Abstract
An approach was taken to treat a mesial proximal carious lesion in a freshly erupted first molar in contact with a second primary molar. Caries were observed in 107 first molars of patients examined in the Pediatric Dental Clinic of Hokkaido University Dental Hospital from December 1998 to Feburary 2000. The second primary molars were extracted when the succedaneous teeth were about to erupt, thus opening up a sufficiently large space in the mesial proximal surface of the first molar to enable exact observation and easy treatment. (In each case, a rubber dam was fitted to the first molar following extraction of the second primary molar. ) Cleaning of the mesial proximal surface with an ultrasonic instrument revealed a surprising degree of decalcification. Of the 107 teeth examined in children aged 8 to 15 years, normal enamel surface was detected in only 8.4% of the teeth. Discoloration enamel but not affected by the ultrasonic instrument showed 10.3%. Decalcified enamel or enamel caries amounted to 66.4% in which caries would have advanced to dentin caries. Decalcified dentin or dentin caries amounted to 15.0%. The results were very surprising. More than 80% of the mesial surface of the first molars was initially decalcified and originated from the contact point between the second primary molars and freshly erupted first molars. This means an increase in risk of caries progression.
This study demonstrated the importance of detecting caries at the earliest possible stage in order to minimize the amount of sound tooth structure that must be removed.
