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feature _ interview I tricians and family physicians to identify at-risk children and refer them for dental treatment. However,formanychildrenaccesstodentalcare remains a problem and the number with dental caries seems to be growing. Many parents do not have dental insurance; thus, they postpone dental treatments until the problem is so advanced that it cannolongerbeignored.Itisunfortunatethateven parents who have third-party coverage for dental care (Medicaid, Child Health Plus) and are from lowersocioeconomicbackgroundsoftenfailtoseek dental care as part of general health-care services. As a result, pre-school children with Medicaid may still have untreated decayed teeth. _Frequent bottle-feeding at night has been iden- tified as a driving factor for ECC. Other studies have foundamicrobiologicalconnectionbetweenmother andchild,labellingECCatransmissibledisease.What is your opinion on the latest research and how will it affectthewaychildrenshouldbetreated? Dr Herman: The nursing bottle is only one of many confounding factors in ECC. What we con- cludefromthelatestresearchisthatdentalcariesis highlycomplexandperplexing,noteasilyprevented or treated in the most susceptible children. It is believed these days that there are nutritional, be- havioural,immunologicalandbacterialfactorsthat mustbeconsideredinordertounderstandandpre- vent dental caries. The surgical approach to ECC—the ‘drill and fill’ solution of placing restorations in teeth as they become cavitated—has long been proven futile and often counter-productive. Therapeutic interven- tions, particularly utilising fluoride varnish, have shown promise in preventing, arresting and revers- ing carious lesions. Much more work must be done to document its success, but at least this ‘medical model’ has begun to address the fact that ECC is a bacterial disease that requires more than just filling up the holes that are merely its symptoms. _Root-canal treatments in primary teeth are also becoming more common. Does the treatment differinanywayfromthatofpermanentteeth? DrLim:We’renotsurethatpulptherapyisonthe increase but if it is, it’s probably because more par- ents (and dentists) realise it’s best to try to preserve a primary tooth rather than extract it (whenever possible). The goals of treatment for primary teeth I hereby agree to receive a free trail subscription of (4 issues per year). I would like to subscribe to cosmetic dentistry for € 44 for German customers including shipping and VAT, € 46 for customers outside Germany including shipping and VAT, unless a written cancellation is sent within 14 days of the receipt of the trial subscription.The subscription will be renewed automati- cally every year until a written cancellation is sent to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany, six weeks prior to the renewal date. Reply per Fax +49 341 48474-290 to OEMUS MEDIA AG or per E-mail to grasse@oemus-media.de Last Name, First Name Company Street ZIP/City/Country E-mail Signature Notice of revocation: I am able to revoke the subscription within 14 days after my order by sending a written cancellation to OEMUS MEDIA AG, Holbeinstr. 29, 04229 Leipzig, Germany. OEMUS MEDIA AG Holbeinstraße 29, 04229 Leipzig, Germany Tel.: +49 341 48474-0, Fax: +49 341 48474-290, E-Mail: grasse@oemus-media.de Signature roots3/10 YYou can also subscribe via www.oemus.com/abo AD