Severe ECC with damage to the maxillary anterior teeth and some posterior teeth WITHOUT a habit of night time feeding practices ( means child consumes milk at the beginning of sleep or in between sleep before the child wakes up from the bed.....use of breast milk or bottle milk or both) ?
On demand or at will breast feeding or bottle milk with or without sugar, frequency while sleeping could be once or more than once
Dear Dr.Muthu,
I have a patient with SECC not due to feeding milk but juice.
hello sir,
Yes I had a 27 months old patient of severe ECC without any breast/ bottle feeding habits but he was a premature low birth weight baby.
There was another patient of severe ECC (24 months old) who was epileptic and on valproate syrup since he was 9 months old. may be that is the reason why he has got multiple caries.
"night time feeding practices"
Not quite sure what you are referring to here. Do you mean any practice where the child is lying on its back with food pooling in its mouth? This includes breastfeeding where the child is in bed with its mother, or feeding from a propped bottle. In these cases there are likely to be ear infections due to pooling of fluids in the middle ear, with secondary lower respiratory and gastrointestinal infections, and malnutrition. Prem/LBW infants are particularly likely to be fed on their backs.
@ Ramesh and Savita - Thanks for the answers and inputs.
@ Anthony Gordon - Thanks for the question - Yes i mean the infants sleeping with milk or liquids or sweetened syrup or sweetened beverages being pooled on the surface of teeth....
Generally low birth weight or pre term infants tend to have a poorly developed enamel which is more susceptible for breakdown with these challenges...
Anyway thanks for all the inputs..
Most of the cases which i had seen parents are not aware about the night feeding habits ,and other etiological factors. A lot of parents have no idea about the nature as well as the etiology of this dental problem at this early age of their children.
ECC is usually characterized by an incredible oral bacterial load along with feeding patterns that support the load.
"ECC is usually characterized by an incredible oral bacterial load along with feeding patterns that support the load."
To rephrase the original question, does ECC or a large oral bacterial load only occur as a result of prolonged supine feeding? If Yes, this has important implications for the cause of malnutrition.
"A lot of parents have no idea about the nature as well as the etiology of this dental problem at this early age of their children."
My guess is that more parents than doctors know about it!
Dr. Gordon. The answer is "No".
Bacterial loads and feeding positions are a small aspect of ECC. There is a lot going on with ECC and most of the issues related to ECC, experienced by the individual are beyond the scope of dentistry.
So, having established that there is no history of abnormal feeding practices or feeding positions, what is the main cause of ECC?
There has been high infant morbidity and mortality in Native American populations for many years, the most likely cause of which is abnormal feeding practices in a population with a strong established breastfeeding culture. Also seen in other transitional societies, eg Australian Aborigines.
ECC is an easily recognized condition that is caused by a multitude of destructive habits combine with an unfavourable oral environment. ECC is the result of the perfect destructive storm in the oral biofilm. So attacking this multifaceted problem with this or that , including increasing the access to care, invariable does little to the incidence of the ECC condition. So the most effective measures against ECC are those that do not require any compliance by the patient or the parent. So SSCs, iodine with fluoride does very well in the actual reduction in caries but compliance with making appointments and keeping those appointments frequently negate the benefit of these expensive modalities. Now silver fluoride solutions are effective in the absence of compliance and even one application is effective and this is the future, So get the silver solution on the teeth and then work on the elimination of oral destructive habits . Changing the culture of destructive habits, no matter these habits are, is the gold standard and the best for dental and overall health. In the interim, use silver solutions .
"ECC is an easily recognized condition that is caused by a multitude of destructive habits... Changing the culture of destructive habits, no matter these habits are, is the gold standard"
Other than supine feeding, bottle propping, and breastfeeding in bed at night, I am unclear what these destructive habits are. Presumbly these are behavioral, and modifiable by instruction.
Theoretically these destructive habits modifiable by instruction. But the recipient of theses instruction must see these instructions as reasonable and doable. Manny EEC patients' support group has prevention of dental problems and medical problems as a very low priority. Life has these people overwhelmed in general.