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Minimally invasive judgement calls: managing compromised first permanent molars in children

British Dental Journal volume 229, pages 459–465 (2020)Cite this article

Abstract

This paper aims to update the reader on how minimally invasive (MI) techniques may be used to improve the longevity of carious or defective/compromised first permanent molars (cFPMs) in young children. Clinical and radiographic diagnosis and the prognostic factors will be discussed in view of recent studies showing that these teeth can be kept in function and have an improved prognosis as the child gets older. Clinical protocols for their care, based on the latest evidence and techniques for MI restorations, together with longevity information of possible restorative options, are described. This paper also explores the rationale behind enforced extractions and related morbidity, in order to help oral healthcare practitioners to determine the optimal management of these key elements in the dentition for the benefit of the patients.

Key points

  • Dental practitioners treating young children frequently face cavitated carious or hypomineralised first permanent molars in their clinical practice.

  • The use of improved minimally invasive techniques and materials, such as high-viscosity glass ionomers, may improve the prognosis of compromised first permanent molars in young children and reduce the need for extractions under general anaesthesia.

  • Compromised first permanent molars may be able to survive longer in the oral cavity of young children, postponing definitive restorative treatment for later in life.

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Acknowledgements

This paper is part of a clinical research collaboration with Brazil entitled: Children Experiencing Dental Anxiety Collaboration on Research and Education (CEDACORE) which was funded by CAPES (Brazil) and Newton Fund British Council (UK). The Ministry of Education, Saudi Arabia is also acknowledged for sponsoring the PhD studentship of Reem Alkhalaf. The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

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Authors and Affiliations

  1. Centre of Oral, Clinical & Translational Science, Faculty of Dentistry, Oral and Craniofacial Research, King’s College London, London, UK

    Reem Alkhalaf

  2. Clinical Lecturer in Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK; Adjunct Professor in Paediatric Dentistry, Federal University of Rio de Janeiro, Brazil

    Aline de Almeida Neves

  3. Professor of Cariology & Operative Dentistry, Honorary Consultant/Clinical Lead, Restorative Dentistry, Conservative & MI Dentistry/Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK

    Avijit Banerjee

  4. Professor of Paediatric Dentistry, Honorary Consultant, Chair of Paediatric Dentistry, Centre of Oral, Clinical and Translational Research, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, London, UK

    Marie Therese Hosey

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  1. Reem Alkhalaf
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Correspondence to Aline de Almeida Neves.

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Alkhalaf, R., Neves, A., Banerjee, A. et al. Minimally invasive judgement calls: managing compromised first permanent molars in children. Br Dent J 229, 459–465 (2020). https://doi.org/10.1038/s41415-020-2154-x

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