Dental Caries Case Study

Introduction

Dental caries is a tooth decay, cavity or hole, which is the most common chronic disease among children and adolescents. Medline Plus Encyclopedia defines caries as the demineralisation of the hard tissue (enamel, dentin and cementum) and destruction of the organic matter of the tooth, usually by production of acid by hydrolysis of the food debris accumulated on the tooth surface by the bacteria.

A correct diagnosis of the pulp conditions is important in treatment planning. The indications, objectives and types of pulpal therapy depend on the diagnosis of the pulp. Diagnosis and treatment planning for pulpal therapy in paediatric patient include an appropriate medical and dental history, clinical tests (palpation, percussion and mobility testing) and radiographic

This is due to the coronal pulp tissue which is adjacent to the carious exposure usually contains microorganisms and shows evidence of inflammation and degenerative changes. The removal of coronal pulp tissue allows the healing process to take place at the entrance of the pulp canal in the area of normal pulp.

Pulpotomy in primary teeth is indicated when extensive caries is present but without radicular pathology and when caries removal results in pulp exposure. During pulpotomy, the coronal pulp is amputated and the remaining radicular pulp tissue surface is treated with Buckley’s Solution of formocresol or ferric sulphate. Then, the coronal pulp chamber is filled with zinc oxide eugenol or other suitable base and restored with a restoration that seals the tooth from microleakage. Stainless steel crown has become the most effective long term restoration. However, if there is sufficient supporting enamel remaining, amalgam or composite resin can become the alternative restorative material when the primary tooth has a lifespan of two years or