Article title: Future caries susceptibility in children with Early Childhood Caries following treatment under general anesthesia

Resident: Ara Cho

Date: 8/6/2010

Author(s): Almeida, G. et al.

Journal: American Academy of Pediatric Dentistry

Year. Volume (number). Page #’s: 2000. 22. 302-305.

Major topic: Early Childhood Caries

Minor topic: Mutans Streptococci

Type of Article: Scientific Article

Main Purpose: Assess the susceptibility of children to future development of caries following comprehensive treatment for ECC

Overview of method of research: A retrospective study was conducted at Franciscan Children’s Hospital & Rehabilitation in Boston, MA. 42 patients who were diagnosed with ECC and treated under general anesthesia were seen at recall visits at six to nine months over a two year period. ECC was defined as the occurrence of one or more carious lesions involving maxillary anterior teeth of toddlers (1-2 years) and preschool children (2-5 years). Bitewing radiographs were taken at recall appointments. New smooth surface caries (NSSC) and new pit and fissure caries (NPFC) were recorded. The number of NSSC and NPFC were also recorded in a control group of 31 children who were of similar age to the ECC subjects. All children diagnosed with ECC were given a more intensive preventive regimen than the control group.

Findings: 79% of ECC children had detectable carious lesions at subsequent recall visits, compared to 29% in the control group. Of the 42 patients treated for ECC under general anesthesia, 7 patient required retreatment under general anesthesia. No relationship was found between subjects who required retreatment under anesthesia and frequency of recall visits. Those initially diagnosed with ECC were more likely to develop NSSC lesions than NPFC lesions. In contrast, children who were initially caries-free were more likely to develop NPFC lesions rather than NSSC at subsequent visits.

Key points/Summary: This study suggests that ECC can predict the risk of future caries development. Dental caries can develop in high caries risk children even after intensive preventive oral hygiene counseling. Perhaps more aggressive antimicrobial therapies may be required to prevent risk of development of caries in ECC children.

Assessment of Article: Good article. Gives scientific support for taking an aggressive approach to OR cases.