1) Early childhood caries (ECC) is defined as the presence of one or more decayed, missing, or filled tooth surfaces in primary teeth in children under 71 months of age. 2) Left untreated, dental caries in children can diminish general health and quality of life through pain, discomfort, reduced growth, and disturbed sleep. 3) The minimal intervention (MI) approach to dental caries focuses on reducing cariogenic bacteria, using preventive measures, and remineralizing early lesions to preserve tooth structure and limit invasive treatment.

2. CARIOLOGY AND CARIES MANAGEMENT
EVIDENCE - BASED DENTAL RESEARCH
TAUGHT US THAT CARIES IS A PROCESS
WHERE : DEMINERALIZATION EXCEEDS
REMINERALIZATION,
THE NET RESULT IS OFTEN CAVITATION .
FILLING THE TOOTH AT THIS POINT
TREATS THE HOLE NOT THE DIEASE ,

3. EARLY CHILDHOOD CARIES (EC C)
Definition: - IT IS THE PRESENCE OF 1 OR
MORE DECAYED (NONCAVITED OR CAVITED
LESIONS ), MISSING (DUE TO CARIES) OR
FILLED TOOTH SURFACES IN ANY PRIMARY
TOOTH IN A CHILD (71 ) MONTHES OF AGE
OR YOUNGER . IN CHILDERN
YOUNGER THAN 3 YEARS OF AGE ANY SIGN
OF SMOOTH –SURFACE CARIES IS INDICATIVE
OF ( S-E CC ) ( AAPD )

6. CARIES ASSESSEMENT AT 6 MONTHS

7. 7

8. CONSEQUENCES OF UNTREATED
DENTAL CARIES IN CHILDREN
 CAN QUICKLY DIMINISH THE GENERAL
HEALH & QUALITY OF LIFE FOR THE
AFFECTED INFANTS, BECOMES MORE
DIFFICULT TO TREAT, THE
COAST INCREASE, PAIN , DISCOMFORT,
REDUCED GROWTH & BODY WEIGHT,
DISTURBED SLEEP AFFECTS
GLUCOSTEROID PRODUCATION,
SUPPRESSION OF HEMOGLOBIN FROM
DEPRESSED ERYTHROCYTE
PRODUCATION ,

9. DENTAL HOME
First visit - First
time First year

11. AAPD Dental Home Web
Resource Center

13. Cleaning Teeth
 Ages 2 &less than 3 years
 Brush with a rice sized
amount of toothpaste using
a soft toothbrush
 Have the child spit out the
toothpaste after brushing
but do not rinse with water

18. 18 www.aap.org/oralhealth/pact
Fluorosis
Ingestion of toothpaste increases the
risk of enamel fluorosis.
If fluoride
toothpaste is used, strategies to limit
the amount swallowed include
limiting the amount placed on the
brush and observing the child as they
brush.
Used with permission from Rama Oskouian

19. XYLITOL CURRENTLY IS available in many
forms (eg,
gums , mints, chewable tablets, lozenges
tooth pastes , mouth washes, cough mixture
XYLTIOL CHEWING GUM HAS BEEN SHOWN
TO BE EFFECTIVE AS PREVENTIVE AGENT
THE EFFECTIVENESS OF OTHER
XYLITOL PRODUCTS IS BEING STUDIED AT

20. XYLITOL
Xylitol chewing gum :- Evidence suggest
that the use of xylitol chewing gum (at
least 2 – 3 times a day by the mother )
has a significant impact on mother- child
transmission of MS and decreasing
the child s caries rate .

21. MI PAST &MI PAST PLUS
 MI PAST USED FOR BABY
MI PAST PLUS USED FOR HIGH RISK ,
DRY MOUTH , ONCOLOGY ,
TOOTH WITING , PORTHODONTIC ,
EROSIVE, PERIODONTAL DIEASE
FLUOR PROTECTOR GEL
(CA+ PH+F) {IVOCLAR }

22. 29$ price

23. MOUTH WASH
TOOTH PASTE
ORAL GELMOUTH SPRAY &

28. It is alkaline
having PH= 7.8
(more alkaline than saliva (7.2-7.4)
Up to 8.38
Carbonated beverage about PH=3.2.
Carbonated water
(280-299)mg/L bicarbonate.
 Bicarbonate has the best buffering effect .
 It limits the fall in PH when bacteria metabolize sugar .
contain fluoride (0.6-0.68 PPM).

29. Mineral water
:
Contain Ca : (230-245) mg/L
contain PH : (0.31-0.46) mg /L
( help remineralization of decayed teeth).
( phosphate is one of protective factor in remineralization).
Hint : Low Ca & PH →Osteoporosis (esp.- women).
So:-
Can be used systemically & locally as mouth wash.
-especially before sleeping & ↑ risk group.
e.g. radiation caries , rampant caries. During and after ortho
treatment.

31. Minimal Intervention Dentistry
- Modern approach to the treatment of
tooth decay
- Based on “Medical Model” of caries
management

32. Details of the MI approach
- (1) Reduces cariogenic bacteria;
- (2) Uses preventive measures;
- (3) Early lesions remineralised;
- (4) Minimal surgery on cavities;
- (5) Repair of defective restorations.

33. The Minimal Intervention approach
- A medical model;
- Caries treated as a biological
infection;
- Surgical techniques are minor and
stress retention of tooth tissue.

34. Conclusions
• Minimal Intervention dentistry is the future:
– Advocated by FDI;
– Cost effective;
– Less trauma for the patient.
• A biological approach, not a mechanical one.
• Makes significant demands on materials.

36. ART POLICY STATMENT
ART MAY BE USED FOR CARIES
CONTROL IN YOUNG CHILDREN WITH
MULTIPLE CARIOUS LESION PRIOR TO
DEFINITIVE RESTROTATION OF THE
TEETH USING HAND INSTRUMENT & GI

37. TREAT THE CHILD NOT THE TOOTH
TREAT THE TOOTH NOT THE HOLE

38. 38
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