CASES OF THE WEEK – “Teeth reconstruction of a four year old child” by Dr Wissam Joseph, Specialist, Prosthodontics and Dr Roleen Pereira, Specialist Paedodontist, NMC Royal Hospital Sharjah

Early childhood caries (ECC) is a major oral health problem, mainly in socially disadvantaged populations. ECC affects infants and pre-school children worldwide. ECC is the presence of one or more decayed, missing, or filled primary teeth in children aged 5 years or younger. It begins with white-spot lesions in the upper primary incisors along the margin of the gingiva.

If the disease continues, caries can progress, leading to complete destruction of the crown. The main risk factors in the development of ECC can be categorized as microbiological, dietary, and environmental risk factors. Even though it is largely a preventable condition, ECC remains one of the most common childhood diseases.

The major contributing factors for the high prevalence of ECC are improper feeding practices, familial socio-economic background, lack of parental education, and lack of access to dental care. Oral health plays an important role in children  to maintain the oral functions and is required for eating, speech development, and a positive self-image.

This is a case of a 4 year old child that visited the clinic with multiple decay involving all the primary teeth ECC with complete coronal destruction of the crowns of the upper primary, central and lateral incisors.

Intraoral periapical X-rays of the upper central and lateral incisors taken, revealed intact and sufficient root length with no periapical infections.

Hence we decided to save the teeth and restore it to it’s full form and function to help the child with esthetics and phonetics.

Pulpectomies were done in the upper primary incisors followed by composite crowns.