PDF: ORAL REHABILITATION of patient with severe early childhood caries: a case report

Currently, the aiming of Pediatric Dentistry is that the patient reaches maturity free of diseases affecting in oral cavity. It is important that its action initiates during pregnancy and continues up to the birth of the baby. 

Thus, preventive measures of oral diseases should begin at the pregnancy period through guidance for an adequate feeding of the mother, rich in vitaminic elements required for tooth formation. Additionally, information on oral health related to both the mother and infant is part of the prenatal examination, assuring that the infant has a childhood free of caries.

However, unfortunately this is not the reality faced by all children. Tooth caries is the most common chronic disease in childhood and a great problem for world public health. Severe early childhood caries (S-ECC) is common and damages speech, swallowing, feeding, development (height and weight), esthetics and emotional (self-esteem) of the child.

Habits, such the unrestricted use of baby bottle, mainly with sugar content during night, are associated with S-ECC. The difficulty in performing oral hygiene of the child and maintenance of food remnants during longer periods, mainly during sleepiness, also contributes for the establishment of the disease.

The initial clinical sign of caries is the presence of opaque and white spots. If not controlled, the process evolves to the appearance of cavities, and this can lead to the destruction of all tooth crown and initiate infectious root processes because of pulp involvement. ECC init iates on the cervical third of the labial surfaces of the maxillary anterior teeth and concomitantly affects the occlusal surface of the maxillary and mandibular first molars, maxillary and mandibular canines and second molars. At more advanced stages, it affects also the mandibular incisors.

Considering the impact on the quality of life and the possibility to prevent, arrest or even treat ECC, it is of great importance that the dentists, especially Pediatric Dentists, are capable of diagnosing and treating this pathology, returning the oral health and smile aesthetics to these children.

This study demonstrated that the use of acetate matrixes is an effective alternative to return aesthetics and functionality to teeth of patients with severe early childhood caries.