Primary, secondary and tertiary treatment of dental caries: a 20-year case report.

BACKGROUND: This case report follows the 20-year clinical treatment of a patient at high risk of developing dental caries. The author describes the treatment of the primary and permanent dentitions. CASE DESCRIPTION: The author describes the use of primary, secondary and tertiary measures to treat caries in a high-risk patient. He emphasizes the need for long-term care to monitor disease activity and describes the use of in-office tests for estimating Streptococcus mutans levels. This case illustrates the episodic nature of the caries process in which caries activity is related to risk factors, and the treatment regimen varies from tooth to tooth. CONCLUSION AND CLINICAL IMPLICATIONS: This case report documents the use of the medical paradigm in the treatment of dental caries, as well as the surgical paradigm as an important component of treatment.