Caries Case Study

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What are caries? Caries is a bacterial infection of the teeth that causes demineralization of the enamel & dentin, and may lead to pulp inflammation and necrosis in case it was reached by the infection. Four factors lead and aggravate caries: 1. Host’s diet 2. Decreased resistance to the bacteria 3. Time of exposure 4. The presence of Streptococci & S.mutans in the plaque What is caries-risk assessment? Caries-risk assessment is protocol followed by the dentist to determine the liability of a patient to develop a carious lesion, and to predict its incidence and the size of its activity after certain measures are taken. Classification 1. According to patient’s behavior: The first classification is based on: 1. When the patient stopped…show more content…
According to financial & social status, diet, and oral hygiene: Some professionals have suggested a correlation between the financial status of the patient and the spread of caries, where a bad financial status will lead to increased caries susceptibly (Ignorance, parents unable to pay for the treatment). Moreover, a high sugar – specifically sucrose – consumption lead to a higher incidence of caries. Finally, the most accurate assessment in this classification is the oral hygiene status, where the presence of S.mutans & Lactobacilli at high numbers in the mouth leads to increased caries exposure. 3. According to previous caries exposure: Many studies have showed that the presence of caries on the first permanent molar at an early age (6-7 years) is an indicator that this patient is a high-risk patient, and predicted accurately that the other molars will eventually show clinical signs of caries. Moreover, other studies have confirmed that proximal caries will raise the patient’s classification to a higher level than class I caries. 4. According to saliva tests & evaluating microbial presence: It is considered the most accurate method used to assess caries-risk. Several studies where done to confirm the correlation between salivary microbs and caries. These studies came out as the…show more content…
Low-risk patients 2. Moderate-risk patients where parents are caring 3. Moderate-risk patients where parents are indifferent 4. High-risk patients where parents are caring 5. High-risk patients where parents are indifferent Each group has specific prevention & management methods & the frequency of follow-ups. Patients Aged between 1-2 years old Classification Diagnostic method Intervention/ Prevention Restoration Follow-up Low-risk Baseline S.mutans Bi-daily brushing Observation 6-12 months Moderate-risk, parents caring Baseline S.mutans Bi-daily brushing with fluoride paste & clinical fluoride application every six months Observation of incipient caries 6 months Moderate-risk, parents indifferent Baseline S.mutans Bi-daily brushing with fluoride paste & clinical fluoride application every six months Observation of incipient caries 6 months High-risk, parents caring • Baseline S.mutans • Critical observation Bi-daily brushing with fluoride paste & clinical fluoride application every three months Observation of incipient caries & temporary/permanent restoration of demineralized areas 3

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