Abstract
A 5year old female patient and her 1year old brother first came to our clinic, both with many caries lesions; they underwent necessary restorative treatments and then continued to make periodical visit to the clinic for maintenance care. This paper is to report the case of these two patients where the caries management failed and many new caries lesions developed during the maintenance period. Risk assessment revealed obvious caries risks: poor plaque control in spite of the toothbrushing instruction, poor sugar control and snacks before bed time were quite frequent due to their late bedtime. As a result the caries activity was high, and it was hard to predict and prevent further development of initial caries lesions. Looking back at this case, I overestimated the effect of maintenance care at the clinic and underestimated the importance of home care such as dietary control and plaque control. Through this case I recognized the need to reform our practice as to better communicate with patients about the home care and be better tuned to ever changing caries risk of patients so that prompt address to increased risks would be possible.
