Restorative Management of Permanent Teeth in Children (Young Permanent Teeth) Flashcards
Which teeth are the most prone to decay in the young permanent dentition?
first permanent molars
What percentage of children will have molar-incisor hypomineralisation?
15%
What percentage of all new carious lesions in adolescents are pit and fissure lesions?
85%
What is the halo effect of fluoride?
the surface of the tooth becomes resistant to acid dissolution due to integration of fluoride but the subsurface has increased porosity
What can the halo effect lead to?
occult caries
What are occult caries?
the tooth surface looks intact, but radiographs show caries beneath the surface
Why is having fluoride present in the mouth as the permanent teeth are erupting important?
the fluoride will be incorporated into the hydroxyapatite crystals as the teeth fully mineralise within the first year of being erupted
What are risk factors for pit and fissure caries?
deep caries, first year of eruption, partially erupted teeth, teeth being difficult to access, MIH
Can you always seen the full extent of caries clinically in the mouth?
no, often they seem small in the mouth but are much larger upon a radiograph
How do you diagnose caries?
visualize tooth by drying it, use a blunt probe to feel the suspected area, bite wing radiographs
What are some preventative techniques used to stop prevent pit and fissure caries from developing?
resin fissure sealants, GIC fissure sealants, fluoride varnish
What are the three situations in which you would use GIC fissure sealants instead of resin fissure sealants?
when child is pre-cooperative, when there are concerns about moisture control, when teeth are partially erupted
What is needed to ensure a good resin fissure sealant placement?
isolation of the tooth and moisture control
What can too much fluoride varnish lead to?
acute/mild toxicity
How long after placement of fluoride varnish should a child refrain from eating?
minimum of 20mins
Which children would benefit from additional fluoride?
children where their general health would be jeopardized by caries, high caries risk children, children with occlusal caries in one permanent molar, children with deep fissures
Why is it important to take a radiograph before placing a fissure sealant?
to ensure you are not unexpectedly placing the sealant over caries
What are some benefits to using resin sealants compared to GIC sealants?
better retention and longer lasting
What are some cons to using resin sealants compared to GIC sealants?
very technique sensitive, take longer to apply, act as a barrier only
What are some benefits to using GIC sealants compared to resin sealants?
easier application, shorter application time, release of fluoride in addition to sealing
What are some cons to using GIC sealants compared to resin sealants?
poorer retention and faster to wear down
In addition to reducing caries incidence in children and adolescents, what other benefit have studies shown sealants can provide in the oral cavity?
they reduce the number of viable bacteria that initiate or progress caries by 100-fold
What is the aim of non-operative caries management?
aim to remineralise or arrest the lesion
When would you undertaken operative management over non-operative management?
if there is cavitation or if the remineralization methods have not worked and caries has progressed