EARN 2 UNITS This self-study CE course is written for dentists, dental hygienists and dental assistants. Comprehensive Approach to IDENTIFYING HIGH-RISK INDIVIDUALS, PROVIDING PATIENT-SPECIFIC EDUCATION, AND EMBRACING INTERPROFESSIONAL CARE CAN HELP SUPPORT PEDIATRIC ORAL HEALTH EDUCATIONAL OBJECTIVES After reading this course, the participant should be able to: 1. Define early childhood caries and its etiology. 2. Discuss the role of risk assessment in caries prevention and management. 3. Identify the importance of establishing a dental home in promoting oral health. 4. Explain appropriate therapeutic and restorative approaches for caries management. D 5. Outline the role of medical providers in identifying caries risk in pediatric patients. ental caries remains a national and global public health epi- demic, affecting children and adults from all races, ethnicities and socioeconomic levels.1–3 The signs and symptoms associ- Among children in the United States, caries is the most com- mon unmet health need, with a prevalence of more than 25% among children age 24 months to 60 months.3 ated with caries include pain and infection from active lesions, nutritional deficiencies, learning and speech problems, and, rarely, death (Figure 1).2–5 Caries is typically caused by disruptions in the balance between cariogenic bacteria and host factors, including enamel susceptibility, salivary flow and composition.2,6 impact caries development.2,6 risk factors are responsible for caries, including frequent sugar consumption, improper or lack of oral hygiene, high levels of oral bacteria, socioeconomic status, race/ethnicity, and inconsistent access to oral health care.2,5,7–11 Family culture, as well as economic and social status, also Current research demonstrates that multiple The American Academy of Pediatric Dentistry (AAPD) defines early childhood caries (ECC) as the presence of one or more decayed (noncav- itated or cavitated lesions), missing (due to caries), or filled tooth surfaces (dmft) in any primary tooth in a child age 71 months or younger.12 In chil- dren younger than 36 months, any sign of smooth-surface caries is indica- tive of severe early childhood caries (S-ECC).12 Children age 36 months to 60 months who have one or more cavitated teeth, missing (due to caries), or filled smooth surfaces in primary maxillary anterior teeth, or a decayed, missing or filled score of ≥ 4 surfaces (36 months), ≥ 5 sur- faces (48 months), or ≥ 6 surfaces (60 months) have S-ECC.12 Children between the ages of 12 months and 30 months have a unique pattern of caries development that differs from older children.7 Within this age group, ECC is distinguished by lesions found on the maxillary primary incisors and first primary molars, reflecting the pattern of eruption.1,2,4,13 Belmont Publications, Inc. is an ADA CERP-recognized provider. Belmont Publications, Inc. designates this activity for 2 credit hours of self-study continuing education units. This course is released December 2017 and expires December 2020. ADA CERP is a service of the American Dental Association to assist dental professionals in identifying quality providers of continuing dental education. ADA CERP does not approve or endorse individual courses or instructors, nor does it imply acceptance of credit hours by boards of dentistry. Concerns or complaints about a CE provider may be directed to the provider or to the Commission for Continuing Education Provider Recognition at ada.org/cerp. 34 Decisions IN DENTISTRY • December 2017 Approved PACE Program Provider FAGD/MAGD credit Approval does not imply acceptance by a state or provincial board of dentistry or AGD endorsement July 1, 2016 to June 30, 2019 Provider ID 317924 AGD Subject Code: 430 DecisionsInDentistry.com Early Childhood Caries By Erin A. Kierce, RDH, BA, MS, MPH, and Lori Rainchuso, RDH, MS, DHSc CREDIT/ISTOCK/GETTY IMAGES PLUS
