Duangthip Duangporn, Chen Kitty Jieyi, Gao Sherry Shiqian, Lo Edward Chin Man, Chu Chun Hung
Faculty of Dentistry, The University of Hong Kong, Hong Kong, China.
Int J Environ Res Public Health. 2017 Oct 10;14(10):1204. doi: 10.3390/ijerph14101204.
Early childhood caries (ECC) is a significant global health problem affecting millions of preschool children worldwide. In general, preschool children from families with 20% of the lowest family incomes suffered about 80% of the ECC. Most, if not all, surveys indicated that the great majority of ECC was left untreated. Untreated caries progresses into the dental pulp, causing pain and infection. It can spread systemically, affecting a child's growth, development and general health. Fundamental caries management is based on the conventional restorative approach. Because preschool children are too young to cope with lengthy dental treatment, they often receive dental treatment under general anaesthesia from a specialist dentist. However, treatment under general anaesthesia poses a life-threatening risk to young children. Moreover, there are few dentists in rural areas, where ECC is prevalent. Hence, conventional dental care is unaffordable, inaccessible or unavailable in many communities. However, studies showed that the atraumatic restorative treatment had a very good success rate in treating dentine caries in young children. Silver diamine fluoride is considered safe and effective in arresting dentine caries in primary teeth. The aim of this paper is to review and discuss updated evidence of these alternative approaches in order to manage cavitated ECC.
幼儿龋齿（ECC）是一个重大的全球健康问题，影响着全球数百万学龄前儿童。一般来说，家庭收入处于最低20%的家庭中的学龄前儿童患ECC的比例约为80%。大多数（如果不是全部的话）调查表明，绝大多数ECC都未得到治疗。未经治疗的龋齿会发展到牙髓，引起疼痛和感染。它可全身扩散，影响儿童的生长、发育和整体健康。基本的龋齿管理基于传统的修复方法。由于学龄前儿童太小，无法承受长时间的牙科治疗，他们通常在专科牙医的全身麻醉下接受牙科治疗。然而，全身麻醉下的治疗对幼儿构成危及生命的风险。此外，在ECC流行的农村地区，牙医很少。因此，在许多社区，传统的牙科护理费用高昂、难以获得或根本无法提供。然而，研究表明，非创伤性修复治疗在治疗幼儿牙本质龋方面成功率很高。氟化银胺被认为在阻止乳牙牙本质龋方面安全有效。本文的目的是回顾和讨论这些替代方法的最新证据，以便管理已形成空洞的ECC。
