Treatment of early childhood caries: A literature review

Restoration of severely damaged primary anterior teeth by early childhood caries is a challenge for clinicians. Due to pernicious nature of this condition, immediate and definitive treatment has been advocated in order to prevent further tooth destruction. It is important to preserve the integrity of natural primary dentition until the expected exfoliation time. The aim of this study was to review all suggested restorative techniques as well as their success rate in treatment of decayed maxillary anterior teeth.

Aside from initial hand searching, all published studies after 1990 were identified by searching Medline, The Cochrane Library, Embase, Scopus, Iran-medex, Google and scholar databases using “bottle caries, early childhood caries, treatment of nursing caries, children caries”.

For intra-canal retention of severely decayed primary teeth, resin composites, reinforced fiber, fiber glass, treated post, nickel chromium cast post with macroretentive element, can be used. A variety of restorative materials and technique are available for restoring primary anterior teeth such as atraumatic restoration, sandwich technique, stainless steel crown, open-face crown, pre-veneered S.S.C, bicarbonate crown, resin composite crown, biologic crown and strip crown. However, due to lack of supporting clinical data, none of these crowns can be determined as superior to others.

Choosing many alternative treatment plans available to repair carious primary anterior teeth, the operator need to consider several factors such as, size and location of lesion, parental esthetic demands, child’s attitude and behavior, moisture and hemorrhage control. These are variables that ultimately affect the treatment outcome.