CARIES IN EARLY CHILDHOOD

Abstract

Caries of primary teeth can appear very early, shortly after their emergence, as a result of bad habits and
inadequate nutrition. The occurrence of caries in this period is emphasized by certain difficulties in maintaining oral
hygiene, as well as parents’ lack of information about the importance of primary teeth and the possibility of
preserving their health. Caries in early childhood or also called circular caries is a specific form of dental caries that
differs from the usual forms of caries in the time of occurrence, localization, course, therapy, outcome and
consequences. Caries is most often localized in the front of maxillary teeth and first molars. This type of caries is
given different names such as rampant caries or bottle syndrome ("baby bottle caries", "nursing caries") or also
referred to as caries in early childhood, as a definition of active caries for the age of 0-3 years. There are different
explanations for the appearance of circular caries, although the etiology is the same as in other forms of caries of
milk and permanent teeth. This type of caries is often associated with bottle feeding and the use of liquid, sweetened
and mushy food, frequent day and night meals during this period. During this period, bad eating habits of the child
are formed, which can be extremely important for the occurrence of caries. Circular caries can also occur in children
who are fed in a natural way and have not used a bottle or a pacifier, but with acquired bad habits such as long and
frequent meals, keeping food in the mouth and frequent and uncontrolled use of sweets between meals. Circular
caries is characterized by specific localization. It appears on caries resistant, smooth, labial and oral surfaces of
incisors, canines and primary molars, but also on caries predilection sites in fissures, pits and proximal surfaces. The
treatment strategy for this type of caries should include all possibilities to stop caries or reduce caries activity, using
general and local procedures. General procedures include information, motivation, advice on preventive measures
during subsequent visits. Caries arrest and preventive measures such as dietary advice, oral hygiene guidelines and
the use of fluorides must be tailored to each patient individually. Local procedures include professional cleaning,
careful removal of plaque and soft tooth tissue with hand instruments, application of fluoride varnish or a thin layer
of glass-ionomer cement. Restorative treatment techniques may include the use of glass-ionomer cements,
composite materials, and compomers. Prosthetic therapy of circular caries is performed after conservative treatment
of teeth and extraction of teeth that cannot be repaired. Taking care of circular caries, especially in some difficult
cases, is a very complex and complicated task that requires good knowledge of other dental disciplines and
extensive experience in working with children.