Restorative Management of the Primary Dentition Flashcards
(52 cards)
Why restore the primary dentition?
To restore form
To restore aesthetics
To restore function
Maintain space
Acclimatisation
Avoiding sepsis and infection to permanent successors
To avoid extraction
Why does caries progress quicker in the primary dentition?
dentine and enamel are less highly mineralised
what are the differences between primary teeth and permanent teeth?
smaller
shorter crown
enamel layer is thinner
less dentine in proportion to tooth size
pulp is RELATIVELY larger
pulp horns are nearer the surface - mesially especially
curved roots
contact points are flatter and wider
How many root canals do deciduous molars usually have?
3
sometimes 4, sometimes 2
where do the root canals sit in a lower primary molar?
mesio buccally
mesio lingually
distally
where do the root canals usually sit in upper primary molars?
mesio bucally
disto bucally
palatally
what should you consider when forming your treatment plan?
take into account the individual child, their behaviour, level of anxiety, what access is like etc
what are the stages of the treatment plan (in order)?
relief of pain
prevention - OHI, diet advice
professional prevention - fluoride application, fissures sealant
restorative aspects
extractions
behaviour management
reinforce prevention
why should you start with the simplest procedure on a child?
don’t want to traumatise them
make their experience positive
acclimatisation
what is the minimum age to give your own consent?
16
what is Gillick competency?
a young person under 16 with capacity to make any relevant decision (if you as a clinician believes they understand the procedure even if mum or dad is unhappy you can take this as consent)
what are the common causes of oral pain in children?
abscess
caries
trauma
tooth wear
infection
soft tissue lesions
exfoliation/eruption
What would the history of reversible pulpitis be if presented?
precipitated by sweet/hot/cold
pain stops when stimuli is removed
short duration
mainly occurs when eating
what would the history of irreversible pulpitis be if presented?
constant
relieved only by analgesics
kept awake
symptoms of reversible but untreated
what would you see on examination if reversible pulpitis was present?
early carious lesions
what would you see on examination if irreversible pulpitis was present?
lymphadenopathy
raised temp
extensive marginal ridge destruction
infection of the sinus
intra oral swelling
what would reversible puplitis look like on a radiograph?
caries into dentine
what would irreversibvle pulpitis look like on na radiograph?
caries close to pulp
radiolucency
how to know whether to restore or extract?
what type of pulpitis is it?
is there enough tooth tissue left to carry out a restoration
has there been previous extractions
would you be leaving a functional dentition if you were to take more teeth out
would we cause early drift and eruption of the permanent dentition if we extracted teeth too early
restore when possible especially when…
majority of other carious teeth are restorable
compliance
patient and parent keen to save
space maintenance
prev hypodontia
for adequate function
extract when…
don’t want to leave asymmetry for function - balancing extractions
non compliance
no parental support
no attendance beyond pain relief
what is temporisation?
placing a temporary dressing on tooth to get patient out of pain, stop tooth feeling sharp etc
arrange pt to come back for a permanent restoration, extraction or review
usually involves 1 or 2 teeth
what is stabilisation?
usually involves a lot of teeth
open cavities in mouth, remove as much caries as possible from amelo dentinal junction as possible, place temp dressing, stops disease getting worse
take time to restore teeth one at a time
what is the purpose of stabilisation?
to buy yourself some time
