Management of Multi-surface caries in Primary Tooth

Multi-surface caries in primary teeth presents a unique challenge due to the rapid progression of decay, thinner enamel and dentin, and the critical role of primary dentition in guiding permanent tooth eruption. Effective management requires a balance between preserving tooth structure, ensuring pulpal health, and maintaining function and aesthetics until natural exfoliation. Treatment approaches vary based on lesion extent, pulp involvement, and patient cooperation, and may include atraumatic restorative treatment (ART), stainless steel crowns (SSC), pulp therapy followed by full coverage restorations, or extraction in non-restorable cases. Preventive measures such as fluoride application, dietary counseling, and reinforcement of oral hygiene are integral to reducing recurrence. This paper discusses diagnostic considerations, treatment planning strategies, and evidence-based interventions aimed at optimizing the prognosis of multi-surface carious primary teeth, emphasizing a minimally invasive yet comprehensive approach

Early Diagnosis through Clinical and Radiographic examination is essential to Prevent Pulpal Involvement.

• Comprehensive treatment planning should consider lesion extent, pulp status, child’s age, and cooperation level.
• Full coverage restorations such as stainless steel crowns (SSC) are preferred for durability in multi-surface lesions.
• Pulp therapy (pulpotomy or pulpectomy) may be required if there is reversible or irreversible pulpitis.
• Atraumatic restorative treatment (ART) can be used in select cases with minimal equipment needs.
• Preventive adjuncts—fluoride varnish, pit and fissure sealants, and dietary counseling—reduce recurrence.

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Dr. Krishna Kumar R MDS PhD FDSRCS ( Eng) Professor Department of Pediatric and Preventive Dentistry Annoor Dental College & Hospital

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