Vadiakas G
Dept. of Paediatric Dentistry, Dental School, University of Athens, Greece.
Eur Arch Paediatr Dent. 2008 Sep;9(3):114-25. doi: 10.1007/BF03262622.
To provide a review of the existing literature on early childhood caries (ECC) with particular reference on the nomenclature, case definition, epidemiology, etiology and risk assessment.
An electronic search was used to identify and critically review papers that have been published and are pertinent to the above issues, evaluate and compile the reported evidence.
The term ECC has been adopted to more accurately describe dental caries that affects primary dentitions, replacing previously used terminology that associated the disease with the nursing habit. Suggested ECC case definition uses caries patterns as defining criteria, however, further refinement to include different clinical expressions of a varying severity is necessary. Significant percentages of preschool child populations are affected by ECC today, with the disease concentrating disproportionately in deprived families. Early colonization by mutans streptococci (MS) is associated with increased ECC development, with bacteria being transmitted in both vertical and horizontal ways. Dietary factors related to sugar consumption predispose to early MS colonization and establishment and increase the risk for ECC development, being part of the causal chain. Inappropriate bottle and breast-feeding behaviors also increase the risk, without showing a direct causal relationship. High risk children belong to ethnic minority groups and to low income families with poor parental behaviors and attitudes.
Further high-quality studies are needed to explore the role bacteria other than MS may play in caries initiation and progression, elucidate the interaction of the saliva immune defence system with a potentially defective tooth, and investigate the effect distant behavioral factors have on the causal chain that leads to ECC development.
对现有关于幼儿龋齿（ECC）的文献进行综述，特别涉及命名法、病例定义、流行病学、病因学和风险评估。
采用电子检索来识别和批判性地综述已发表的、与上述问题相关的论文，评估并汇总所报道的证据。
采用“幼儿龋齿”这一术语来更准确地描述影响乳牙列的龋齿，取代了先前将该疾病与护理习惯相关联的术语。建议的幼儿龋齿病例定义以龋齿模式作为定义标准，然而，有必要进一步细化以纳入不同严重程度的不同临床表现。如今，相当比例的学龄前儿童受幼儿龋齿影响，该疾病在贫困家庭中分布不均。变形链球菌（MS）的早期定植与幼儿龋齿发病率增加相关，细菌通过垂直和水平方式传播。与糖摄入相关的饮食因素易导致变形链球菌早期定植和滋生，并增加患幼儿龋齿的风险，是因果链的一部分。不当的奶瓶喂养和母乳喂养行为也会增加风险，但未显示出直接因果关系。高危儿童属于少数族裔群体以及父母行为和态度不良的低收入家庭。
需要进一步开展高质量研究，以探索除变形链球菌之外的其他细菌在龋齿发生和发展中可能发挥的作用，阐明唾液免疫防御系统与潜在有缺陷牙齿之间的相互作用，并研究远距离行为因素对导致幼儿龋齿发展的因果链的影响。
