Nursing caries is a unique pattern of dental caries seen in very young children due to prolonged, improper feeding habits.
It is a specific form of rampant caries.
Seen in infants and toddlers.
It affects the primary teeth in the following sequence,
Maxillary central incisors
Maxillary lateral incisors
Maxillary first molars
Maxillary canine and second molars
Progression of the lesion
Initially a demineralized, dull white area is seen along the gum line on the labial aspect of the maxillary incisors which remains undetected.
These lesions become cavities involving the necks of teeth in a ring like fashion.
Finally the whole crown is destroyed leaving behind brown, black root stumps.
It can be divided into 3 visits
All lesions should be excavated and restored
Indirect pulp capping procedures can be evaluated.
X-rays should be taken to assess the condition of the succedaneous teeth.
Collection of saliva for dtermining the salivary flow and viscosity.
Topical fluoride application.
Parents should be questioned about the childs feeding habit, use of noctornal bottles, use of pacifiers dipped in sweetening agents.
Parents should be asked to try weaning the child the bottle as a pacifier while in bed.
In case of a emotional dependence on the bottle, suggest the use of plain or fluoridated water.
The parents should be instructed to cleam the childs teeth after every feed.
Parents should be advised to maintain the diet record of the child for a week.
Scheduled one week after the 1st visit.
analysis of the diet chart and a detailed explanation on the disease of the childs teeth.
Isolate the sugar factors from the diet chart and replace them.
Re assess the restorations, and redo if needed.
Caries activity test can be repeated at monthly intervals.
3rd and subsequent visit
Restoring all grossly decayed teeth
Endodontic treatment should be carried out
Unrestorable teeth should be extracted
Crowns should be given on all endodontic teeth
Review and recall after every 3 months.
The main strategies for nursing caries should be to create awareness and alert prospective parents about the condition and its causes.