Department of Pediatric Dentistry, Centre for Early Childhood Caries Research (CECCRe), Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Department of Pediatric and Preventive Dentistry, Madha Dental College and Hospital, Chennai, India.
Front Public Health. 2022 Oct 18;10:931243. doi: 10.3389/fpubh.2022.931243. eCollection 2022.
Early Childhood Caries (ECC) remains a global issue despite numerous advancements in research and interventional approaches. Nearly, 530 million children suffer from untreated dental caries of primary teeth. The consequences of such untreated dental caries not only limit the child's chewing and eating abilities but also, significantly impact the child's overall growth. Research has demonstrated that ECC is associated with nearly 123 risk factors. ECC has also been associated with local pain, infections, abscesses, and sleep pattern. Furthermore, it can affect the child's emotional status and decrease their ability to learn or perform their usual activities. In high-income countries, dental care continues to endorse a "current treatment-based approach" that involves high-technology, interventionist, and specialized approaches. While such approaches provide immediate benefit at an individual level, it fails to intercept the underlying causes of the disease at large. In low-income and middle-income countries (LMICs), the "current treatment approach" often remains limited, unaffordable, and unsuitable for the majority of the population. Rather, dentistry needs to focus on "sustainable goals" and integrate dental care with the mainstream healthcare system and primary care services. Dental care systems should promote "early first dental visits," when the child is 1 year of age or when the first tooth arrives. The serious shortages of appropriately trained oral healthcare personnel in certain regions of the world, lack of appropriate technologies and isolation of oral health services from the health system, and limited adoption of prevention and oral health promotion can pose as critical barriers. The oral health care systems must focus on three major keystones to combat the burden of ECC-1. Essential oral health services are integrated into healthcare in every country ensuring the availability of appropriate healthcare accessible and available globally, 2. Integrating oral and general healthcare to effectively prevent and manage oral disease and improve oral health, 3. Collaborating with a wide range of health workers to deliver sustainable oral health care tailored to cater to the oral health care needs of local communities.
尽管在研究和干预方法方面取得了许多进展，但幼儿龋仍然是一个全球性问题。近 5.3 亿儿童患有未经治疗的乳牙龋齿。未经治疗的龋齿的后果不仅限制了孩子的咀嚼和进食能力，还严重影响了孩子的整体生长发育。研究表明，幼儿龋与近 123 个风险因素有关。幼儿龋还与局部疼痛、感染、脓肿和睡眠模式有关。此外，它会影响孩子的情绪状态，降低他们学习或进行日常活动的能力。在高收入国家，牙科护理继续采用“基于当前治疗的方法”，该方法涉及高科技、介入性和专门性方法。虽然这些方法在个体层面上提供了即时的好处，但未能从整体上拦截疾病的根本原因。在低收入和中等收入国家（LMICs），“当前治疗方法”往往仍然受到限制、负担不起，并且不适合大多数人口。相反，牙科需要关注“可持续目标”，并将牙科护理与主流医疗保健系统和初级保健服务相结合。牙科保健系统应促进“首次牙科就诊的早期”，即孩子 1 岁或第一颗牙齿萌出时。世界上某些地区适当训练的口腔保健人员严重短缺，缺乏适当的技术，口腔卫生服务与卫生系统隔离，以及预防和口腔健康促进的采用有限，这些都可能构成重大障碍。口腔卫生保健系统必须关注三个主要基石，以应对幼儿龋的负担-1. 将基本口腔卫生服务纳入每个国家的医疗保健中，确保全球范围内提供适当的、可及的医疗保健，2. 将口腔和一般医疗保健相结合，以有效预防和管理口腔疾病，改善口腔健康，3. 与广泛的卫生工作者合作，提供可持续的口腔卫生保健，以满足当地社区的口腔卫生保健需求。
