High Risk Patient, Caries Active:

This patient has cavitated lesions that appear caries active and may have white spot lesions that are caries active or inactive.
Treatment for the bacterial infection is primary, as in any infectious disease. Procedure for Treating the Infection.
In the open or active cavitated carious lesions remove the bulk of the soft carious material and place temporary glass ionomer restorations at one of the early appointments.  Permanent restorations are placed after the infection is controlled.
Procedure for the patient where the ms levels are difficult to control.
Once the infection is under control, initiate the remineralization of the incipient lesions and restore cavitated lesions.
Recall
In most patients this program will provide for caries control. This is accomplished by working toward the goal of having the patient comply to procedures and achieve a low risk classification. In severe cases specific factors which may present the patient from achieving caries control must be identified and treated.
For the geriatric patient and the patient with disabilities repeated professional support may be required for prolong periods of time until control is achieved.