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BDS2b: Caries Symposium Part 2 > Caries Managnent For Children And Young People - Strategies At Tooth Level > Flashcards

Caries Managnent For Children And Young People - Strategies At Tooth Level Flashcards

1
Q

List 5 management strategies for caries in primary teeth

A
  1. Complete caries removal + restoration
  2. Partial caries removal + restoration
  3. No caries removal + seal with restoration
  4. No caries removal + provide prevention alone or after making the lesion self cleansing
  5. Extraction or review with extraction if pain or sepsis develops
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2
Q

What management options are only appropriate if no alternative is feasible for occlusal caries/lesions?

A
  1. Seal caries with hall crown

2. Make lesion self cleansing and provide prevention

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3
Q

What are the preferred management strategies for occlusal caries/lesions?

A
  1. Complete caries removal and restoration
  2. Partial caries removal and restoration
  3. Seal caries with hall crown
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4
Q

What management strategies should only be used if there are no alternatives for early approximal caries/lesions?

A
  1. Provide prevention alone
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5
Q

What are the preferred methods used for early approximal caries/lesions?

A
  1. Complete removal and restoration
  2. Partial removal and restoration
  3. Seal caries with hall crown
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6
Q

What management strategies are only appropriate when there are no alternatives for advanced approximal lesions?

A
  1. Provide prevention alone

2. Make lesion self cleansing and provide prevention

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7
Q

What management strategies are preferred for advanced approximal caries/lesions?

A
  1. Complete caries removal and restoration
  2. Partial caries removal and restoration
  3. Seal caries with hall crown
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8
Q

What management options are preferred for anterior cavitated lesions?

A
  1. Complete caries removal and restoration
  2. Partial caries removal and restoration
  3. Provide prevention alone
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9
Q

What are the preferred management strategies for grossly carious, unrestorable teeth without signs and symptoms of pain or sepsis?

A
  1. Provide prevention alone

2. Extraction or review, with extraction if pain or sepsis develops

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10
Q

What two factors must be considered and balanced for management of caries in primary teeth?

A
  1. Reduction in risk of pain or sepsis from the tooth in future
  2. The child’s ability to accept treatment now
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11
Q

What types of procedures should be avoided in young and inexperienced patients?

A

Procedures involving LA (until the child can cope)

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12
Q

What material should not be used for permanent restorations in children?

A

Conventional glass ionomer

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13
Q

What are the management options for a primary tooth that is associated with sepsis?

A

Pulp therapy or extraction

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14
Q

What are the indicators of a tooth associated with sepsis?

A

Signs and symptoms of:

  1. Abscess
  2. Sinus
  3. Inter-radicular radiolucency
  4. Non-physiological mobility
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15
Q

What are indicators for the use of preformed crowns?

A
  1. > 2 surfaces affected
  2. Extensive 2 surface lesions
  3. Pulpotomy/pulpectomy
  4. Developmental defects
  5. # d primary molars
  6. Excessive tooth loss
  7. High caries
  8. Impaired OH
  9. Space maintainer
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16
Q

What are the advantages of partial caries removal and restoration?

A
  1. Evidence largely from secondary care and private practice that this approach can be effective
  2. Reduced risk of pulp exposure
  3. Reduced time for cavity prep, less need for LA
17
Q

What are the disadvantages of partial caries removal and restoration?

A
  1. As caries is left in the cavity, the marginal seal must be effective to prevent caries progression
  2. No evidence, as yet that this approach is effective in primary care
18
Q

Describe the technique used for interproximal discing of primary anterior teeth

A
  1. Sand paper discs, tapered stone or diamond in slow speed
  2. Tapered crown - narrower incisally
  3. Round off proximal surfaces
  4. Polish and fluoride varnish
19
Q

What are indications for the use of interproximal discing?

A
  1. Exfoliation time close, pre-cooperative patient, extensive superficial/minimal interproximal caries
20
Q

What are advantages of interproximal discing?

A
  1. Simple
  2. Fast
  3. Opens contacts
21
Q

What are disadvantages of interproximal discing?

A
  1. Potentially close proximity to pulp
  2. Food impaction
  3. Space loss
  4. Aesthetics poor
22
Q

What are indications for the use of strip crowns?

A
  1. Enamel hypoplasia
  2. Dental anomalies - ameloblast, dentino
  3. Labial and interproximal caries
23
Q

Describe the technique for the use of strip crowns

A
  1. LA and isolation
  2. Tapered prep - high speed diamond
  3. Create a labial groove for retention
  4. 2mm incisal reduction
  5. Place Cellulose acetate crown form and composite - using all available enamel for bonding
24
Q

What steps should be taken to identify and arrest mesial surface, enamel only caries on primary 1st molars?

A
  1. Apply fluoride varnish and monitor for progression using bitewing radiographs
  2. Ensuring parents/carers are aware of the potential impact on their child’s oral health
    - encourage flossing and use of floss wands on the 6/E contact 2-3 times per week
25
Q

Describe the proper management of suspicious fissures

A
  1. Thoroughly clean the fissures of all debris, dry the tooth and view it with bright, direct light
  2. Take good quality radiographs
  3. If there is:
    - micro cavitation
    - shadowing under enamel
    - dentinal caries
    • remove caries and place a conventional composite restoration limited to the site of the caries
    • fissure seal the remaining fissure system
26
Q

What are the advantages of using separators to examine interproximal surfaces of teeth?

A
  1. Caries can be detected via direct vision and micro cavities repaired without having to resort to cutting a conventional interproximal cavity
27
Q

What steps should be taken when managing a developing enamel lesion on a FPM which is adjacent to a carious SPM?

A
  1. Provide a preformed crown on the primary molar

Or

  1. Make the area self cleansing whilst taking care not to cause iatrogenic damage
28
Q

At what age should planned loss of poor prognosis FPM be considered?

A

8-9 years

29
Q

When is planned loss most ideal radiographically?

Why is this?

A
  1. When there is the start of calcification of the bifurcation of the unerupted lower second molars
    - ideally all premolars and 3rd molars should be present
  2. This prevents over eruption of the opposing tooth
30
Q

What are the advantages of planned loss/removal or poor prognosis FPMs?

A
  1. If extracted at the correct time, this action can allow the development of a caries free dentition in the adolescent, without spacing
31
Q

What are the disadvantages of planned loss for poor prognosis FPMs?

A
  1. Requires extraction of permanent molar teeth from young children
    - =demanding
    - may require the use of GA with associated risks

BDS2b: Caries Symposium Part 2 (3 decks)

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