DentaltownUK June 2018 - 19

I would do #30/#31 if it were my mouth, any of my three kids' mouths, my wife's mouth,
etc. and be satisfied they no longer have decay as I remove the mush. ■

UIDent
Member Since: 05/10/13
Post: 31 of 102

22/11/2017

This is a perfect application for the Dexis CariVu. Just my opinion. Since I have started
using my CariVu I have taken a lot of my guesswork out of diagnosing. Dexis did not pay me in
any way to say this. Simply just stating from my experiences. ■

B2_DMD
Member Since: 03/05/11
Post: 34 of 102

22/11/2017

Or you could save a lot of money and get one of these: addent.com/microlux-2/ ■

John Kanca
22/11/2017

Radiographs are simply a snapshot, a moment in time. Taken alone, they don't tell us a lot
about what occurred when, how quickly, circumstances etc. I'm sure you know. We have to use
our heads and context. Has the patient been decay prone, has anything changed in their habits,
medications, etc.? I have patients that have had incipient lesions for years.
I have others that have literally never had a cavity and something suspicious or incipient may
pop up. I'm not going to jump immediately for the handpiece on those folks.
As dentists we do procedures. It's what we do. However, sometimes (maybe more often
than we do) we need to keep the handpiece in the holster and not jump to cutting away enamel
first thing. ■

Member Since:21/06/03
Post: 35 of 102

Timmy G
Member Since: 14/04/02
Post: 43 of 102

22/11/2017

I wouldn't watch these. SDF and Rx of PreviDent is conservative treatment. I would present
a plan with the SDF as well as a plan for the fillings. I would recommend the conservative plan
but let the patient decide. Doing nothing and watching these will result in larger caries. ■

Chief Teef
Member Since: 18/04/14
Post: 47 of 102

23/11/2017

A motivated patient can arrest decay even once it breaks the DEJ. I have lots of sequential X-rays
of lesions like this that are static or even reversing. Even on the most motivated patient these would
need fixing. If your patient is going to sit on the couch and drink Red Bull all day, forget it. ■

RichardEhrlich
Member Since: 21/01/16
Post: 48 of 102

23/11/2017

I have filled a lot of teeth. Many of them looked like these. I think that #30 could have a
pulpal exposure. To quote Gordon Christensen, digital radiographs understate the depth of
decay.
Fill these teeth. Fill all teeth where there is penetration of more 50 percent of enamel. Start
doing this now and you will be shocked by how much decay you will see.
Tell the patient they need two fillings and rec tx soon. If they don't want tx that's fine, they'll
enjoy the endo that will come along sooner or later. ■
23/11/2017

For sure fill #30, if you are still on the fence about #31, prep #30 first and directly inspect
#31 at that time. Tell the patient she has one for sure cavity and one really borderline cavity that
you will look closer at when you fix the for sure one. And then tell her she has two more maybe
cavities on top that for now, you aren't going to do anything with. But, if the bottom ones turn
out to be way bigger than the X-ray shows, you will have to come back and do those too. Tell her
you are giving her a "worst case scenario" plan and treatment-plan all four. Let her know you'd
rather take things off the bill if things go better than you think they will, than add things to the
bill because you found surprises. ■

drurban
Member Since: 19/10/01
Post: 52 and 57 of 102

Lady Elaine
Member Since: 16/08/03
Post: 62 of 102

2/12/2017

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