Treatment
Stage 1: Non-Cavitated Lesions
Remineralization and preventive therapy
- • High-fluoride varnish application (22,600 ppm)
- • Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) products
- • Dietary counseling and oral hygiene instruction
- • Silver diamine fluoride (SDF) 38% for high-risk patients
- • 3-month recall monitoring
Stage 2–3: Cavitated Lesions
Restorative treatment
- • Caries removal — selective (partial) or complete removal
- • Adhesive bonding system application
- • Composite resin restoration for anterior/small posterior cavities
- • Amalgam or posterior composite for large posterior cavities
- • Glass ionomer cement as an interim or base material
Stage 4: Pulp Involvement
Endodontic treatment or extraction
- • Pulp capping (direct or indirect) for early pulp exposure
- • Root canal treatment (pulpectomy, canal shaping, obturation)
- • Crown restoration following endodontic treatment
- • Extraction when tooth is unrestorable