Caries care as a management strategy according to risk and comprehensive treatment in pediatric Dentistry: clinical case

Abstract

Introduction:Caries care determines the risk of caries, establishes comprehensive treatment with full patient participation and a minimally invasive approach.Objective:Apply the caries care guide for the comprehensive management of clinical cases.Material and methods:Guide the pediatric dentist through a four-step process, which leads to personalized intervention: 1st D: determine the risk of caries; 2nd D: detect injuries, identify their severity and assess their activity status (diagnosis); 3rd D: decide on the most appropriate and personalized treatment plan for the patient; 4th D: perform comprehensive treatment with preventive techniques according to risk; control the initial non-cavitated lesions with non-operative management and restore cavitated lesions with minimal intervention.Case presentation:A 7 years old male patient, with a history of breastfeeding for up to 2 years, presents a high cariogenic risk due to factors related to irregular tooth brushing and high sugar consumption. Active carious lesions are observed in the mouth: ICDAS 2, 3, 4, 5 and 6 in several teeth.The personalized treatment plan includes minimal intervention techniques: motivational phase (health promotion); preventive phase: brushing with toothpaste (1,100 ppm NaF), fluoride varnish and microinvasive techniques (sealants); restorative phase: selective removal of caries and the maintenance phase with periodic controls every 2 months.Conclusions:Caries care allows a comprehensive management of the patient according to caries risk with minimally invasive techniques and a contemporary approach oriented to the patient and not to the tooth.