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幼儿龋齿:一种以家庭为中心的疾病。

Early Childhood Caries: a Family-Centred Disease.

作者信息

Paglia L

机构信息

Editor in chief European Journal of Paediatric Dentistry.

出版信息

Eur J Paediatr Dent. 2025 Jun 1;26(2):87. doi: 10.23804/ejpd.2025.26.02.01.

Abstract

We know that ECC (Early Childhood Caries) has a multifactorial aetiology, in which dietary factors play a particularly significant role. Early childhood is a critical period during which exposure to various foods and flavours significantly shapes dietary preferences and future eating behaviours. Early dietary patterns can also influence bacterial ecology, including the colonisation of Streptococcus mutans, whose presence is a strong predictor of future caries incidence in young children. Early exposure to sugary foods and beverages can, therefore, have important consequences, laying the groundwork for future cariogenic dietary patterns or shaping acidogenic bacterial populations in the oral cavity. The American Heart Association recommends avoiding added sugars in food and beverages for children under two years of age. Furthermore, the American Academy of Pediatrics advises against introducing fruit juices before 12 months of age and recommends limiting their consumption to no more than four times per week for children aged one to three years. ECC also shares common risk factors with other noncommunicable diseases (NCDs), such as cardiovascular disease, diabetes, and obesity. Therefore, strategies for the prevention of dental caries should aim not only at ensuring proper oral hygiene but also at promoting appropriate dietary habits from early childhood- namely, limited intake of sugar-sweetened beverages (SSBs) and refined foods. In this context, parents can and must play a crucial role by providing their children with healthier dietary choices and behaviours. We must thus consider early childhood caries as a condition whose origins-and solutions-lie within the family environment: children learn habits from those who care for them and control what, when, and how they eat. Changing a family's dietary habits is undoubtedly challenging, but we must recognise that interventions in ECC cases-especially early forms-necessarily require a family-centred approach. It is therefore essential to work in close collaboration with experienced nutritionists to collect data on dietary habits, identify unhealthy patterns, and design balanced, healthy diets for the entire family- supporting a virtuous path toward overall, not just oral, health.

摘要

我们知道,幼儿龋齿(ECC)病因多因素,其中饮食因素起着特别重要的作用。幼儿期是一个关键时期,在此期间接触各种食物和味道会显著塑造饮食偏好和未来的饮食行为。早期的饮食模式也会影响细菌生态,包括变形链球菌的定植,其存在是幼儿未来龋齿发病率的有力预测指标。因此,早期接触含糖食物和饮料可能会产生重要后果,为未来的致龋饮食模式奠定基础或塑造口腔中的产酸细菌群体。美国心脏协会建议两岁以下儿童避免食用食品和饮料中的添加糖。此外,美国儿科学会建议在12个月龄之前不要引入果汁,并建议1至3岁的儿童将果汁摄入量限制在每周不超过四次。幼儿龋齿还与其他非传染性疾病(如心血管疾病、糖尿病和肥胖症)有共同的风险因素。因此,预防龋齿的策略不仅应旨在确保适当的口腔卫生,还应旨在从幼儿期就促进适当的饮食习惯,即限制含糖饮料(SSB)和精制食品的摄入量。在这种情况下,父母可以而且必须发挥关键作用,为孩子提供更健康的饮食选择和行为。因此,我们必须将幼儿龋齿视为一种其根源和解决方案都在于家庭环境的状况:孩子从照顾他们的人那里学习习惯,并控制他们吃什么、何时吃以及如何吃。改变家庭饮食习惯无疑具有挑战性,但我们必须认识到,对幼儿龋齿病例的干预——尤其是早期形式——必然需要以家庭为中心的方法。因此,与经验丰富的营养师密切合作收集饮食习惯数据、识别不健康模式并为整个家庭设计均衡、健康的饮食至关重要,这有助于走上通往整体健康而非仅仅口腔健康的良性道路。

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