Caries management for children and young people at the tooth level Flashcards
What are the management strategies for primary teeth
- Complete caries removal, and restoration
- Partial caries removal, and restoration
- No caries removal, seal with restoration
- No caries removal, provide prevention alone or after first making the lesion self-cleansing
Extraction or review with extraction if pain/sepsis develops
If the tooth is not restorable and there is signs and symptoms of abscess formation what should be done
extraction
If the tooth is not restorable and there is no signs and symptoms of abscess formation what should be done
provide enhanced prevention and monitor the tooth
If the tooth is restorable and there is no signs and symptoms of sepsis and the caries is not active what should be done
provide enhanced prevention and monitor the tooth
If the tooth is restorable and there is no signs and symptoms of sepsis and the caries is active what should be done
select most appropriate caries management option
If the tooth is restorable and there is signs and symptoms of sepsis and the tooth is near exfoliation what should be done
extraction
If the tooth is restorable and there is signs and symptoms of sepsis and the tooth is not near exfoliation what should be done
carry out pulp treatment
What is the management strategy for caries in occlusal, non cavitated lesions in primary teeth
- Complete caries removal and restoration
- Partial caries removal and restoration
- Seal caries with fissure sealant (no caries removal)
- Provide prevention alone (no caries removal) - only appropriate if no alternative is feasible
What is the management strategy for caries in occlusal, cavitated lesions in primary teeth
- Complete caries removal and restoration
- Partial caries removal and restoration
- Seal caries with Hall Crown (no caries removal)
What is the management strategy for caries in approximal early dentinal lesions in primary teeth
- Complete caries removal and restoration
- Partial caries removal and restoration
- Seal caries with hall crown (no caries removal)
What is the management strategy for caries in approximal advanced lesions in primary teeth
- Complete caries removal and restoration
- Partial caries removal and restoration
- Seal caries with hall crown (no caries removal)
What is the management strategy for caries in anterior cavitated lesions
- Complete caries removal and restoration
- Partial caries removal and restoration
- Provide prevention alone (no caries removal)
What is the management strategy for caries in grossly carious unrestorable tooth without signs or symptoms of pain or sepsis
- Provide prevention alone (no caries removal)
- Extraction or review, with extraction if pain or sepsis develops
Describe the management of caries in primary teeth
- Choose management options for primary teeth that balance a reduction in the risk of pain or sepsis from the tooth in the future with the child’s ability to accept treatment now
- Avoid operative interventions which involve local anaesthetic until the child can cope
- Do not use conventional glass ionomer for permanent restorations (RMGI is fine)
closely monitor lesions with prevention only
DO NOT leave active caries in primary teeth unmanaged (even if it is just enhanced prevention)
How should caries in a primary tooth be managed if associated with sepsis
either a pulp therapy or an extraction; do not leave sepsis untreated
What is the procedure for complete caries removal and restoration
- Give LA
- Gain access via highspeed, leave wall of enamel to protect adjacent teeth
- Remove caries with slow speed/excavator (beware of proximity of pulp)
- Prepare approximal cavity margins with gingival margin trimmers (to avoid iatrogenic damage)
Place restoration
What is the mercury regulations
- Minimata Treaty - global treaty to reduce release of mercury into environment
Phase-down in use of amalgam is advocated
Who is amalgam contraindicated for
○ Primary teeth
○ Persons U15
○ Pregnant/breastfeeding woman
- There is an exception if specific medical needs of patient requires amalgam
What are restorative options for primary molars
- Composite
- Compomer
- Stainless steel crown
- GI cement (temp restorations only)
RMGI