Update on Early Childhood Caries Since the Surgeon General's Report
Update on Early Childhood Caries Since the Surgeon General's Report
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DOI：
10.1016/j.acap.2009.08.006
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发表时间：
2009-11-01
影响因子：
3.1
通讯作者：
Reisine, Susan
中科院分区：
文献类型：
--
作者：
Tinanoff, Norman;Reisine, Susan
2000年卫生局局长的口腔健康报告对儿童早期龋齿进行了有限的讨论。由于其高患病率、对幼儿生活质量的影响以及可能增加他们患恒牙龋齿的风险，幼儿龋齿可以说是幼儿中最严重和最昂贵的健康状况之一。预防学龄前儿童龋齿的第一步是了解和评估儿童龋齿的危险因素。以前的龋齿经历和白斑病变应该自动将学龄前儿童划分为龋齿的高风险人群。微生物因素，如可见菌斑的存在和确定儿童是否有高水平变形链球菌的测试，也可以预测幼儿的龋齿。食糖频率、牙釉质发育缺陷、社会经济地位、社会心理因素等社会因素以及是否为少数民族也被证明与龋齿风险有关。根据对个人具体危险因素的了解，可以实施不同的预防策略和不同强度的预防治疗。学龄前儿童的龋齿预防策略包括氟化物治疗，例如在监督下用含氟牙膏刷牙，对居住在不含氟地区且有患龋齿风险的儿童进行全身氟化物补充，以及用氟化物清漆专业局部氟化物。越来越多的证据表明，加强患者咨询或与父母进行动机性访谈，以改变他们的特定行为，可能会减少他们孩子的龋齿患病率。关于抗菌干预措施、改变饮食的努力和传统牙齿健康教育的研究结果不太一致。
The 2000 Surgeon General's Report on Oral Health included a limited discussion of the condition known as early childhood caries. Because of its high prevalence, its impact on young children's quality of life and potential for increasing their risk of caries in the permanent dentition, early childhood caries is arguably one of the most serious and costly health conditions among young children.A necessary first step in preventing dental caries in preschool children is understanding and evaluating the child's caries risk factors. Previous caries experience and white spot lesions should automatically classify a preschool child as high risk for caries. Microbial factors, such as presence of visible plaque and tests that identify a child as having high levels of mutans streptococci, also predict caries in young children. Frequency of sugar consumption, enamel developmental defects, social factors such as socioeconomic status, psychosocial factors, and being an ethnic minority also have shown to be relevant in determining caries risk.On the basis of this knowledge of specific risk factors for an individual, different preventive strategies and different intensities of preventive therapies can be implemented. Caries preventive strategies in preschool children include fluoride therapy, such as supervised tooth brushing with a fluoridated dentifrice, systemic fluoride supplement to children who live in a nonfluoridated area and who are at risk for caries, and professional topical fluoride with fluoride varnish. There is emerging evidence that intensive patient counseling or motivational interviews with parents to change specific behaviors may reduce caries prevalence in their children. Findings regarding antimicrobial interventions, efforts to modify diets, and traditional dental health education are less consistent.