Dentist must strongly emphasize on oral hygiene, educating the patients about measures
to minimize the effects of dry mouth and establishing a tight recall system.
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"Debug the mouth with chlorhexidine mouthwashes for two weeks followed by daily
long term topical fluoridation."This is the rule of thumb in home care preventive
approach.
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Immediately after caries control, when all carious lesions are removed and teeth
filled by temporary or permanent restorations, the above mentioned preventive approach
should be followed.
- Teeth that cannot be restrained or restored should be extracted.
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A programme of caries prevention should be added to the Oral Hygiene Protocol.
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Reduction of Oral Microbiota is achieved by two weeks of night mouthwashes with
solution of Chlorhexidine1.2% followed by application of fluoride gel with toothbrush
on the teeth, just before bedtime.
- The excess is expectorated without washing the mouth, drinking or eating thereafter.
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Instruct the patient to leave some of the gels in contact with the teeth overnight.
The flouride gel should be used every night thereafter.
- Initially 3 month recalls are recommended.
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After 3 visits when the oral cavity is stable with good oral hygiene the period
between visits can be extended to 6 months.
- Bitewing X-rays would be necessary if any new or recurrent caries occur.
