sdcep caries management

Question 1

How would you manage an initial carious lesion?

Tooth presents with a white spot lesion / discolouration / stained fissure with early enamel breakdown but no dentine visible. Radiographically into the outer 1/3 of dentine.

Answer 1

Seal the lesion by placing a resin fissure sealant and monitor at each recall visit.

(if the child is unable to accept a resin sealant, consider GIC and if this is also unacceptable, seal with a hall crown)

Question 2

How would you manage an advanced occlusal caries lesion on a primary molar?

Lesions may extend into inner 1/3 of dentine radiographically with a clear band of dentine separating the caries from the pulp. Visually this may present as clinical cavitation or dentine shadow with visible dentine.

Answer 2

If cooperative carry out selective removal before restoring with composite / RMGIC / GIC.

If uncooperative for selective caries removal, use the Hall Technique.

Question 3

How would you manage an initial carious lesion in anterior teeth?

Answer 3

1. Carry out site-specific prevention.
2. Monitor at each recall visit and continue if there is no evidence of progression.
3. Adopt an alternative management strategy if progression is seen.

Question 4

How would you manage an advanced carious lesion in an anterior tooth?

Answer 4

Carry out selective caries removal and restore with composite.