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Early childhood caries (ECC) represents a major health and economic problem worldwide. Its consequences such as early pain experience may affect the immediate and long-term quality of life of the child. In very young and uncooperative children the therapy of ECC is often viable only under general anesthesia. After treatment these affected children have a higher risk for future caries either soon thereafter, or later in life. The aim of the present study was to determine risk indicators and their correlation among children with high caries prevalence and high treatment needs, in order to facilitate the development of targeted prophylaxis programs that would reduce future occurrences of ECC or at least positively influence the outcome. For this purpose, between 2010 and 2014 the parents of these children (n=82) were interviewed in the University Children’s Hospital in Basel (UKBB) prior to the children's treatment under general anesthesia. The standardized questionnaire included questions regarding the age of the child, the mother's country of origin, the oral hygiene, and the drinking habits of the child. The analysis shows that the high mean dmft/ dmfs values (dmft: 9.49 and dmfs: 26.35) correlated significantly with the geographic origin of the mother (p<0.05), the beginning of tooth brushing (p<0.05), lack of supervised tooth brushing (p<0.01), and nighttime consumption of sugar-sweetened beverages (p<0.05). In contrast, the duration of breastfeeding and prolonged use of a baby bottle (about 2.5 years) did not have a clear impact on high caries prevalence.

Pain is always a subjective experience. Therefore the term "psychogenic pain sensation" seems to be a pleonasm at first sight. In fact, however, the dentist's attention should not only be focussed on the removal of the objective causes of pain, but the fact itself, i.e. the patient's subjectivity, must be considered, too. Unless this is done, the results are serious diagnostic and therapeutic errors.