Penatalaksanaan Karies Rampan dengan Evaluasi Menggunakan Kariogram: Laporan Kasus pada Anak dengan Self-Mutilation
DOI:
https://doi.org/10.35790/eg.9.1.2021.32606Abstract
Abstract: To date, rampant caries has still a high prevalence. Evaluation of caries can be carried out comprehensively in patients with rampant caries by using a cariogram which can describe the causes and risks of caries. We reported a case of a girl aged 4 years, complaining of swelling of the back part of her lower gum. The patient was diagnosed as self-mutilation by a pediatrician. There were some scars in her left forefinger and wrist. Moreover, her teeth 51, 61, 72, 71, and 81 were loose. Clinical examination revealed poor oral hygiene, abscesses in the teeth 74 and 75, and many dental caries as well as tooth radixes. The patients had bottle feeding until the age of 3 years. Cariogram was performed at the first visit, followed by dental health education (DHE) and topical application of fluoride. Cariogram evaluation was carried out at the first visit, the 3rd month, and the 6th month, resulting in 15%, 19%, and 35% in prediction of preventing new caries, respectively. The patient was treated with cariogram follow-up, total care with block system, DHE, and topical application of fluoride. In this case, there was an increased prediction of caries prevention, and a decreased caries risk factors including diet and bacteria.
Keywords: rampant caries, cariogram, caries management
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Abstrak: Sampai saat ini karies rampan masih memiliki prevalensi yang tinggi. Penilaian karies dilakukan secara komprehensif pada pasien dengan karies rampan dengan menggunakan kariogram yang dapat menggambarkan penyebab dan urutan risiko karies. Kami melaporkan kasus seorang anak perempuan berusia 4 tahun dengan keluhan gusi belakang kiri bawah bengkak. Pasien didiagnosis oleh dokter spesialis anak menderita self mutilation. Terdapat bekas luka pada jari telunjuk kiri, pergelangan tangan, dan gigi 51, 61, 72, 71, 81 sudah tanggal. Pemeriksaan klinis menunjukkan oral hygene buruk dengan abses pada gigi 74 dan 75, banyak terdapat karies dan radiks. Pasien memiliki kebiasaan minum susu botol dengan dot sampai usia 3 tahun. Kariogram dilakukan pada kunjungan awal, diikuti edukasi kesehatan gigi dan mulut (DHE) dan pemberian topikal aplikasi fluor (TAF). Evaluasi dengan menggunakan kariogram dilakukan pada awal kunjungan, bulan ketiga dan bulan keenam dengan hasil kemungkinan menghindari karies baru sebesar 15%, 19% dan 35% secara berturut. Penatalaksanaan kasus ini ialah dengan follow-up  kariogram, total care dengan sistem blok, DHE, dan TAF. Pada kasus ini terjadi peningkatan kemungkinan menghindari karies baru yang cukup tinggi dan terjadi penurunan besarnya faktor risiko karies pada faktor pola diet dan bakteri.
Kata kunci: karies rampan, kariogram, penatalakasanaan
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