of enamel hypoplasia.

v  Presence of various developmental defects in the teeth also predispose to early childhood caries.

•         Environment encouraging growth & dominance of mutans streptococci in dental plaque.

v  Lack of immunity, vertical and horizontal transmissions, imbalance between salivary protective and pathologic factors, low birth weight and preterm babies, increased intake of fruit juices, use of sweetened pacifiers.

 

Pattern of occurrence:

·         It occurs in various forms ranging from very mild to severe stage.

·         In the initial stages white patchy areas appear on the tooth, later these areas get discolored and start chipping off.

·         In severe stages the whole crown of the tooth will be lost leaving behind a brown black discoloration at the neck of the tooth.

·         The teeth which are affected include maxillary central incisor, maxillary lateral incisor, maxillary and mandibular molars, canines and in the late stage the mandibular anteriors are affected.

 

Early childhood caries is more than just caries because

·         The Oral health is directly related to child development.

·         There is a high risk of dental caries in primary and permanent dentition.

·         Early tooth loss leads to impaired speech development, failure to thrive, absence from preschool, inability to concentrate, reduced self- esteem & other psychological problems.

·         Extensive caries causes pain leading to compromise in the ability to eat.

·         It is associated with diminished physical growth in toddlers.

·         Children with early childhood caries weigh less than 80% of their ideal weight.

 

Prevention and treatment:

·         First dental visit before the 1^st birthday.

·         Frequent evaluation of child’s oral cavity for any chalky white spots, yellow to brown discolorations, chipping of teeth, pain and sinus opening.

·         Proper use of fluoride.

·         Oral hygiene practices.

·         Age appropriate treatment can help in restoring the child’s oral and general health. 

 

“Parents, be aware. Take care of your child’s oral cavity and ensure that your child has a cavity free mouth.”