23 High caries risk adolescents
Peter is 13 years old. He is concerned about the appearance of his teeth, especially the spaces between his front teeth and would like this improved (Fig. 23.1). He is not very keen on the prospect of complex restorative or orthodontic treatment. On presentation he is diagnosed as high caries risk. How would you plan treatment for this patient focusing initially on preventive care?
Peter’s oral hygiene is not ideal. Normal saliva levels are noted. He is in the permanent dentition with missing lower central incisors and a retained lower left primary central incisor. His upper right first permanent molar has been extracted and the upper and lower first permanent molars and lower right first and second molars restored. No fissure sealants are present. There is evidence of mild buccal crowding in the lower arch with lower left second permanent premolar lingually placed. The lower left primary central incisor is retained and both lower permanent central incisors missing (see Figs 23.2 and 23.3).