Rampant Caries is also known as Baby Bottle Caries.
The commonest cause of almost all the teeth of a young Toddler getting infected is the prolonged use of the feeding bottle.
The bottle is used as a pacifier rather than a feeder.
The milk remains in the mouth for long periods of time and as it ferments in the mouth, the teeth also get infected.
Unfortunately, most of children are not treated timely. They usually need to be given a General Anesthetic in a hospital setting and then treated.
Treating this kind of infection is extremely vital. The milk teeth act as space maintainers for the permanent teeth that have yet to erupt. Delay in treatment causes infections requiring repeated administration of Antibiotics.
This is a situation that can be avoided by timely treratment of the child.
It includes the most probable cause which is the frequent intake of sugar, then the oral hygiene methods that have been adapted by the patient. But we must be able to visualize adequately a child’s teeth and mouth and have access to a reliable historian for non-clinical data elements.
How rampant caries can be prevented?
Prevention programme starts with assessing all 3 components of caries risk–clinical conditions, environmental characteristics, and general health conditions; a complete analysing of the diet regime; then build a new diet system prevents less frequent take of carbohydrates and in severe cases could include changing sugar to carbohydrate free substitute. Endorsing a good oral hygiene plan that suits the patient and the advice for a regular topical fluoride application is as important as the diet. Systemic fluoride may be applicable depends on the case and the water fluoridation program in the area.
How rampant caries can be treated?
It includes that there is no specific treatment for this disorder. One must identify the cause for it and must act against it.
The management includes,
• Gathering general information including but not limited to name, age, sex, previous major operations, any medication is taken at the time she is presented…etc. mostly this is prepared and universal for all patients.
• Building the medical and the dental history to reach a proper diagnosis and find the aetiology of the chief complaint so I can start assessing the case by evaluating the available information; the overall case assessment is an essential step that allows the considerations of treatment options and a provisional treatment plan to be formulated.
• Clinical examination in both directions Extra and intra. Extra examination includes the general morphology, skeletal base, skin colour and lesions, eyes, lymph nodes, lip, breathing, TMJ and masticatory muscles. Intra orally starts with soft tissues and oral mucosa and muscles followed by the dental examination by examining the teeth and focusing on the tissues, bone and teeth next to tenderness; look for any attrition, abrasion, erosion, hypo minerlization or any abnormality in the gingiva or hard tissues “Faceting, fracture or caries of the enamel” then examine the periodontal tissues and record any tooth mobility or badly restored teeth.
• Check the occlusal view if possible and the result of the blow on the occlusal harmony and the other tissues.
• Assess the case and treat according to the diagnosis outcome; bearing in mind that the target is to treat the acute problems or manage any source of pain then reserve as much as possible of the child teeth tissues.
The patient with rampant caries who
is likely to be seen in dental practice
may present with the following signs
and symptoms:
The patient may present with a
history of frequent replacement
and/or new fillings or a recent
change in social or medical history
or medication use;
Multiple lesions at different stages
of progression, from early enamel
decalcification to larger lesions and
frank cavitation;
the dentinal base of cavities is
usually soft and a yellowish brown
colour. These characteristics
differentiate rampant caries from
arrested or slowly progressing caries
where the dentinal base is firmer
and usually dark in colour;
Lesions can develop anywhere often
including surfaces that are usually
at low risk of caries;
Dentinal sensitivity from untreated
carious lesions.
The patient’s history may not suggest
high caries risk, depending on the
specific aetiology of the problem.
However, in most cases, if the
clinician is able to overcome the
patient’s guilt barrier and discuss
sensitive/embarrasing dietary, social
or family issues, the histories will
confirm high caries risk status
.
