Leave + monitor, restore and extract primary teeth

Question 1

When to leave and monitor primary teeth?

Answer 1

• Caries can be left to remineralise/arrest in certain circumstances such as early enamel caries where there is no evidence of cavitation into dentine and pt is a regular attender
• Primary tooth with caries into dentine which is close to exfoliation ensuring that the tooth is asymptomatic and free of any clinical or radiographic evidence of pathology
• Pt not at risk of infection such as infective endocarditis or immunocompromised

Question 2

When to extract primary teeth?

Answer 2

• Pain history: if pt has history of swelling due to a dental abscess, you will be thinking of extracting the carious primary tooth to prevent damage to the permanent successor (Turner’s tooth)
• DH: if primary tooth is asymptomatic and child won’t sit for treatment, extracted under GA
• MH: if child is at risk of infection such as infective endocarditis or if they are immunocompromised, can’t do pulp therapy
• SH: If child can’t attend multiple visits, consider extraction under GA

Question 3

When to restore primary teeth?

Answer 3

• If child has a bleeding disorder, restore primary carious tooth rather than extracting it