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