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.comhttp://www.dentaltown.com