The type of treatment instituted for patients with rampant caries depends on the patient's and parents motivation toward dental treatment, the extent of the decay, and the age and cooperation of the child. These factors should be assessed during the child's first few visits to the dentist. Restorative dentistry is expensive and by itself, is not a complete cure for rampant caries.
Many practitioners have gone to considerable efforts to restore all the teeth in subjects with high-caries activity only to find new lesions within a very short time. Initial treatment, including provisional restorations, diet assessment, oral hygiene instruction, and home and professional fluoride treatments, should be performed before any comprehensive restorative treatment commences. The initial therapy will help the dentist to determine the ultimate success or failure of the case.
Caries stabilization and provisional restorations should be placed in symptom-free teeth with established dentinal caries to minimize the risk of pulpal exposure in the future and to improve function. However, in patients presenting with acute and severe signs and symptoms of gross caries, pain, abscess, sinus, or facial swelling, immediate treatment is indicated. Formocresol pulpotomy may be performed if the pulp is still vital, but pulpectomy followed by obturation with formalized zinc oxide-eugenol cement is indicated if the pulp is nonvital.
Because diet is one of the major factors in the initiation and development of caries, a dietary assessment should form a fundamental part of the examination.
Regards Dr. Ratnika Agrawal, Smile Up Dental Care & Implant Center of Kharadi in Pune
Answered2016-11-11 13:58:57
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