Early childhood caries (ECC) is the presence of one or more decayed, missing or filled tooth (DMFS) surfaces in any primary tooth in a child 71 months of age or younger.
In children aged 3–5 years, severe ECC (S-ECC) is defined as: one or more cavitated, missing (due to caries) or smooth filled surfaces in primary maxillary anterior teeth, or DMFS scores of ≥4 (age 3), ≥5 (age 4), or ≥6 (age 5).
It follows a characteristic pattern of development: maxillary incisors are affected first followed by maxillary then mandibular molars, and due to the protective nature of the tongue, the mandibular incisors are often spared.
ECC has multifactorial etiology. One of the reasons is improper feeding practices adopted and adoption of more cariogenic food with the weaning of milk during this age.
The loss of anterior teeth in children can lead to reduced vertical dimension and unesthetic smile which effect the child psychologically. Thus, it can interfere with the personality and behavioral development of the child.
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When these teeth are lost, replacement, and prosthetic management is very important to restore all functions including esthetics of the child. Treatment of S-ECC is complex and expensive, often requiring extensive restorative treatment and extraction of teeth at an early age.
The most challenging in treatment of ECC is that children with age group 2–5 years are least manageable group of patients.
° Divya Doneria / Seema Thakur / Parul Singhal / Deepak Chauhan