CARIOLOGY AND CARIES MANAGEMENT

EVIDENCE - BASED DENTAL RESEARCH TAUGHT US THAT CARIES IS A PROCESS WHERE : DEMINERALIZATION EXCEEDS

REMINERALIZATION, THE NET RESULT IS OFTEN CAVITATION . FILLING THE TOOTH AT THIS POINT

TREATS THE HOLE NOT THE DIEASE ,

EARLY CHILDHOOD CARIES (EC C)

Definition: - IT IS THE PRESENCE OF 1 OR MORE DECAYED (NONCAVITED OR CAVITED LESIONS ), MISSING (DUE TO CARIES) OR FILLED TOOTH SURFACES IN ANY PRIMARY TOOTH IN A CHILD (71 ) MONTHES OF AGE OR YOUNGER . IN CHILDERN YOUNGER THAN 3 YEARS OF AGE ANY SIGN OF SMOOTH –SURFACE CARIES IS

INDICATIVE OF ( S-E CC ) ( AAPD )

The mandibular incisors are usually unaffected due to protection by tongue and saliva.

CARIES ASSESSEMENT AT 6 MONTHS

CHILD RECEVIE RISK ASS. AT 6 MONTHS S E C C

Streptococcus Mutans Transmission

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CONSEQUENCES OF UNTREATED DENTAL CARIES IN CHILDREN

CAN QUICKLY DIMINISH THE GENERAL HEALH & QUALITY OF LIFE FOR THE AFFECTED INFANTS, BECOMES MORE DIFFICULT TO TREAT, THE COAST INCREASE, PAIN , DISCOMFORT, REDUCED GROWTH & BODY WEIGHT, DISTURBED SLEEP AFFECTS GLUCOSTEROID PRODUCATION, SUPPRESSION OF HEMOGLOBIN FROM DEPRESSED ERYTHROCYTE PRODUCATION ,

DENTAL HOME

First visit -

First time First year

AAPD Dental Home Web Resource Center

Cleaning Teeth Ages 2 &less than 3

years Brush with a rice sized

amount of toothpaste using a soft toothbrush

Have the child spit out the toothpaste after brushing but do not rinse with water

Fluoride Varnish Fluoride varnish for preschool children with

special care need.Duraphat ( -2-5% F) Fluor protector (0.8%).Recommended in decalcified enamel secondary

to poor plaque removal or poor feeding & used for newly erupted teeth.

Arresting of early caries ,hyper sensitive area.

18 www.aap.org/oralhealth/pact

FluorosisIngestion of toothpaste increases the risk of enamel fluorosis. If fluoride toothpaste is used, strategies to limit the amount swallowed include limiting the amount placed on the brush and observing the child as they brush. Used with permission from Rama Oskouian

XYLITOL XYLITOL CURRENTLY IS available in many forms

(eg, gums , mints, chewable tablets, lozenges tooth pastes , mouth washes, cough mixture XYLTIOL CHEWING GUM HAS BEEN SHOWN TO BE EFFECTIVE AS PREVENTIVE AGENT THE EFFECTIVENESS OF OTHER XYLITOL PRODUCTS IS BEING STUDIED AT THE TIME

XYLITOLXylitol chewing gum :- Evidence suggest

that the use of xylitol chewing gum (at least 2 – 3 times a day by the mother ) has a significant impact on mother- child transmission of MS and decreasing the child s caries rate .

MI PAST &MI PAST PLUS MI PAST USED FOR BABY

MI PAST PLUS USED FOR HIGH RISK , DRY MOUTH , ONCOLOGY , TOOTH WITING , PORTHODONTIC , EROSIVE, PERIODONTAL

DIEASE FLUOR PROTECTOR GEL (CA+ PH+F)

{IVOCLAR }

29$ price

BIOTENE (GSK)

(DRY MOUTH TREATMENT)

MOUTH WASH TOOTH PASTE

ORAL GEL MOUTH SPRAY &

Click icon to add picture

Zam zam water

Zam zam waterIt is alkaline

having PH= 7.8 (more alkaline than saliva (7.2-7.4)Up to 8.38Carbonated beverage about PH=3.2.

Carbonated water (280-299)mg/L bicarbonate.Bicarbonate has the best buffering effect . It limits the fall in PH when bacteria metabolize

sugar . contain fluoride (0.6-0.68 PPM).

Mineral water : Contain Ca : (230-245) mg/L contain PH : (0.31-0.46) mg /L

( help remineralization of decayed teeth .) ( phosphate is one of protective factor in remineralization.)

Hint : Low Ca & PH →Osteoporosis (esp.- women).

So -:Can be used systemically & locally as mouth wash.

-especially before sleeping & ↑ risk group.e.g. radiation caries , rampant caries. During and after

ortho treatment.

Minimal Intervention Dentistry

- Modern approach to the treatment of tooth decay- Based on “Medical Model” of caries management

Details of the MI approach

- (1) Reduces cariogenic bacteria; - (2) Uses preventive measures;- (3) Early lesions remineralised;- (4) Minimal surgery on cavities; - (5) Repair of defective restorations.

The Minimal Intervention approach

- A medical model; - Caries treated as a biological infection;- Surgical techniques are minor and stress retention of tooth tissue.

Conclusions

• Minimal Intervention dentistry is the future:– Advocated by FDI;– Cost effective;– Less trauma for the patient.

• A biological approach, not a mechanical one.• Makes significant demands on materials.

ART POLICY STATMENTART MAY BE USED FOR CARIES CONTROL

IN YOUNG CHILDREN WITH MULTIPLE

CARIOUS LESION PRIOR TO DEFINITIVE

RESTROTATION OF THE TEETH USING

HAND INSTRUMENT & GI OR IRM

TREAT THE CHILD NOT THE

TOOTH

TREAT THE TOOTH NOT THE

HOLE

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