Dentaltown April 2018 - 36

message board

Should I Fill These Interproximal Lesions?
Townies debate the pros and cons of treating patients who develop potential caries later in life

DDS58
Member Since: 11/24/09
Post: 1 of 102

Patient is 25 years old and has never had any cavities. She is getting her cleaning right now
and I was hoping to get Townies' takes if #30 DO and #31 MO look like caries. If so, would you
fill both of them? Thanks! ■

11/21/2017

danamc
Member Since: 02/15/04
Post: 2 of 102

She may not have had cavities before, but she does now. And look more closely at 4-MO
and 5-DO. ■
11/21/2017

Chief Teef
Member Since: 04/18/14
Post: 3 of 102

I'd try SDF first. Four applications over 2-3 months. Rx 1.1% NaF toothpaste. New BWX
in 6 months. Then continue SDF every 6 months or fill if caries have grown. ■
11/21/2017

DDS58
Member Since: 11/24/09
Posts: 4 and 5 of 102

Thanks. I was thinking I should watch these given her caries history. I always get a bit gun
shy about recommending fillings on patients who haven't had any work done previously, so I was
beginning to doubt if there is actually decay on the lower molars, but it is what it is.
Does SDF work for interproximal lesions into the dentin? ■
11/21/2017

Chief Teef

Yes. Super floss the contact and apply a drop of SDF onto the floss. It will get into the lesion. ■

Member Since: 04/18/14
Post: 8 of 102

11/21/2017

John Kanca

Yes to 30 and 31, no to 4 and 5.
I've seen cases in which the papilla is damaged by SDF. ■

Member Since: 06/21/03
Posts: 9 and 10 of 102

11/22/2017

danamc
Member Since: 02/15/04
Post: 17 of 102

My suggestion is to increase the gamma on your X-rays to add some contrast between tooth
structure and potential caries. Then post the updated BWX here for evaluation.
Also remember that clinical caries extension into the tooth has been shown to be 40 percent
further along than radiographic evidence. If the X-ray indicates decay to the DEJ, the clinical
caries has extended well into dentin.
And give us a better BWX of the 4,5 area to determine the extent of the decay. ■
11/22/2017

36

APRIL 2018 // dentaltown.com


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Table of Contents for the Digital Edition of Dentaltown April 2018

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