RAMPANT CARIES ITS MANAGEMENT AND PREVENTION.pptx

RAMPANT CARIES ITS MANAGEMENT AND PREVENTION.(PEDIATRIC DENTISTRY )

1. RAMPANT CARIES ITS MANAGEMENT AND PREVENTION PEDODONTICS MUGILARASAN MUNISAMY CRRI PRIYADARSHINI DENTAL COLLEGE AND HOSPITAL

2. WHAT IS DENTAL CARIES Dental caries is an irreversible microbiological disease of the calcified tissue of the tooth , characterized by demineralization of the inorganic part and destruction of organic substance of tooth , which leads to cavitation . - Shafer .

3. RAMPANT CARIES Defined as suddenly appearing widespread ,rapidly spreading ,burrowing type of caries ,resulting in early involvement of pulp and affecting those tooth ,which are more usually regarded as immune to decay . massler -1945

4. How it differs from ECC and NBC EARLY CHILDHOOD CARIES Complex disease involving maxillary incisors within a month after eruption and spreading rapidly to other primary teeth is called childhood caries . NURSING BOTTLE CARIES This is an unfortunate form of rampant caries affecting decidious dentition . Which is caused by prolonged use of bottle filled with any liquid other than the water .

5. ETIOLOGY Salivary deficiency 1.radiation therapy 2.xerostomia 3.children in stress Acidogenic bacteria ,dental plaque ,etc Genetics Habits 1. feeding sweetened milk through the night . 2. sweetened pacifiers 3. nursing of child through night Nutritional deficiency Diet – cariogenic food ,sucrose content Psyhcological factors .

6. FEATURES OF RAMPENT CARIES Which affects Infants ,young children ,teenagers ,adults of all age . Prevelence age – 4 to 8 yrs , 11 to 19 yrs . Common site –proximal surface of lower anterior teeth labial surface of maxillary anterior teeth . Type of lesion and nature Soft consistancy light yellow in color More in females and moe in child age .

7. SEQULAE OF RAMPENT CARIES Pain Infection Tongue thrusting Abnormal swallowing habits Speech difficulties .

8. TREATMENT Treatment depends on the , 1. patient and parents motivation towards treatment 2. the extreme of decay 3. the age 4. co operation of the child. TREATMENT Initial treatment Comprehensive restorative treatment . 1.provisional restorations 2.Diet assesment 3.Oral hygeine practice 4. Home and professional fluride treatment .

9. Provisional restoration IF NO SYMPTOMS Caries stabilization gross excarvation provisional restoration WITH SYMPTOMS AND SIGNS immediate treatment required If the pulp is vital Foam cresol pulpatomy If pulp is nonvital Pulpotomy followed by ZOE cement Diet assesment Reduce the frequency of sucrose consumtion Restriction of sugar containing food Bottle feeding habit should to stopped and reduce amount of sugar added Dietry vitamin suplement as well as oral medications

10. ORAL HYGEINE INSTRUCTIONS Under age of 8 years a circular scrub technique Foons technique After age of 8 years a sulcular brushing technique Bass technique Explaining the proper brushing technique to the patients FLURIDE treatment Both systemic and topical to prevent dental caries Depends on level of fluride in drinking water and the stage of development of dentition Various methods are there for prevention

11. COMPREHENSIVE RESTORATIVE TREATMENT Early caries minimal loss of enamel topical fluride application Extensive cavitation with no pulpal involvement 1.Acid etched composite resin restoration 2.Glass ionomer cement restoration 3.Pedo strip crowns – anterior teeth 4.Stainless steel crown – posterior teeth Extensive cavitation with pulp involvement 1. pulpotomy or pulpactomy 2.Extraction then space maintainer , partial dentures

12. PREVENTION OF RAMPANT CARICS DIETRY ADVICE Diet counselling with parents and patient depending on patient age FLURIDE THERAPY 1. Fluridated tooth paste 2. Fluride tablets , if an area without water fluridation - age o to 8 years 3. Professional topical fluride application every 6 months 4. Mouth rinse - age after 5 yrs PLAQUE CONTROL 1.Oral hygiene instructions instructions for patients and parents 2. tooth brushing 3.Sealents 4. Interdental cleansing with floss -after 12 yrs

13. THE RAMPANT CARIES CONTROL PROGRAM – RCCP January 2003 at the university of loaw college of dentistry . THREE IMPORTANT COMPONENTS OF PHASE ONE DISEASE CONTROL 1.Acute / emergency treatment RCT and EXTRACTIONS 2.Operative treatment Caries removal and restoration and seslents 3.Preventive treatment and chemotherapeutic agents Dental visit and home care

14. Thank you PREVENTION IS BETTER THAN CURE