It is well known that it is difficult to diagnose dental caries accurately. Topical fluoride application — such as fluoride varnish or use of fluoridated toothpaste — is a key part of preventive therapy.10By comparison, pediatric patients with high CRA will require more extensive treatment. Once the caries is into the dentine, removal of the carious tissue and restoration of the tooth is required. Oral-B iO electric toothbrush combines the dentist-inspired round brush head with micro-vibrating bristles to remove more plaque between teeth and along the gum line for a thorough clean. However, when the same material is used for first permanent molars gingivitis is a common finding in late adolescence. Also, keep up with regular dental checkups in order to identify pre-existing conditions before they lead to more serious issues down the road. The majority of published studies show that class II amalgam or glass ionomer restorations in primary teeth have a poor life expectancy, but this is not the experience of the careful dentist. We can't wait to share upcoming news and special offers for Oral-B. Operative Treatment of dental caries in the young Permanent Dentition, 33: Pulp Therapy for the Young Permanent Dentition, 34: Managing Traumatic Injuries in the Young Permanent Dentition, 32: Pit and Fissure Sealants: Scientific and Clinical Rationale, 22: Pulp Therapy for the Primary Dentition, 21: Restorative Dentistry for the Primary Dentition, 7. Patients with a low CRA who present with small incipient (noncavitated) lesions can be successfully managed with noninvasive preventive modalities. 8.2). Treatment methods for caries of primary teeth . The extent of the disease. When you eat certain foods, the bacteria on your teeth breaks them down and produces acids that have the ability to seriously damage the hard tissues of your tooth. When no plaque is present on a tooth, the caries process will stop. Where there is pulpal involvement of primary teeth, pulpotomies or pulpectomies are essential. 8.3). Unpredictability of the speed of attack. Additionally, it has been shown that early lesions that remineralize are less susceptible to caries than intact surfaces, and these areas of the tooth are all too easily removed when preparing an adjacent tooth. In the authors’ view there is no doubt that untreated caries in the primary dentition causes abscesses, pain, and suffering in children. 8.4). Many adults can be seen to be suffering from overenthusiastic treatment of approximal caries in their youth, and while the relative importance of poor margins compared with bacterial plaque can be debated, the potential damage from approximal restorations is sufficient reason to avoid treatment unless a definite indication is present. Figure 8.2 The marginal ridges of both the lower left first and lower right second primary molars have been involved in the carious process. Some studies have shown an even poorer success rate when looking at primary teeth, and this has been put forward as a reason for not treating these teeth. A logical treatment plan should be made which usually involves treating a quadrant of the mouth at a time. Tooth mobility and tooth loss. The short life of dental restorations. Treatment of Cavities in Front Teeth. Currently, medium-term studies appear to show no detrimental effect with adjacent teeth over-erupting to accommodate the ‘high’ crown, although a significant amount of research is still required to show that this is indeed the case. Radiographs should form a routine part of any dental examination, and it is necessary to repeat radiographs for dental caries diagnosis at suitable intervals. The earlier a dental professional can spot the signs of poor oral hygiene, such as a • Early lesions that remineralize are less susceptible to caries. By registering, I agree to receive emails from Oral-B and other trusted P&G brands and programs. A recent randomized trial (New England Children’s Amalgam Trial (NECAT)) could find no difference in neuropsychological or renal complications between the use of amalgam and compomer/composite when restoring posterior primary or permanent molars. With this information the dentist can start to formulate a treatment plan and philosophy which is appropriate for each child. Percent of Children with Caries in Primary Teeth. The following are the various treatment options that could be considered for tooth decay in children. Conventional restorative materials are mainly limited in use to occlusal lesions, small proximal lesions, and cavities on anterior teeth. Every time that a restoration is replaced more sound tissue has to be removed, putting the tooth at further risk. As discussed in earlier chapters, there are a number of different techniques and philoso… preventable with a great oral hygiene regimen,, While there is no doubt that the best way to tackle the problem of dental caries is through an effective programme of prevention as outlined in the previous chapters, it is unfortunate that many children still suffer from the disease and its consequences. These acids are strong enough to demineralize the enamel on your teeth and form tiny holes—the first stage of dental caries. Good-quality restorative care (Fig. Although it is difficult to show reversal of lesions on radiographs, many studies have demonstrated that a substantial proportion of early enamel lesions do not progress over many years. The fact that remineralization can arrest and repair enamel caries. Where possible the order of quadrants will start with the upper arch, as this is easier to anaesthetize painlessly. This chapter is devoted to the discussion of such techniques. Author information: (1)Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia. They are sensitive to variations in technique and take longer to place than equivalent amalgam restorations. Even when coarse criteria such as those developed for the UK Child Dental Health Surveys are used, there is variation between examiners. 8.8.1 Pulpal response to caries progression and the assessment of pulpal health, 8.8.2 Treatment options for the inflamed pulp, 8.8.8 Management of non-vital and abscessed primary molars—the pulpectomy technique, 8.9 Treatment of a child with high caries rate. Background: Due to the lack of evidence to determine the best treatment for deep cavitated caries lesions in primary molars, the search for an effective restorative technique, which results in a minimal discomfort to patients, and reduce the time needed for the treatment, becomes relevant. Hence there is a need to consider operative treatment to prevent the breakdown of the dentition. This was the rationale behind the early suggestions of a ‘prophylactic filling’ for pits and fissures, and for the modern versions in the form of fissure sealants and preventive resin restorations. 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