This communication can be improved by calling the child by their name, using eye contact and including them in any conversation about their treatment.Vaccines are also under development. Treatment
Most importantly, whether the carious lesion is cavitated or non-cavitated dictates the management. Clinical assessment of whether the lesion is active or arrested is also important. Noncavitated lesions can be arrested and remineralization can occur under the right conditions. However, this may require extensive changes to the diet (reduction in frequency of refined sugars), improved oral hygiene (toothbrushing twice per day with fluoride toothpaste and daily flossing), and regular application of topical fluoride. More recently,  Immunoglobulin Y specific to Streptococcus mutans has been used to suppress growth of S mutans. Such management of a carious lesion is termed "non-operative" since no drilling is carried out on the tooth. Non-operative treatment requires excellent understanding and motivation from the individual, otherwise the decay will continue. Once a lesion has cavitated, especially if dentin is involved, remineralization is much more difficult and a dental restoration is usually indicated ("operative treatment"). Before a restoration can be placed, all of the decay must be removed otherwise it will continue to progress underneath the filling. Sometimes a small amount of decay can be left if it is entombed and there is a seal which isolates the bacteria from their substrate. This can be likened to placing a glass container over a candle, which burns itself out once the oxygen is used up.
Café au lait spots, or café au lait macules, are flat, hyperpigmented birthmarks. The name café au lait is French for "coffee with milk" and refers to their light-brown color. Café au lait lesions with rough borders ("coast of Maine") may be seen in McCune-Albright syndrome. In contrast, Café au lait lesions of neurofibromatosis have smooth borders ("coast of California").They are caused by a collection of pigment-producing melanocytes in the epidermis of the skin.These spots are typically permanent and may grow or increase in number over time.Café au lait spots are often harmless but may be associated with syndromes such as neurofibromatosis type 1 and McCune–Albright syndrome. Cause
Café au lait spots can arise from diverse and unrelated causes:
Ataxia–telangiectasia
Basal cell nevus syndrome
Benign congenital skin lesion
Bloom syndrome
Chédiak–Higashi syndrome
Congenital melanocytic naevus
Fanconi anemia
Gaucher disease
Hunter syndrome
Jaffe–Campanacci syndrome
Legius syndrome
Maffucci syndrome
They can be caused by vitiligo in the rare McCune–Albright syndrome. Multiple mucosal neuroma syndrome
Having six or more café au lait spots greater than 5 mm in diameter before puberty, or greater than 15 mm in diameter after puberty, is a diagnostic feature of neurofibromatosis type I (NF-1), but other features are required to diagnose NF-1. Familial multiple cafe-au-lait spots have been observed without an NF-1 diagnosis. Noonan syndrome
Silver–Russell syndrome
Tuberous sclerosis
Watson syndrome
Wiskott–Aldrich syndrome

Diagnosis
Diagnosis is visual with measurement of spot size. The number of spots can have clinical significance for diagnosis of associated disorders such as Neurofibromatosis type I.