At two and a half, decay in many of the milk teeth.
What we did
Calming medicine by mouth kept the child relaxed. We stopped the decay, placed fillings without a drill, and fitted tooth-coloured caps.
After
The family moved to Sharjah. Three years later the child walked back in, with no fear and no tears.
Doctor, we never had any problem. Everything just worked perfectly.
The parents, three years after treatmentThe doctor’s notes
Age
2½ at treatment, 5½ at the return visit
Came from
Treated in Greater Noida. The family then moved to Sharjah, UAE, 2,214 km away in a straight line
Treatment
A liquid that stops decay spreading (silver diamine fluoride, SDF), fillings placed without a drill (the SMART technique) and tooth-coloured caps (zirconia crowns), with calming medicine given by mouth (oral sedation)
In Austin, the family was told their child needed 8 to 12 caps, with the child asleep. They wanted to know whether a smaller plan was possible.
What we did
Online calls first, then a full check-up in person. The plan kept as much natural tooth as possible: a liquid that stops decay spreading, fillings without a drill, and fillings only where needed.
After
The family went home with a daily routine, including flossing, and follow-ups with the clinic wherever they live.
Caps with the child asleep are the right plan for many children, and the clinic offers it. For this child, a smaller plan was possible.
The doctor’s notes
Came from
Austin, Texas, USA, 13,464 km away in a straight line. The family had moved there from Noida
Before the visit
Online consultations. The family heard about the clinic through word of mouth
Treatment
A liquid that stops decay spreading (silver diamine fluoride, SDF), fillings placed without a drill (the SMART technique), fillings only on the teeth that needed them, and a daily prevention routine including flossing
What we did not do
Caps (crowns) on 8 to 12 teeth under general anaesthesia
Special needs: all dental treatment done asleep, in under 90 minutes.
Before
Slow development, seizures, a heart condition, and decay across the mouth. The parents had already seen more than one dentist.
What we did
All the treatment in one session, with the child asleep (general anaesthesia) and an anaesthesia team. Teeth that could be saved were saved with silver caps. The rest were removed.
After
Done in under 90 minutes. At the follow-up, the child was eating well again.
She has started eating well again, and is even asking for food.
The parent, at follow-upThe doctor’s notes
Age
4½
Came in with
Slower development than expected for their age (global developmental delay), a history of seizures, and decay across the mouth
Treatment
All treatment in one session under general anaesthesia, with an anaesthesia team. Teeth that could not be saved were removed. The rest were repaired with silver caps (stainless steel crowns) and treatment that removes as little tooth as possible
Healthy teeth, but the check-up found mouth breathing.
Before
A routine check-up. No pain, no cavities.
What we did
A closer look found signs that do not hurt and are easy to miss: breathing through the mouth, a mouth that rests open, and teeth starting to crowd.
After
The check-up became a two-hour talk with the family about breathing and daily habits, because left alone these can affect how the jaws grow and how a child sleeps.
The doctor’s notes
Came in with
A routine check-up, with no pain and no cavities
Found
Mouth breathing, a mouth that rests open, and early crowding
Five years of care: from tooth decay to mouth breathing.
Before
A young child at high risk of tooth decay.
What we did
We stopped the decay in small steps, with a liquid that stops decay spreading, and followed the child closely for years.
After
Five years in, the teeth have stayed healthy. Now the care moves to mouth breathing and crooked teeth coming in, starting with exercises for the tongue and lips.
The doctor’s notes
Care so far
About 60 months, with a few unavoidable gaps
Treatment
Four years of decay care built around a liquid that stops decay spreading (silver diamine fluoride, SDF), removing as little tooth as possible. Now exercises for the tongue, lips and breathing (myofunctional therapy), with clear aligners when the time is right
Case report
The first four years were written up as a case report, a joint winner of the Caries Management Case Report award at the 30th IAPD Congress, Cape Town, 2025