PSYCHOSOCIAL AND BEHAVIORAL ISSUES IN EARLY-CHILDHOOD CARIES

Rampant caries in infants and young children has long been recognized as a clinical syndrome referred to by various names, including nursing caries, nursing bottle syndrome, night bottle mouth, and baby bottle tooth decay The common theme among these terms is the perceived centra l role of inappropriate use of the baby bottle in the etiology and pro gression of carious lesions. Use of the baby bottle is not the only, a nd may not be the most important, factor in caries development. Becaus e of questions about the role of the baby battle in caries among young children, the Centers for Disease Control and Prevention recently sug gested that the term for this clinical syndrome be replaced with early childhood caries (ECC). The purpose of this paper is to evaluate the literature on the influence of psychosocial and behavioral factors in early childhood caries. Prevalence of caries and maxillary anterior de cay varies greatly in developed and undeveloped countries and among so cioeconomic groups in developed countries. However, relatively little is known about the onset and progression of the disease or the anteced ents of ECC, such as high risk behaviors, cultural norms, health belie fs and attitudes, or health fare delivery factors. Furthermore, studie s that do exist are limited by small and possibly biased samples and a lack of clear case definition. Future research should aim to develop a clear case definition of ECC, differentiate patterns of caries and c onduct community-based epidemiological studies in order to obtain accu rate estimates of the etiology and epidemiology of ECC in the general population, as well as in high risk groups.