3 paediatric caries management Flashcards
what are the management strategies for occlusal non-cavitated lesions?
complete caries removal and rest.
partial caries removal and rest. seal caries with fissure sealant
prevention alone only if no alternative
what are the management strategies for occlusal, cavitated lesions?
complete caries removal and rest
partial removal and rest
seal caries with hall crown
prevention alone/make lesion self-cleansing and prevention only if no alternative
what are the management strategies for approximal, early dentinal lesions?
caries removal can rest
partial removal and rest
hall crown
prevention if no alternative
what are the management strategies for approximal, advanced lesions?
complete removal and rest
partial removal and rest
hall crown
prevention/self cleansing if no alternative
what are the management strategies for anterior cavitated lesions?
complete removal and rest
partial removal and rest
prevention
what are the management strategies for grossly carious unrestorable teeth without signs or symptoms of pain/sepsis
prevention
extraction
which restorable material shouldnt be used in primary teeth (permanent resotration)
conventional glass ionomer
how should you treat a primary tooth with sepsis?
pulp therapy or extraction
describe a primary tooth associated with sepsis?
signs or symptoms of abscess, sinus, inter-radicular radiolucency, non-physiological mobility
when is amalgam not used?
primary teeth
person under 15 yo
pregnant/breastfeeding
what are the restorative options for primary molars?
composite compomer ss crowns gic temporary rmgi
describe the setting of compomer
light cured
must have good isolation
what are the indications for traditional preformed crowns?
> 2 surfaces affected extensive lesions pulpotomy/pulpectomy developmental defects fractured primary molars excess tooth surface loss high caries impaired oral hygiene space maintainer
what are the advantages of partial caries removal?
reduce risk of pulp exposure
reduced time for cavity prep, less need for LA
what are the disadvantages of partial caries removal?
marginal seal must be effective to prevent caries progression
no evidence from primary care
what are the indications for interproximal discing of primary anteriors?
exfoliation time close
pre-cooperative
extensive superficial/minimal interproximal
what are the advantages of interproximal discing of primary anteriors?
simple
quick
opens contacts
what are the disadvantages of interproximal discing of primary anteriors?
pulp
food impaction
space loss
aesthetics poor
what is the technique for interproximal discing of primary anteriors?
sand paper discs, tapered stone or diamond in slow speed
tapered crown- narrower incisally
round off proximal surfaces
polish & fluoride varnish
what are the indications for strip crowns in primary anteriors?
enamel hypoplasia
dental anomalies
labial and interproximal caries
what is the technique for strip crowns on primary anteriors?
LA & dam tapered prep- high speed diamond labial groove 2mm incisal reduction cellulose acetate crown form and composite
how to arrest early enamel only lesions on mesial of 6’s?
fluoride varnish and monitoring with bitewings
ensure parents aware of potential impact
use floss on 6/E contact 2-3 times a week
if distal of E is carious consider rest ot hall crown or slice prep or extraction
how to manage a suspicious fissure
clean, dry, view in bright direct light
radiographs
if micro-cavitation/shadowing under enamel/dentinal caries remove caries and place composite restoration then fissure seal remaining
if stained but no caries just fissure sealant
what should you do where an enamel lesion is developing on a FPM next to a carious 2nd
provide a preformed crown on the primary molar/make area self cleansing
what should you do at age 8-9 for RMP’s of poor prognosis?
make an assessment on likely prognosis, if poor consider planned loss
radiographically ideal when start of calcification on bifurcation of unerupter lower 2nd molars
