Abstract
Xerostomia leads to great challenges for patients and dentists in managing and maintaining oral health due to the high risk of developing dental caries. We discuss a case of a 10-year-old male patient who presented with complaints of decayed teeth and difficulty chewing and swallowing food. He had bilateral congenital stenosis and stricture of lacrimal ducts and a family history of lacrimal gland agenesis and Hashimoto's disease. The diagnosis reached was agenesis of all major salivary glands confirmed by saliva testing and ultrasound examination of the glands. Comprehensive preventative, restorative, and maintenance protocols based on caries management by risk assessment (CAMBRA) were implemented, including fissure sealants, amalgam and composite resin restorations, professional and home-applied fluoride, chlorhexidine mouthwash, frequent water consumption, and two-monthly recalls. We were able to stabilize the patient's risk of dental caries for over three years. The implementation of stringent restorative, preventive, and maintenance protocols is key to improving and maintaining oral health in severe cases of xerostomia.