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Management of compromised first permanent molars in a cohort of UK paediatric patients referred to hospital‐based services
Author(s) -
AlKhalaf Reem,
Neves Aline de Almeida,
Warburton Fiona,
Banerjee Avijit,
Hosey Marie Therese
Publication year - 2022
Publication title -
international journal of paediatric dentistry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.183
H-Index - 62
eISSN - 1365-263X
pISSN - 0960-7439
DOI - 10.1111/ipd.12951
Subject(s) - medicine , cohort , molar , cohort study , dentistry , pediatrics , data extraction , medline , political science , law
Background There are diverse opinions among dentists about managing compromised first permanent molars (cFPMs) in children and a perceived lack of guidance to help them evaluate prognosis. Aim To evaluate the current management of cFPM in children referred to a UK hospital centre and to report the severity of the affected teeth. Design A service evaluation was undertaken, based on case records of medically fit children (6‐11 years) referred to for the management of cFPMs. The presence of hypomineralisation, post‐eruptive breakdown and the proposed care plans were recorded. Radiographic signs of severity were scored using the ICDAS index (intra/inter‐rater kappa 0.96/0.82). Results From 349 records screened over a 4‐month period, 249 met the selection criteria. Almost 81% were planned to have extraction of at least one cFPM, whereas 19.3% were managed without extraction. More than half of the extraction cases ( n = 105) had radiographic radiolucencies not exceeding the middle third of dentine in the worst‐affected FPM. At the time of extraction, the mean age of the patients was 9.8 years (±0.9). GA was used in 196 (97.5%) cases, and 40.8% had not received previous treatment in any of their cFPMs. Conclusion Potentially restorable cFPMs in children is, most of the time, in a cohort of UK patients referred for tier 3 services, being managed by timed extractions under general anasethesia.