Baby Clinic- A Program to Prevent Severe Early Childhood Caries

Background: Severe Early Childhood Caries (S-ECC) affects primary teeth soon after their eruption. The serious consequences of this condition include malnutrition, tooth extractions and/or restorations. Extensive treatment is often needed, usually under sedation or general anesthesia. Objective: The present study was designed to examine the feasibility of implementing a comprehensive pre-natal and post-natal oral care program, to prevent S-ECC and to assess its effectiveness on the prevalence of this condition. Methods: Pre-natal phase: Lectures were given by pediatric dentists to couples enrolled in Hadassah's Birth Preparation Class (BPC). Emphasis was placed on feeding habits, avoidance of Streptococcus Mutans transmission and the early establishment of oral hygiene and its possible relation to caries development. At the end of the lecture, all parents were invited to enroll in the baby clinic. The post-natal phase consisted of dental visits scheduled at regular intervals according to the babies' risk for caries development and comprised: (a) oral health assessment (b) diet and hygiene counseling (c) fluoride varnish application in high risk patients. Preliminary results: Almost all the mothers and babies were healthy and the deliveries were uneventful. Approximately 100 babies attended the first dental consultation; their average age at this appointment was 12.5 months. Maternal age at labor was 30 years on the average. The majority of the babies were breastfed from 1st to 8th month with an average of 4.7 months. Tooth brushing was started at 8 months in about half of the babies. Almost all the caregivers demonstrated interest in continuing the follow up. Only two of the attending babies developed initial cavitation during the follow up program. Conclusion: The current approach seems to be effective in preventing and controlling the severity of S- ECC.