Caries Management Of A High-Risk Patient: A Case Report

This case demonstrates comprehensive caries management of a 30-year-old female with generalized active caries. Multiple teeth with carious lesions at various stages, highlighting the limitations of the traditional "restorative-dominant" approach. This case underscores the importance of caries management by personalized prevention and treatment. The patient reported tooth discoloration for two years. Clinical and radiographic examination revealed reversible pulpitis in tooth 17, and there were 23 teeth of all with active caries. The International Caries Classification and Management System (ICCMS) assessment classified the patient as high caries risk. Caries risk management included home care (fluoride toothpaste, sugar substitutes, dental floss) and in-office interventions (dietary counseling, oral hygiene instructions, periodontal therapy, and fluoride application). A personalized caries management plan was developed: vital pulp therapy for tooth 17, resin restorations for teeth 16-47, resin infiltration for teeth 33-43, and stepwise excavation followed by GIC for teeth 13-23, with definitive aesthetic composite restorations after caries risk control. Follow-up at 6 and 12 months showed FDI restoration scores of 1–2, with the patient maintaining a moderate caries risk. Caries management provides precise clinical decision-making guidance. Stepwise excavation combined with aesthetic composite restorations effectively preserves vital pulp. Patient compliance remains pivotal for successful outcomes. This case represents a standardized caries management workflow, demonstrating how integrating behavioral interventions with minimally invasive restorative techniques can significantly improve clinical outcomes, serving as a valuable reference for clinical practice.