Small class I cavity in a very young child

Date: 2015-10-07; view: 530.

Cavity preparation in primary teeth

The steps in the preparation of a cavity in a primary tooth are not difficult but do require precise operator control. Many authorities advocate the use of small, round-ended carbide burs in the high-speed handpiece to establish the cavity outline and perform the gross preparation. For efficiency and convenience, all necessary high-speed instrumentation for a given preparation may be completed with a single bur in most situations. Therefore the dentist should select the bur that is best designed to accomplish all the high-speed cutting required for the procedure planned. There are four high-speed carbide burs designed to cut efficiently and yet allow conservative cavity preparations with round line angles and point angles - round-ended, high-speed carbide burs No. 329, No. 330, No. 245, and No. 256. Alternatively, cavity preparations may be made with aluminum oxide air abrasion systems or with laser systems approved for hard-tissue procedures.

During the routine examination of a child younger than 2 years of age, the dentist may occasionally discover a small but definite carious lesion in the central fossa of one or two first primary molars, with all other teeth being sound. Thus restorative needs are present but minimal. Because of the child's psychologic immaturity and because it is usually impossible to establish effective communication with the child, the parent should hold the child on his or her lap in the dental chair. This will help the child feel more secure and provide a better opportunity to restrain the child's movement during the operative procedure. The small cavity preparation may be made without the aid of a rubber dam or local anesthetic. A No. 329 or No. 330 bur is used to open the decayed area and extend the cavosurface margin only to the extent of the carious lesion. The preparation can be completed in just a few seconds. Restoring the tooth with glass ionomer will arrest the decay and at least temporarily prevent further tooth destruction without a lengthy or involved dental appointment for the child.