Presentation on theme: "Caries Stabilization John Zimmer, DDS R. Patrick Sewell, DMD."— Presentation transcript:
Caries Stabilization John Zimmer, DDS R. Patrick Sewell, DMD
Caries Stabilization Interim therapeutic restorations (ITRs) Resin and glass ionomer sealants Regular recharging of ITRs and sealants with fluoride Fluoride varnish applications Twice daily brushing with fluoride toothpaste
Why Caries Stabilization? Poor Dental Access for 0-5 year olds Only 10% of 0-2 year olds are seen yearly in the dental clinic. Only 25% of 3-5 year olds are seen yearly in the dental clinic.
Indications for interim therapeutic restorations (ITRs), and glass ionomer sealants Appropriate technique for placing ITRs and GI sealants Variables that influence the success of ITRs and GI sealants Behavioral management when working with young children Oral health messages for parents and caregivers of young children Strategies for follow-up and coding Objectives
Policy Statement The AAPD recognizes ITR as a beneficial provisional technique in contemporary pediatric restorative dentistry. ITR may be used to restore and prevent caries in young patients, uncooperative patients, patients with special needs and situations in which traditional cavity preparation and restorations are not feasible. Download AAPD policy on ITRs.
Indications for ITRs No pulpal involvement 1 or 2 surface lesions Reduce fear Defer treatment Provide care at schools
Contraindications for ITRs Necrotic pulp Irreversible pulpitis 3 or more surfaces affected by decay affected by decay
GLASS Ionomer (GI) Materials Bonds with tooth Remineralization Bacterial reduction Within dentin Oral environment
Oral Health Messages Recharging ITR Twice daily brushing with fluoride toothpaste Fluoride varnish every three months Goal setting to improve oral health
Coding Current Dental Terminology 2009-10, Page 147, #12 2940 for ITRs 1351 for resin or glass ionomer sealants. 1203 Fluoride varnish for child at low risk for caries 1206 Fluoride varnish for child at moderate to high risk for caries 1310 Nutritional counseling provided to child and caregiver 1330 Oral hygiene instructions provided to child and caregiver
Goals: Improve access for young children and increase options for treating ECC.
We hope YOU incorporate Caries Stabilization into your dental program!
References American Academy of Pediatric Dentistry, Policy on Interim Therapeutic Restorations, Reference Manual V 31/No6 09/10. Chadwick BL, Treasure ET, Playle RA, Caries Res. 2005 Jan-Feb;39(1):34-40. A randomised controlled trial to determine the effectiveness of glass ionomer sealants in pre-school children. Community Dentistry and Oral Epidemiology Supplement 1 1998, Proceedings: Conference on Early Childhood Caries, Ed: B. Burt Lindemeyer, R. JCDA. March 2007, Vol. 73, No. 2. The Use of Glass Ionomer Sealants on Newly Erupting Permanent Molars. Maltz M, Oliveira EF, Fontanella V, Carminatti G. Deep caries lesions after incomplete dentine caries removal: 40-month follow-up study. Caries Res. 2007;41(6):493–496. Mejare I, Mior, IA. Scand J Dent Res. 1990 Aug;98(4):345-50. Glass ionomer and resin-based fissure sealants: a clinical study. Ricketts DN, Kidd EA, Innes N, Clarkson J. Complete or ultraconservative removal of decayed tissue in unfilled teeth. Cochrane Database Syst Rev. 2006;3:CD003808. Vij, Coll, Shelton, Farooq; Caries control and other variables associated with success of primary molar vital pulp therapy. Ped Dent 2004, 26: 214-20