Management of Adolescent CariesTooba Syed
Defination•According to WHO:•Localized post eruptive pathological
process of external origin involving softening of the hard tooth tissue & proceeding to the formation of cavity.
Adolescent Caries•Considered a variation of rampant caries•Teeth generally considered immune are
effected•Caries to be of a rapid burrowing type,
with a small enamel opening•Presence of large pulp chamber causes
early pulp involvement•Little time for formation of reparative
dentine
Management Management includes1. Assessment of carious lesions 2. Provisional Restorations3. Dietary assessment4. Oral Hygiene Instructions5. Home & Professional Fluoride Tx6. Follow up
Assessment of Carious lesions•Patient is assessed for carious lesions
•Assessment of rate of progression of caries
Provisional Restorations•Caries stabilization with gross excavation
of each carious lesion & provisional restorations should be placed in symptom free teeth established dentinal caries to minimize the risk of pulpal exposure in future and to improve function.
Diet•Patient is educated regarding diet and
reducing the frequency of sucrose consumptions and sugary drinks
•Consumption to be reduced to only meal times
Oral Hygeine •Patient is educated about the brushing
techniques e.g, Bass Technique
•Advised to brush regularly and proper brushing technique demonstrated on models of dental arches and brushes
Flouride Tx•The flouride Tx depends upon the level of
flouride present in the water and stage of development of dentition
Sources of Flouride
•Flouride tx through
1. Tooth Paste2. Mouth wash3. Professional application every 6 months
Plaque Control•Oral Prophylaxis •Oral Hygiene instructions to Patients. •Scaling•Tooth brushing. •Disclosing tablets. • Inter dental Cleaning with floss or tooth
picks
Comprehensive Restorative Tx• Once Rampant caries is under control
Comprehensive tx can be done• Restorative strategies for rampant caries are: • Early caries with minimal loss of enamel • Weekly professionally applied topical fluoride. • Extensive cavitations with no pulpal involvement. * Anterior Teeth:- * Acid – etched – composite resin restoration * Pedo strip crowns. * GIC restorations.
•* Posterior Teeth:- * Posterior composite resin restorations. * Glass- Ionomer cement restorations. * Stainless Steel crowns. •3. Extensive cavitations with pulpal
involvement. Pulpotomy or pulpectomy where appropriate, followed by permanent restoration.
•Extraction followed by space maintainer or partial or complete dentures.
Follow Up•Follow up and regular check up every 6
months
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