3 paediatric caries management

Question 1

what are the management strategies for occlusal non-cavitated lesions?

Answer 1

complete caries removal and rest.
partial caries removal and rest. seal caries with fissure sealant
prevention alone only if no alternative

Question 2

what are the management strategies for occlusal, cavitated lesions?

Answer 2

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

Question 3

what are the management strategies for approximal, early dentinal lesions?

Answer 3

caries removal can rest
partial removal and rest
hall crown
prevention if no alternative

Question 4

what are the management strategies for approximal, advanced lesions?

Answer 4

complete removal and rest
partial removal and rest
hall crown
prevention/self cleansing if no alternative

Question 5

what are the management strategies for anterior cavitated lesions?

Answer 5

complete removal and rest
partial removal and rest
prevention

Question 6

what are the management strategies for grossly carious unrestorable teeth without signs or symptoms of pain/sepsis

Answer 6

prevention

extraction

Question 7

which restorable material shouldnt be used in primary teeth (permanent resotration)

Answer 7

conventional glass ionomer

Question 8

how should you treat a primary tooth with sepsis?

Answer 8

pulp therapy or extraction

Question 9

describe a primary tooth associated with sepsis?

Answer 9

signs or symptoms of abscess, sinus, inter-radicular radiolucency, non-physiological mobility

Question 10

when is amalgam not used?

Answer 10

primary teeth
person under 15 yo
pregnant/breastfeeding

Question 11

what are the restorative options for primary molars?

Answer 11

composite
compomer
ss crowns
gic temporary
rmgi

Question 12

describe the setting of compomer

Answer 12

light cured

must have good isolation

Question 13

what are the indications for traditional preformed crowns?

Answer 13

> 2 surfaces affected
extensive lesions
pulpotomy/pulpectomy
developmental defects
fractured primary molars
excess tooth surface loss
high caries
impaired oral hygiene
space maintainer

Question 14

what are the advantages of partial caries removal?

Answer 14

reduce risk of pulp exposure

reduced time for cavity prep, less need for LA

Question 15

what are the disadvantages of partial caries removal?

Answer 15

marginal seal must be effective to prevent caries progression
no evidence from primary care

Question 16

what are the indications for interproximal discing of primary anteriors?

Answer 16

exfoliation time close
pre-cooperative
extensive superficial/minimal interproximal

Question 17

what are the advantages of interproximal discing of primary anteriors?

Answer 17

simple
quick
opens contacts

Question 18

what are the disadvantages of interproximal discing of primary anteriors?

Answer 18

pulp
food impaction
space loss
aesthetics poor

Question 19

what is the technique for interproximal discing of primary anteriors?

Answer 19

sand paper discs, tapered stone or diamond in slow speed
tapered crown- narrower incisally
round off proximal surfaces
polish & fluoride varnish

Question 20

what are the indications for strip crowns in primary anteriors?

Answer 20

enamel hypoplasia
dental anomalies
labial and interproximal caries

Question 21

what is the technique for strip crowns on primary anteriors?

Answer 21

LA & dam
tapered prep- high speed diamond
labial groove
2mm incisal reduction
cellulose acetate crown form and composite

Question 22

how to arrest early enamel only lesions on mesial of 6’s?

Answer 22

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

Question 23

how to manage a suspicious fissure

Answer 23

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

Question 24

what should you do where an enamel lesion is developing on a FPM next to a carious 2nd

Answer 24

provide a preformed crown on the primary molar/make area self cleansing

Question 25

what should you do at age 8-9 for RMP’s of poor prognosis?

Answer 25

make an assessment on likely prognosis, if poor consider planned loss
radiographically ideal when start of calcification on bifurcation of unerupter lower 2nd molars