Atraumatic Restorative Technique (ART) for Early Childhood Caries (ECC)

Explanation for Parents

Early Childhood Caries (ECC) is a very aggressive fast moving type of decay! ECC is a particular challenge to treat due to the child’s limited capacity to understand at this age (age 1 or 2). We are also very limited in the length of time a child will sit still and allow us to work. If the work is significant, our only alternative to treat these cavities and avoid infections, abscesses and extractions used to be general anesthesia in the hospital.

ART is a variety of new techniques designed to slow down or stop the decay, place temporary fillings and allow the child to grow older so more conventional fillings can be placed. We are buying time and attempting to avoid the hospital treatment. It works very well if we get good compliance from the parents. You will see this technique relies on daily support at home. If we do not have excellent help at home, we will fail. We will soon be faced with the general anesthesia choice and the extensive dental work indicated.

• Identify the cause of the early caries and stop whatever that is. Without excellent cooperation with this step at home all the rest of our efforts will be in vain. We will loose a lot of time, spend a lot of money, and still need to do immediate conventional treatment on a worsened condition.
• Remineralizing with topical fluoride applications at the office and at home. All the fluoride research the last 20 years demonstrates (first) the beneficial effect of fluoride is topical. We don’t need to swallow it to get the benefit. And (second) the fluoride can actually trap calcium and remineralize areas where the cavity has started. It is healing the cavity.
• Remove bulk decay from the cavities with quiet instruments and open the areas to easier cleaning with tooth-brushes, floss and toothpicks.
• Place temporary fillings where feasible or necessary. We use materials that will inhibit the potential for new active caries to start.
• Monitor carefully! We recommend follow-up visits at a 3-month interval.
• A. If caries is progressing we want to identify that quickly while as many options for treatment as possible are still available.
• B. If we need to modify the program, or add to the program, we want to identify the need and reasons at the earliest interval possible.

I want to emphasize. If this program is followed correctly, it is highly successful. If the program is not followed adequately it is not successful and leads to a delay in treatment and a worsening of the problem. If at any time in the process you feel you cannot fulfill what is being requested in your home care activities, let us know so we can adjust the program appropriately and/or discuss the alternative decisions you will want to make before the problem gets worse.