Tooth decay in children

Early tooth decay in children (eec) is very common, accounting for 30-50% in developing countries and up to 70% in developed countries. Children with tooth decay as young people are found to be at risk of tooth decay when they grow up, so preventing early tooth decay in children helps to avoid important dental problems later on.

Disease mechanisms

(Photo: qualitydentistry)

The formation of cavities depends on the organic acids produced by the fermentation of carbohydrates in the food by bacteria that reduce the pH of dental plaque and create mineral loss. Initial cavity lesions take the form of white spots on the enamel, and cavities will appear when the mineral loss progresses.

The group of streptococcus mutans is involved in the formation of tooth decay. These bacteria are capable of adhering to tooth enamel, creating a lot of acid and living in a low pH environment. When enamel is punctured, other bacteria (lactobacillus) will proliferate in the teeth, creating an acid environment and promoting mineral loss. Bacterial acid-induced mineral loss depends heavily on the amount of consumption and the type of carbohydrate present in the food.

Symptoms, manifestations

Cavities on baby teeth usually start in pits and grooves. Small lesions are difficult to detect with the naked eye; but large lesions often show a hole in the chewing surface. The location of tooth decay is often ranked second in the lateral (contact between the teeth), and many cases can only be detected when a dental X-ray is taken. The lesions caused by cavities in smooth surfaces (outer and inner surfaces) are usually seen only in children with severe tooth decay.

Serious tooth decay in children and young children is called early childhood caries (ECC), nursing bottle caries or baby bottle tooth (baby bottle tooth). decay) was incorrectly recorded with bottle feeding. Although the combination of bacterial infection of children with caries and the number of sugars, both in bottle-fed and solids-fed children, it is important, but there are other factors. An important role in tooth decay is the loss of enamel of the baby teeth due to lack of nutrition in pregnancy or premature birth.

Early childhood tooth decay (ECC) is very common. The disease may appear soon before 12 months of age, many months before the child is taken to the dentist. Subjects at risk of ECC include children who regularly eat sugars (often using drinks, sugary foods or snacks), migrant children, children with many relatives such as parents or siblings. The intestine has tooth decay, and the child has malformation in the tooth.

Complications

If left untreated, tooth decay will lead to the complete decay of the tooth and damage to the pulp, leading to root canal inflammation and pain. Myelitis can progress to necrosis, cavity invasive bacteria and tooth abscess. Baby teeth infections can affect the permanent tooth development process. Some cases of baby teeth infection cause sepsis or infection of the face area.

Treatment

The age of children with tooth decay is important for dental treatment. Children younger than 3 years of age are incapable of cooperating with dental treatment and often require support such as child restraint, anesthesia or anesthesia during filling. After 4 years, children are able to respond to dental treatment and with local anesthetics.

Dental treatment using silver amangam, comprehensive fillings or crowns can help retain cavities. If the lesion spreads to the pulp, it is necessary to take a part of the root canal or take the entire pulp. If the tooth is to be extracted, the space after the extraction of the tooth should be maintained to prevent movement of the remaining teeth, leading to the wrong position of the permanent teeth.

Tooth infection is also confined to the bones of the drive, which can be treated with topical measures (extraction of teeth, entire pulp). Oral antibiotics have been indicated for dental infections with cellulitis, swelling of the face or in normal cases that cannot cause anesthesia due to inflammation. Penicillin is an antibiotic of choice except in patients with a history of allergy to this drug, when it can be replaced with clindamycin or erythromycin. Oral pain relievers such as ibuprofen often have good control over pain. If the infection spreads, it threatens the life of a child who needs injectable antibiotics.

Prevent

The most effective measure to prevent tooth decay is to give optimal fluoride to water used at a concentration of 1ppm. Children living in areas with fluorine-deficient water are at high risk of tooth decay and need to be supplemented with fluoride. To avoid too much fluoride, an over-the-counter fluoride doctor has a quantity of more than 120mg. Acute manifestations of overdose of fluoride (higher than 5 mg / kg) should be treated urgently. Using external fluoride forms (performed by a doctor or pediatrician) is beneficial for pediatric patients at risk of tooth decay.

Dental hygiene

Daily brushing, especially with fluoride toothpaste, will help prevent tooth decay. Most children under 8 years of age do not fully brush their teeth. Therefore, parents are responsible for children's oral hygiene, changing their habits in a positive way.

Diet

Reducing the number of times to eat sugary substances effectively prevent tooth decay. So do not give them sweet drinks, or use sweeteners at night; For children at high risk of tooth decay, avoid using snacks between meals.

Fillings of groove holes

Resin fillings are noted to be effective in preventing cavities in molar teeth and permanent molars. Fillings are most effective when placed immediately after the newly developed teeth (children 1-2 years) and for cases of molars with deep or deep grooves.

MSc. Doctor NGO LE THU THAO