The importance of the primary dentition to children - Part 1: Consequences of not treating carious teeth

Abstract

Humans are diphyodonts, which means that they have two successive sets of teeth: primary and permanent. The primary teeth are important in a child's life as they help in mastication, in speech, contribute to aesthetics and preserve the integrity of the dental arches, finally guiding permanent teeth into their correct positions. Dental caries (decay) which is avoidable, remains a common chronic disease of early childhood with an occurrence rate five times higher than that of asthma and seven times higher than that of allergic rhinitis. Untreated carious teeth in young children frequently lead to pain and infection, necessitating emergency visits to the dentist. Carious teeth in early childhood are not only indicative of future dental problems, they also adversely affect growth and cognitive development by interfering with nutrition, sleep and concentration at school. In addition, they may have a significant impact on an individual's quality of life. Primary teeth are not always given a high priority although physicians and health policy-makers have an interest in playing an active role in children's oral health, owing possibly to lack of simple well-defined practical guidelines to follow when performing dental screenings and other activities relating to the infant's oral health. Also, many parents are unaware of the importance of primary teeth; consequently, dental attendances before the age of two years are uncommon. They consider primary teeth to be only temporary and think that related problems are rarely life-threatening. Intervention to prevent or arrest dental caries should focus on reducing the availability of refined carbohydrates (substrate), reducing the microbial burden (causative organism), increasing the resistance of the teeth (host) to caries, or a combination of these approaches. Nevertheless, dental caries can be effectively treated using various restorative materials with suitable pain control measures. This is possible if proper advice and referral is made by medical practitioners who have early and often frequent contact with young children. There seems to be no logical reason for leaving carious primary teeth untreated in a child's mouth. Early recognition and timely referral of infants and young children with dental caries is critical in preventing the unpleasant complications. Primary care providers who have contact with children are well placed to offer anticipatory advice to reduce the consequences of dental caries.