OPERATIVE DENTISTRY IN KIDS

Question 1

Why do we restore primary teeth?

Answer 1

• Control active disease (Caries)
• Preserve pulp vitality of pri teeth, prevent potential pain/ damage to permanent successor (Turners tooth)
• Avoid negative psychosocial effects on child
• Restore function, mastication & speech
• Restore occlusion and maintain arch length (prevent space loss for permanent teeth)
• Maintain aesthetics esp for anterior
• Avoid extractions in kids (painful, unpleasant, potential space loss

Question 2

How does deciduous teeth compare to permanent teeth?

Answer 2

• Fewer (20 vs 32)
• Smaller in size: specifically the ratio (cervical-Invisal:MD)
• Morphological difference in crown, pulp, roots
• Color: baby teeth appear whiter

Question 3

How to identify pri teeth?

Answer 3

• Presence of wear facets (esp canines near exfoliation)
• Whiter in color; rarely have fluorosis
• Baby incisors no mamelons
• Narrower MD than their successors, except primary molar > perm PM successors

Question 4

Considerations when deciding whether to restore primary teeth?
Think: Tooth Factors, Host factors

Answer 4

Tooth factors:
- Restorability: but also need see roots
- Extent of pulp pathology
- Arrested lesion then dn
- Extent of root resorption
- Extent of pathological root resorption: if severe, unable to do RCT
- Space loss

Host factors:
- Ability to cooperate for tx
- Systemic medical conditions
- Caries risk & OH: high CR & poor OH restore!
- Development status of dentition
- Parental compliance to bring back for recall