High Risk patient, caries inactive:

This type of patient has cavitated lesions that are inactive.  Note the color and texture of lesions to help in determining activity.  This type of patient may also have white spot lesions, which may be inactive (note the enamel surface will be shiny and smooth) or active.

If both cavitated and non-cavitated lesions appear inactive, the bacterial exam will probably be low. Therefore, no bacterial treatment is necessary.

If cavitated lesions appear inactive and the non-cavitated lesions appear active, bacterial treatment with CHX is necessary.

When white spot lesions appear to have healed or controlled, initiate restorative procedures for cavitated lesions.  Once this patient has restorations placed, he/she can be classified as a low dental caries risk patient.

1. Have patient maintain normal oral hygiene habits.
2. Stress diet compliance.
3. The patient should chew 2 sticks of xylitol gum for 5 minutes 5 times/day as a preventive measure. Use dairy products such as cheese and milk since studies suggest that the phosphoprotein, casein, and calcium phosphate may be anticariogenic (present in Trident Advantage gum--Recaldent).
4. Recall the patient every 6 months.

   

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