Early childhood caries - challenges and methods of treatment

Abstract

Karijes rane dječje dobi pojam je koji označava pojavu karijesa u dobi do treće godine, a uzrokovan je skupinom mikroorganizama, Streptococcusa mutansa. Nastaje kao infektivna bolest zbog rane kolonizacije usne šupljine navedenim mikroorganizmima. Najčešće nastaje na mjestima koja inače nisu podložna karijesu, ponajprije na mliječnim gornjim središnjim sjekutićima. Prvo uzrokuju demineralizaciju cakline oko vratova zuba, a onda u potpunosti razara zub. Majka može prenijeti na svoje dijete ove bakterije slinom, preko dude ili kapljično. Toj kolonizaciji pogoduju i loša oralna higijena te karijesogena prehrana. Rani dječji karijes može se prevenirati promjenom načina ishrane, promjenom oralne higijene i preventivnim mjerama u prenatalnom i perinatalnom razdoblju koje uključuju edukaciju majke, a potom i stomatološku intervenciju topikalnim fluoridiranjem, edukacijom o oralnoj higijeni koju će stjecati kod kuće. Ovaj tip karijesa ima puno negativnih utjecaja na psihosocijalni razvoj djeteta te je bolje poraditi na njegovoj prevenciji nego terapiji. Ukoliko je terapija potrebna, ona se može provoditi na više načina ovisno o tome koliko su zubi zahvaćeni karijesom, a kreće se od restauracije malog dijela zuba, koji je destruiran karijesom, preko izrade krunica kod većih destrukcija krune zuba, uz prethodni endodontski tretman, sve do ekstrakcije ukoliko se pojave apscesi.Early childhood caries is a term that indicates the appearance of caries at the age of 0-3 years, and is caused by a group of microorganisms, Streptococcus mutans. It occurs as an infectious disease due to early colonization of the oral cavity of the mentioned microorganisms. It is most commonly found in places that are otherwise not subject to caries, primarily in the primary upper middle incisors. First, they cause the enamel demineralization around a tooth cervix, then completely destroys a tooth. A mother can transmit to her child this bacterium through saliva, via a pacifier or droplets. Such colonization is also favoured by poor oral hygiene and cariogenic diet. Early childhood caries can be prevented by changing diet, changing oral hygiene and preventive measures in prenatal and perinatal period involving mother's education, and then dental intervention by topical fluoridation, education on oral hygiene to be acquired at home. This type of caries has a lot of negative impacts on the psychosocial development of a child and it is better to work on its prevention than on therapy. If it comes to therapy, it can be performed in several ways depending on how much teeth are affected by caries. A therapy can include the restoration of a small part of the tooth, which was destroyed by caries, crowning, in a larger crown destruction, with the previous endodontic treatment, in the larger destruction of the tooth crown and finally, if the abscess occurs, extraction