Management of Adolescent

Caries
Tooba 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 includes
1. Assessment of carious lesions
2. Provisional Restorations
3. Dietary assessment
4. Oral Hygiene Instructions
5. Home & Professional Fluoride Tx
6. 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 Paste
2. Mouth wash
3. 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