Case Presentation 11SshrutiHRUTI

8/13/2019 Case Presentation 11SshrutiHRUTI

1/26

Case presentation 11

Severe Early Childhood Caries

Presented by : Dr. Shruti Deshmukh

PG student

Pedodontics


2/26

Patient information :

Name : Shraddha Gangurde

Age : 6 years

Sex : Female Address : Nashik road

Accompanying person : Mother

Date : 29-5-2012


3/26

Chief complaint :

Patient reported to our department for the

treatment of multiple carious teeth, poor

appearace of front primary teeth.


4/26

History of present illness :

Patients mother has been noticing the

decayed teeth since last 2-3months for which

she did not report to any general or pediatric

dentist. Patient experiences generalized mild

pain in all teeth aggravated on food lodgementand sweet foods and beverages.

There has been occurrence of repeated

intraoral swelling in relation to upper right andleft deciduous molar tooth.


5/26

Medical history :

Nil

Past dental history : No previous dental visit or treatment


6/26

Prenatal history : Normal delivery

No illness or accidents during pregnancy

Post natal history : Bottle feeding habit which started since early

childhood is persistent till present day

Feeding of milk with added sugar frequentlyduring day times between meals and also atnight before bed and is not followed by anyoral hygiene measure.


7/26

Eruption primary teeth uneventful within their

normal eruption periods

Oral habits : Nil

Other habits : Nil


8/26

Behavior rating (Frankle 1962):

Negative

Brushing habits : Patient does not perform any oral hygiene

measure.


9/26

General physical examination :

Built : normal

Height : 3.5 feet

Weight : 17 kg Gait : normal

Motor co-ordination : normal


10/26

Extraoral examination :

Face is symmetrical

No abnormalities present in relation to lips

and skin

Submandibular lymph nodes are not palpable

TMJ movements are normal with no pain,

clicking or deviation


11/26

Intraoral examination : Soft tissue

No abnormal findings in relation to buccal and

labial mucosa, palate, floor of mouth, tongue,

gingiva, frenum attachments and tonsils/

oropharynx

Gingival swelling in

relation to 54-55 and 64-65


12/26

Intraoral examination : Hard tissue

Type of dentition : Primary

Number of teeth : 20


13/26

Teeth present :

51, 52, 53, 54, 55,16

61, 62, 63, 64, 65,26

71, 72, 73, 74, 75, 3681, 82, 83, 84, 85, 46


14/26

Dental caries

status :

Advanced caries : 55,65

Moderate caries : 52, 54,55, 62, 64, 83

Deep pits and fissures inrelation to 16, 26, 36, 46

Arrested Proximal caries:51,52,53,61,62,63,72, 73,

74, 75, 82, 83, 84, 85 Root pieces :54,64

deft : 20


15/26

55,65 - tender to percussion

Grade I mobility in relation to root pieces of

54,64.

No restorations present

No supernumerary/missing/unerupted teeth No developmental anomaly or hypoplastic

teeth present


16/26

Orthodontic evaluation :

Arch shape (maxillary and mandibular) :

U shaped

Molar and canine relationship : cannot be

determined


17/26

Diet analysis :

Consumes only milk with added sugar 5-6 timesdaily and soft sweet food items and beverages due

to inability to chew other food items.

Major concerns :

Lack of proteins and lipids

Lack of vitamins (vegetables and fruits)

Intake of cariogenic food at breakfast and evening

snacks times.


18/26

Provisional diagnosis :

Case of Severe Early Childhood Caries

Investigations : Periapical radiographs with 54-55,64-65


19/26

Final diagnosis :

Case of Severe Early Childhood Caries.


20/26

Treatment plan :

Preventive treatment :

Patient and parent education Diet counseling

Oral hygiene measures

Fluoride application

Corrective treatment :

Restorations Endodontic management

Surgical management

Orthodontic management


21/26

Preventive treatment :

Patient and parent education

Importance of preservation of primary teeth

Role of harmful dietary habits like bottle feedingin causation of caries

Importance of balanced diet in physical growth

and development

Importance of appropriate oral hygiene

measures


22/26

Diet guidance

Breakfast : pohe, upma, idli, dosa, rajgira-milk,nachani-milk etc.

Lunch : boiled vegetables (including green

leafy), soup, chapati, dal, rice, curd Evening snacks : fruits- banana, chiku,

mosambi etc; boiled sprouts, corn, salad

sandwich, groundnuts, dates etc. Dinner : boiled vegetables, soup, sprouts,

chapati, dal, rice, curd, khichadi etc.


23/26

Oral hygiene and plaque control methods

Twice daily supervised brushing with a soft

toothbrush and a fluoridated toothpaste withscrub technique including the lingual and occlusalsurfaces

Fluoride application

Professional use : Topical application of APF gelrepeated every 3 months

Home use : Fluoride dentrifice, mouthrinse

Pit and fissure sealant for 36, 46


24/26

Corrective treatment :

Oral prophylaxis

Pit and fissure sealant for 16, 26, 36, 46

Composite restorations for 52, 53, 62, 63, 72,73, 82, 83

Stainless steel crown for 74, 75, 84, 85

Pulpectomy 55, 65 Extraction 54, 64

Follow up every 3 months


25/26

Post operative


26/26

Case Presentation 11SshrutiHRUTI

Documents

Transcript of Case Presentation 11SshrutiHRUTI