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Multiple post-orthodontic interproximal initial carious lesions

  • 1
  • Dr. Alisha Gray
  • USA
  • Product: Curodont Repair Fluoride Plus
Before
  • Figure 1: Interproximal carious lesions in enamel of multiple teeth, diagnosed on February 2023; lesions put on watch. CRFP applied after 6 months on September 2023.
After
  • Figure 2: 6 months post-treatment with CRFP (February 2024), the bitewing x-ray revealed reduction in the sizes of the lesions, indicative of remineralization.

Patient Presentation and examination: 

  • Personal information: 14-year-old male
  • Dental history: Recently completed fixed orthodontic treatment, during which the patient used a prescription-strength toothpaste. 
  • Routine radiographic examination: On a bite-wing radiograph, multiple radiolucencies in the enamel of #18 (mesial), #19 (distal), #20 (mesial), and #21 (distal) were observed (Figure 1)

Diagnosis: 

  • #18: Initial caries extending to the inner half of enamel (E2) on the mesial surface
  • #19: Initial caries extending to the inner half of enamel (E2) on the distal surface
  • #20: Initial caries extending to the outer half of enamel (E1) on the mesial surface
  • #21: Initial caries extending to the outer half of enamel (E1) on the distal surface

Treatment: 

  • After diagnosis, the patient was put on a ‘watch’ for 6 months. 
  • At the 6-month recall, the lesions were treated with Curodont Repair Fluoride Plus, followed by 5% fluoride varnish. 
  • Advised to continue using a prescription-strength toothpaste (prescribed during the orthodontic treatment)

Follow-up: At the 6-month post-treatment follow-up, the following observations were made: (Figure 2)

  • #18, #19: Reduction in lesion sizes to E1, indicative of remineralization
  • #20, #21: Reduction in lesion sizes to E0, indicative of complete remineralization.

Take-away: Fixed orthodontic treatment has been documented to be associated with the development of initial caries lesions.* Curodont Repair Fluoride Plus can be used as a proactive treatment of initial caries rather than risking progression by ‘waiting-and-watching.’

*Richter AE et al. Am J Orthod Dentofacial Orthop. 2011;139:657-64

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