Restorative Management Of Deciduous Flashcards
What is turners tooth?
Defect to permanent tooth caused by sepsis to deciduous - abnormal shape or colour
What is important to consider when preparing a deciduous tooth?
Access may be difficult- pt unable or unwilling to open mouth for long periods of time and very wide
Enamel is thinner- spreads to dentine quicker
Pulp is relatively larger in relation to the size of the tooth
Pulp horns are nearer the surface
Contact points are flatter and wider
How does anatomy and morphology of deciduous teeth lead to more rapid progression of caries
Enamel is thinner and therefore reaches dentine quicker
By the time evidence can be seen clinically- may already have reached dentine
Where are pulp horns positioned in deciduous molars
3 canals in upper and lower
Upper- mb mp d
Lower mb ml d
Pulp horns are high in the crown particularly mesially
Describe the order of tx for paediatric patients
Relieve pain
Prevention at home- OHI , DIET DIARIES
Proffesional prevention- application of fluoride varnish, fissure sealants
Stabilisation of caries- important re. Rapid progression
Restorations- start with smallest. Preferably uppers
Pulp therapy
XLA
behaviour management - oh, diet, habits
Reinforce prevention- plaque scores encouragement
What can cause pain in paeds patients?
Abscess Caries Trauma Tooth wear Infection Soft tissue lesions Exfoliation/ eruption
What accounts for reversible pulpitis?
Precipitated by sweet/ hot/ cold Pain stops when stimuli is removed Short duration Mainly occurs when eating Early various lesion on examination Caries into dentine radiographically
What accounts for irreversible pulpitis?
Constant pain Relieved only by anaesthetic Lymphadenopathy Raised temperature Sinus Intraoral swelling Caries close to pulp radiographically Peri apical radiolucency
When is restoration of a tooth the best option
When enough tooth tissue remains for definitive restoration
When majority of other carious teeth have been restorable
When good compliance
Patient is keen to save tooth and willing to maintain good oh
Space maintenance
If hypodontia
Attendance good and parent keen to help improve oh
When should XLA be the best tx option
Balancing extractions
No compliance for restoration
No parental support to improve oh or diet
No attendance beyond pain relief
What is temporisation?
Placement of temporary material to relieve pain
until permanent restoration can be placed after pulp therapy
Maintain a tooth under observation
What is stabilisation?
Stabalising whole dentition to allow time to complete permanent restorations with other lesions progressing
Removal or caries from adj and temp dressing
Allows time for patient cooperation to improve
What are the values of stabilisation?
Allows time for patient to become more confident in dental environment and more cooperative
Used for multiple carious lesions- arrests caries in long term plan
Prevents sensitivity in teeth close to others requiring restorations
What area of the mouth should be started on
Maxillary buccal segment
Delay IDBS
What is the restoration choice for a class 2 cavity?
Hall crown due to risk of exposure when preparing cavity
Due to height or pulp horns and size of pulp in relation to tooth
