DTP 4b - Caries Management

- Determine

- Detect

- Decide

- Do

(Risk-based recall interval)

What are the 4Ds of the CariesCare Cycle?

- Tooth brush twice a day with a fluoride toothpaste (≥ 1,100 ppm F)

- Follow the dental exam instructions based on comprehensive risk (Fl rinse, gel, interproximal cleaning, oral health behaviors, nutrition and diet, and other oral hygiene advice).

What is the home care for low-moderate risk?

- Brush teeth twice a day with a 5,000 ppm fluoride toothpaste (or, as recommended by dentist, in specific circumstances)

- Follow the dental exam instructions based on comprehensive risk (Fl rinse, gel, interproximal cleaning, oral health behaviors, nutrition and diet, and other oral hygiene advice).

What is the home care for high-extreme risk?

- Solid: active

- X: Arrested

What is the difference between solid vs x?

1. Cavitation

2. Activity

3. Cleansibility

What are the 3 key factors that determine caries management strategies?

- Dietary and habits counseling (visuals and frequency of snacking/stephan's curve)

- Brush twice daily with 1100 ppm fluoride

- Floss twice daily

- Rinse with water after every meal

What can you educate patients on for home care?

No - avoid brushing immediately after eating something acidic and instead rinse with water and wait a while before brushing

It is recommended to brush immediately after eating?

Moderate and high-risk patients

What patient risk do you use fluoride varnish for?

Restore MO - Operative

What is the treatment for #2?

Findings:

- Visual: Occlusal-Initial

- Radiographic: M- Advanced

Restore DO - Operative

What is the treatment for #3?

Findings:

- Visual: Oclussal-Initial; Distal-shadow

- Radiographic: D - Moderate

Restore DO - Operative

What is the treatment for #4?

Findings:

- Visual: Occlusal - Initial

- Radiographic: D- Moderate

Restore DO - Operative

What is the treatment for #5?

Findings:

- Radiographic: D-Initial/Moderate

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #29?

Findings:

- Visual: Occlusal-Initial

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #30?

Findings:

- Visual: Occlusal-Initial

Restore O

What is the treatment for #31?

Findings:

- Visual: Occlusal- Shadow-Mod.

Restore DO

What is the treatment for #12?

Findings:

- Visual: Sound

- Radiographic: D- Moderate

No treatment

What is the treatment for #13?

Findings:

- Visual and Radiographic: MO Composite and DO Composite

Restore DOL (MOL?)

What is the treatment for #14?

Findings:

- Visual: D fossa sealant

- Visual: M fossa Microcav.

- Visual: L-Chalky and microcav.

- Radiographic -M-Initial

Restore MO

What is the treatment for #15?

Findings:

- Visual: M-fossa-Shadowing

- Radiographic: M-Advanced

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #18?

Findings:

- Visual: O- Initial

- Radiographic: M-Initial

Restore DO operative

What is the treatment for #19?

Findings:

- Visual: O- Initial

- Visual: D Shadowing, Microcav.

- Radiographic: D-Moderate

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #20?

Findings:

- Visual: O-Initial

- Radiographic- DO-Composite

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #21?

Findings:

- Visual: O-Initial

MO operative

What is the treatment for #3?

Findings:

- Visual: Occlusal-Broken amal-Mesial-Adv.

- Radiographic: M - Advanced

MOD operative

What is the treatment for #4?

Findings:

- Visual - Occlusal Amalgam

- Radiographic: D-Advanced-sec; M-Moderate

DO operative

What is the treatment for #5?

Findings:

- Radiographic: D- Advanced

ML operative

What is the treatment for #8?

Findings:

- Visual: M- Shadowing

- Radiographic: M- Moderate

DO operative

What is the treatment for #12?

Findings:

- Radiographic: D - Advanced

Operative (DO or prosth)

What is the treatment for #14?

Findings:

- Visual: Occlusal-MOB Amalgam-OK

- Radiographic: D- Advanced

Non-operative care

(Diet, habit counseling, Fluoride, recare, 1100ppm Ftoothpaste, Fvarnish, sealants?)

What is the treatment for #20?

Findings:

- Radiographic: D-Initial; M- Initial

DO operative

What is the treatment for #29?

Findings:

- Radiographic: D-Moderate

Operative (DOB or prosth)

What is the treatment for #30?

Findings:

- Visual: D/O/B- Advanced

- Broken amal?

- M-Initial

- DO composite

- Monitor mesial caries

What is the treatment for #3?

Findings:

- DOL Composite

- Distal recurrent caries/Open Margin

- Mesial Initial caries

MO composite

What is the treatment for #5?

Findings:

- DO Composite

- Mesial Moderate caries

DO composite

What is the treatment for #13?

Findings:

- MOD composite

- Distal secondary caries (Clinical)

MOD composite

What is the treatment for #14?

Findings:

- Occlusal Composite

- Staining on margins

- Mesial Moderate (Clinical)

- Distal Moderate (Radiographic)

DO composite

What is the treatment for #15?

Findings:

- Occlusal Composite

- Distal Moderate Caries (Radiographic)

- DO composite

- Monitor Mesial Initial Caries

What is the treatment for #20?

Findings:

- Mesial Initial Caries

- Distal Advanced Caries

DIFL composite

What is the treatment for #6?

Findings:

- DIFL Composite

- Defective/missing restoration (completed 4x)

- Possible internal root resorption

MOD composite

What is the treatment for #20?

Findings:

- MOD composite

- M and D open margins

DO composite

What is the treatment for #4?

Findings:

- D Moderate caries

OL composite

What is the treatment for #5?

Findings:

- OL fracture

- OL caries clinical

ML composite

What is the treatment for #7?

Findings:

- Advanced ML caries (radiographic)

- Moderate ML caries (clinical)

ML composite

What is the treatment for #10?

Findings:

- Advanced ML caries (radiographic)

- Moderate ML caries (clinical)

O composite

What is the treatment for #12?

Findings:

- Occlusal composite

- D initial (radiographic)

- O moderate secondary caries (cavitation)

To restore defective teeth, complete endodontics, and consider interim removable partial dentures if extractions are required.

What is the purpose of Phase II in dental treatment?

To stabilize gingival health before restorative work, address pain, and prevent the progression of decay.

What is the rationale for a phased approach in dental treatment?