Early Childhood Caries: Current Concepts and Innovative Treatment Approaches

✅ Abstract
Early Childhood Caries (ECC) remains one of the most prevalent and challenging oral diseases in children under six years of age. Once referred to as Baby Bottle Tooth Decay (BBTD), ECC is now recognized as a multifactorial, biofilm-mediated disease influenced by biological, behavioral, and environmental factors.

📌 Recommended Article :

Dental Article 🔽 Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application ... Chemical caries removal is a minimally invasive technique that allows for the selective elimination of decayed dentin without the use of a dental drill.

Despite preventive efforts, ECC continues to affect global pediatric populations. This review explores the etiology, pathogenesis, diagnosis, prevention, and modern evidence-based treatments, emphasizing emerging approaches such as silver diamine fluoride, bioactive restorative materials, and minimally invasive dentistry.

Advertisement


✅ Introduction
Historically, Baby Bottle Tooth Decay referred to a specific pattern of dental caries in infants associated with prolonged bottle feeding, especially with sweetened liquids during sleep. However, research in recent decades has shown that this terminology is limited, as caries in young children arise from multiple risk factors, not just feeding habits.
To address this, the American Academy of Pediatric Dentistry (AAPD) introduced the term Early Childhood Caries (ECC) — defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth of a child under six years old (AAPD, 2023). This broader perspective allows for a comprehensive, preventive, and biological approach to pediatric oral health.

📌 Recommended Article :

Dental Article 🔽 SMART Technique in Pediatric Dentistry: Caries Management in Children ... The SMART technique (Silver Modified Atraumatic Restorative Technique) is a minimally invasive and innovative approach in pediatric dentistry.

✅ Etiology and Pathogenesis
ECC is a biofilm-mediated, sugar-driven, dynamic disease resulting from an imbalance between demineralization and remineralization. The key etiologic components include:

▪️ Cariogenic bacteria (Streptococcus mutans, Lactobacillus spp.)
▪️ Frequent exposure to fermentable carbohydrates
▪️ Host factors, such as enamel hypoplasia or reduced saliva flow
▪️ Socio-behavioral determinants, including parental education and socioeconomic status

Recent studies (Berkowitz, 2022; Tinanoff et al., 2023) highlight that the oral microbiome composition plays a critical role, with early colonization of S. mutans strongly associated with rapid lesion development.

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... Glass ionomer cement (GIC) is a widely used dental material in pediatric dentistry due to its strong adhesion, fluoride release, and biocompatibility.

✅ Clinical Presentation
The initial lesions appear as chalky white spots on the smooth surfaces of the maxillary incisors, followed by brown discoloration and cavitation. In advanced cases, caries may involve multiple teeth, leading to:

▪️ Pain and infection
▪️ Difficulty eating or sleeping
▪️ Premature tooth loss and potential malocclusion

Lower incisors are often spared due to protection from the tongue and saliva, a key clinical distinction in diagnosis.

📌 Recommended Article :

PDF 🔽 Step-by-step Procedure Manual on Atraumatic Restorative Treatment ... Atraumatic restorative treatment is a procedure that removes carious tissue from teeth using only hand instruments. This procedure is performed when patients live in areas where basic services are lacking.

✅ Diagnosis
Diagnosis should combine visual-tactile inspection with caries detection technologies such as:

▪️ ICDAS II system for lesion classification
▪️ Laser fluorescence (DIAGNOdent) for early detection
▪️ Bitewing radiographs to assess interproximal involvement

Risk assessment tools such as the AAPD Caries Risk Assessment Tool (CAT) and CAMBRA for children help clinicians develop individualized preventive plans.

📌 Recommended Article :

Dental Article 🔽 How Is Early Childhood Caries Managed in Canada? Evidence-Based Pediatric Approaches ... Early Childhood Caries (ECC) remains one of the most prevalent chronic diseases among Canadian children, particularly in underserved and Indigenous populations.

✅ Modern Preventive Strategies

1. Parental Education and Behavior Modification
Educating caregivers remains essential. Key measures include:
▪️ Avoiding night-time bottle feeding with anything other than water.
▪️ Initiating toothbrushing with fluoride toothpaste (1000 ppm) when the first tooth erupts.
▪️ Weaning from the bottle by 12–14 months.
▪️ Reinforcing fluoride exposure through toothpaste, varnishes, and community programs.

2. Fluoride-Based Approaches
Recent studies confirm the efficacy of 5% sodium fluoride varnish for preventing ECC and remineralizing white spot lesions (Marinho et al., 2021). In cases of active caries, Silver Diamine Fluoride (SDF 38%) has emerged as a non-invasive alternative capable of arresting lesions with minimal discomfort — a valuable tool for uncooperative or medically compromised children.

3. Probiotic and Microbiome Modulation
New evidence suggests that oral probiotics containing Lactobacillus rhamnosus GG and Bifidobacterium lactis may reduce S. mutans levels and modulate the oral microbiome, although results remain preliminary (Aparna et al., 2023).

📌 Recommended Article :

Webinar 🔽 Webinar: Oral Health in the Perinatal and Early Childhood Periods ...Oral health during the perinatal and early childhood periods is essential for lifelong well-being, as this stage sets the foundation for healthy growth and development.

✅ Modern Treatment Modalities

1. Minimally Invasive Dentistry (MID)
The focus has shifted toward preserving healthy tooth structure.
▪️ Atraumatic Restorative Treatment (ART): Uses high-viscosity glass ionomer cements (GICs) that release fluoride and bond chemically to enamel.
▪️ Resin infiltration (Icon system): Effective for non-cavitated lesions to halt progression.

2. Bioactive Restorative Materials
Innovations such as bioactive glass ionomer and calcium silicate-based materials (ACTIVA BioACTIVE, Cention N) provide ion release, enhancing remineralization and promoting enamel repair (Santanoni et al., 2023).

3. Hall Technique
The Hall technique, which seals carious lesions under preformed stainless steel crowns without caries removal, has shown high success rates (Innes et al., 2022) and reduces the need for local anesthesia.

4. Pulp Therapy Advances
In cases of pulpal involvement, bioceramic materials like Mineral Trioxide Aggregate (MTA) and Biodentine offer superior sealing ability, biocompatibility, and dentin bridge formation compared to traditional calcium hydroxide (Stringhini et al., 2023).

5. Behavior Management and Sedation
For extensive cases or young uncooperative patients, conscious sedation (nitrous oxide) or general anesthesia may be required, ensuring complete oral rehabilitation and prevention of future disease progression.

📌 Recommended Article :

Webinar 🔽 Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed ... In pediatric dentistry, minimally invasive approaches emphasize a preventive philosophy supported by early risk assessment and tailored care.

💬 Discussion
The paradigm shift from Baby Bottle Tooth Decay to Early Childhood Caries represents more than a change in terminology — it reflects a modern understanding of caries as a chronic, multifactorial disease.
Recent evidence supports the integration of bioactive, fluoride-releasing restorative systems and non-invasive techniques such as SDF and ART. Moreover, addressing behavioral and microbiological factors remains key to long-term control.
Public health programs incorporating fluoride varnish applications, caregiver counseling, and community-level interventions have demonstrated measurable reductions in ECC incidence, especially in low-income populations (WHO, 2022).

✍️ Conclusion
Early Childhood Caries remains a major public health concern despite being largely preventable. Modern approaches emphasize early detection, biofilm control, fluoride use, and minimally invasive management. Pediatric dentists should integrate behavioral guidance, restorative innovation, and interprofessional collaboration to ensure comprehensive care.
The evolution from “Baby Bottle Tooth Decay” to “Early Childhood Caries” reflects the profession’s ongoing commitment to evidence-based, preventive, and patient-centered dentistry.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... Silver diamine fluoride (SDF) is a topical medicine that is used to stop the advance of caries and in cases of dentin hypersensitivity. It can be used in both primary and permanent dentition.

🔎 Recommendations
▪️ Apply fluoride varnish and SDF as primary preventive and arresting agents.
▪️ Incorporate bioactive and minimally invasive materials in pediatric restorative care.
▪️ Conduct microbiome-based risk assessment for early intervention.
▪️ Strengthen parental education programs on feeding and hygiene habits.
▪️ Promote community fluoride and probiotic initiatives where applicable.

📚 References

✔ American Academy of Pediatric Dentistry (AAPD). (2023). Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Retrieved from https://www.aapd.org
✔ Aparna, R., et al. (2023). Probiotic modulation of Streptococcus mutans in children with early childhood caries: A randomized clinical trial. Pediatric Dentistry, 45(2), 89–97.
✔ Berkowitz, R. J. (2022). Causes, treatment and prevention of early childhood caries: A microbiologic perspective. Journal of the Canadian Dental Association, 88(2), 12–20.
✔ Innes, N. P. T., et al. (2022). Hall technique crowns for primary molars: Evidence update and clinical outcomes. International Journal of Paediatric Dentistry, 32(4), 544–553.
✔ Marinho, V. C. C., et al. (2021). Fluoride varnishes for preventing dental caries in children and adolescents. Cochrane Database of Systematic Reviews, (12), CD002279.
✔ Santanoni, C., et al. (2023). Bioactive restorative materials and their role in pediatric caries management. Clinical Oral Investigations, 27(5), 2653–2665.
✔ Stringhini, P. H. M., et al. (2023). Clinical performance of bioceramic materials in pulpotomy of primary molars: A systematic review and meta-analysis. Journal of Dentistry, 132, 104531.
✔ Tinanoff, N., Reisine, S., & Milgrom, P. (2023). Early Childhood Caries: Prevention, Diagnosis, and Management—Updated Review. Pediatric Dentistry, 45(1), 13–25.
✔ World Health Organization (WHO). (2022). Oral Health Fact Sheet. Retrieved from https://www.who.int/news-room/fact-sheets/detail/oral-health

📌 More Recommended Items

► Severe early childhood caries: an integral approach
► Atraumatic Restorative Treatment (ART) for dental caries : Step by step
► Enamel Hypoplasia vs Dental Fluorosis: Key Differences, Diagnosis, and Treatment

How Is Early Childhood Caries Managed in Canada? Evidence-Based Pediatric Approaches

✅ Summary
Early Childhood Caries (ECC) remains one of the most prevalent chronic diseases among Canadian children, particularly in underserved and Indigenous populations. Canada’s approach stands out for its early prevention, community-based programs, and integration of social determinants of health. This article reviews current strategies, clinical protocols, and public health initiatives designed to manage ECC in Canada.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... Silver diamine fluoride (SDF) is a topical medicine that is used to stop the advance of caries and in cases of dentin hypersensitivity. It can be used in both primary and permanent dentition.

✅ Introduction
Early Childhood Caries (ECC) is defined as the presence of one or more decayed, missing, or filled tooth surfaces in any primary tooth in children under six years of age. In Canada, ECC represents a major public health challenge, contributing to pain, infection, and reduced quality of life.

Advertisement


Unlike purely clinical approaches, Canadian strategies combine evidence-based dentistry with social, cultural, and preventive frameworks, aligning with the goals of the Canadian Dental Association (CDA) and Health Canada.

✅ Etiology and Risk Factors
ECC in Canada is strongly associated with:

▪️ Early exposure to sugary liquids or prolonged bottle feeding.
▪️ Lack of access to fluoridated water in rural or northern communities.
▪️ Socioeconomic disparities and limited parental education.
▪️ Cultural and geographic barriers among Indigenous populations (CPS, 2022).

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... Glass ionomer cement (GIC) is a widely used dental material in pediatric dentistry due to its strong adhesion, fluoride release, and biocompatibility.

✅ Preventive Strategies
Canadian dental policies emphasize prevention over intervention:

▪️ Early dental visits: CDA recommends the first dental check-up within six months after the eruption of the first tooth or by 12 months of age.
▪️ Fluoride varnish programs are applied regularly in community and school settings.
▪️ Oral health education for parents and caregivers focuses on nutrition, bottle use, and daily hygiene.
▪️ Integration with other health professionals (nurses, pediatricians) to identify risk factors early.

✅ Clinical Management
When ECC develops, Canadian pediatric dentists follow a minimally invasive, evidence-based approach:

▪️ Interim Therapeutic Restorations (ITR) and stainless steel crowns for extensive lesions.
▪️ Silver Diamine Fluoride (SDF) use to arrest caries progression in young or uncooperative children.
▪️ General anesthesia for severe or multiple lesions, commonly used in hospital-based dental care, especially for northern or Indigenous communities.
▪️ Post-operative preventive reinforcement to reduce recurrence rates (Amin et al., 2016).

📌 Recommended Article :

Dental Article 🔽 Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application ... Chemical caries removal is a minimally invasive technique that allows for the selective elimination of decayed dentin without the use of a dental drill.

✅ Community and Public Health Programs

▪️ The Canadian Dental Care Plan (CDCP) includes coverage for preventive pediatric care for families without insurance.
▪️ Indigenous-specific oral health initiatives, like Children’s Oral Health Initiative (COHI), deliver culturally adapted preventive care.
▪️ Collaboration between provincial health authorities and dental schools for outreach and public health campaigns.

📌 Recommended Article :

Dental Article 🔽 Top Benefits of Chemical Caries Removal in Children and Patients with Dental Anxiety ... Modern dentistry increasingly embraces minimally invasive approaches that prioritize preserving healthy tooth structure and enhancing the patient experience.

💬 Discussion
The Canadian model of ECC management is noteworthy for its holistic vision. Unlike systems that focus solely on treatment, Canada integrates social determinants, early intervention, and public health education. However, challenges persist:

▪️ Geographic inequity: northern and Indigenous communities still face limited access to care.
▪️ High costs and hospital dependency for severe ECC under general anesthesia.
▪️ Need for national data standardization to evaluate outcomes and long-term program success.

Despite these limitations, Canada’s multi-level approach has become an international reference in pediatric oral health promotion and equity.

📌 Recommended Article :

Dental Article 🔽 SMART Technique in Pediatric Dentistry: Caries Management in Children ... The SMART technique (Silver Modified Atraumatic Restorative Technique) is a minimally invasive and innovative approach in pediatric dentistry.

✍️ Conclusion
Canada’s strategy to manage Early Childhood Caries demonstrates the power of evidence-based, preventive, and community-oriented dentistry. By combining early detection, fluoride-based prevention, education, and social equity, Canada offers a replicable model for other countries facing similar pediatric dental health challenges.

📊 Comparative Table: Distinctive Aspects of Early Childhood Caries Management in Canada

Aspect	Advantages	Limitations
Dental Home Model	Ensures continuous, family-centered care from infancy, improving prevention and trust.	Requires early parental engagement and system coordination; limited access in remote areas.
Personalized Caries Risk Assessment (CRA)	Allows individualized prevention plans and targeted fluoride application.	Time-consuming for practitioners; variable implementation consistency.
Silver Diamine Fluoride (SDF) Protocols	Non-invasive, cost-effective option for arresting caries in high-risk or uncooperative children.	Causes permanent dark staining; parental acceptance may be low.
Integration with Public Health Programs	School-based fluoride varnish and sealant initiatives increase reach in underserved populations.	Dependent on government funding and local health authority priorities.
Interdisciplinary Collaboration	Involves pediatricians, nurses, and educators in early detection and referral.	Requires training alignment and communication across health disciplines.

🔎 Recommendations

1. Expand national fluoride varnish programs to all provinces.
2. Increase parental education and engagement through digital platforms.
3. Strengthen interprofessional collaboration between dentists and pediatric healthcare providers.
4. Implement mobile dental clinics for rural and Indigenous areas.
5. Ensure standardized monitoring and evaluation of ECC prevention outcomes.

📚 References

✔ Amin, M., Elyasi, M., & Schroth, R. J. (2016). Early Childhood Caries: A Review of Etiology, Clinical, and Public Health Perspectives. Frontiers in Public Health, 4(204). https://doi.org/10.3389/fpubh.2016.00204
✔ Canadian Dental Association (CDA). (2023). Position Statement on Early Childhood Caries (ECC). Retrieved from https://www.cda-adc.ca/_files/position_statements/earlyChildhoodCaries.pdf
✔ Canadian Paediatric Society (CPS). (2022). Early Childhood Caries in Canada: Position Statement. Retrieved from https://cps.ca/documents/position/early-childhood-caries
✔ Health Canada. (2024). Children’s Oral Health Initiative (COHI) Annual Report. Government of Canada. https://www.canada.ca/en/indigenous-services-canada/services/first-nations-inuit-health/reports-publications.html
✔ Tinanoff, N., & Reisine, S. (2021). Update on Early Childhood Caries. Journal of the Canadian Dental Association, 87(g20). https://jcda.ca/g20

📌 More Recommended Items

► Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed
► Fluoride Recommendations for Children in the US: What Parents Should Know
► Fluoride Varnish for Preventing and Treating White Spot Lesions: Clinical Evidence and Best Practices

Webinar: Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions

The webinar “Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions” highlights the importance of preserving pulp vitality in young permanent teeth.

📌 Recommended Article :

Dental Article 🔽 Medications for Pulp Capping in Primary Teeth: Indications, Composition, and Clinical Management ... Pulp capping in primary teeth is a conservative procedure aimed at preserving pulp vitality following an accidental or intentional pulp exposure during caries removal.

It reviews current evidence on pulpotomy indications, direct and indirect pulp capping, and other biologically driven strategies that aim to maintain pulp function when lesions are in close proximity to the pulp chamber.

Advertisement

Emphasis is placed on case selection, material choice, and clinical protocols that reduce the need for more invasive procedures, while ensuring long-term success and continued root development.

📌 Recommended Article :

Video 🔽 Pulpotomy and pulpectomy procedures. Indications and Differences ... Pulpectomy is recommended when it is necessary to completely remove the affected dental pulp, and pulpotomy partially removes the dental pulp.

This session provides clinicians with practical, evidence-based approaches to managing deep caries conservatively, promoting both tooth preservation and patient-centered outcomes.

📌 Watch webinar: "Vital Pulp Therapy: A Conservative Alternative in the Treatment of Deep Carious Lesions"

Youtube/ Dentistree Academy

📌 More Recommended Article

► Webinar: Clinically applicable Pulpotomy for the Primary Tooth - Dr. Joby Peter
► Pulp Polyps in Children: Causes, Diagnosis, and Treatment Options in Pediatric Dentistry
► Clinical Pulpectomy Protocol: Updated Step-by-Step Guide

Webinar: Oral Health in the Perinatal and Early Childhood Periods

Oral health during the perinatal and early childhood periods is essential for lifelong well-being, as this stage sets the foundation for healthy growth and development.

📌 Recommended Article :

Video 🔽 What are the causes of white spots on teeth? ... It can occur in both primary and permanent dentition, and a professional evaluation is necessary to determine what is the cause of the white spots and perform an appropriate treatment.

This webinar addresses the most relevant oral diseases affecting infants and young children, with a focus on understanding the causes and risk factors of dental caries, including early childhood caries (ECC), which remains a global public health concern.

Advertisement

Attention is also given to conditions such as tongue-tie, its impact on feeding and speech, and the importance of timely diagnosis and management.

📌 Recommended Article :

PDF 🔽 Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review ... Fluoride varnish is easy to apply, offers greater absorption of minerals on the teeth, and is very safe, unlike other topical fluoride treatments (gels and rinses).

Through a combination of prevention, education, and evidence-based treatment, pediatric dentists and healthcare providers can work together to reduce disease burden, empower families, and promote sustainable oral health habits from the very beginning of life.

📌 Watch webinar: "Webinar: Oral Health in the Perinatal and Early Childhood Periods"

Youtube/ labestbabies

📌 More Recommended Article

► How to Apply: Clinpro Sealant - Step by step
► Webinar: Silver Diamine Fluoride – A Silver Renaissance in Dentistry - Dr. Anas Al Salami
► ORAL HYGIENE : How to care for your baby's gums

Webinar: The SMART pediatric dentistry: Minimally Invasive Restorative Techniques - Dra. Jeanette MacLean

Minimally invasive restorative techniques, particularly the use of glass ionomer cement (GIC) and the atraumatic restorative treatment (ART) protocol, represent a paradigm shift in how pediatric dentistry addresses caries management.

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use.

By prioritizing early detection, conservative intervention, and restorations that mimic natural tooth properties, SMART dentistry creates functional and aesthetic outcomes while maintaining patient comfort.

Advertisement

Case selection and careful treatment planning are essential, ensuring that each intervention respects the principles of modern cariology and supports long-term oral health.

📌 Recommended Article :

PDF 🔽 Severe early childhood caries: an integral approach ... Treatment will depend on the extent of the injuries and requires interdisciplinary management to achieve successful rehabilitation. In these cases the cooperation of the parents is necessary.

This approach not only provides predictable clinical results but also enhances cooperation, reduces treatment anxiety, and establishes a foundation for sustainable pediatric dental care.

📌 Watch webinar: "The SMART pediatric dentistry: Minimally Invasive Restorative Techniques - Dra. Jeanette MacLean"

Youtube/ Elevate Oral Care

📌 More Recommended Article

► Use of Silver Diamine Fluoride (SDF) - General Guide on its application
► Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application
► Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed

SMART Technique in Pediatric Dentistry: Caries Management in Children

The SMART technique (Silver Modified Atraumatic Restorative Technique) is a minimally invasive and innovative approach in pediatric dentistry.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment.

It combines the application of 38% silver diamine fluoride (SDF) with atraumatic restorative treatment (ART), offering effective caries control in children without the need for anesthesia or extensive drilling.

Advertisement

✅ Introduction
Dental caries remain one of the most common chronic diseases in childhood, especially in underserved populations. In this context, the SMART technique has emerged as an accessible and effective option for managing carious lesions, particularly in pediatric patients.

✅ What is the SMART technique?
The SMART technique integrates two approaches:

1. Application of 38% silver diamine fluoride (SDF): halts caries progression and provides an antimicrobial effect.
2. Atraumatic Restorative Treatment (ART): sealing the lesion with glass ionomer cement, which releases fluoride and reinforces tooth structure.

This approach does not require anesthesia or rotary instruments, making it a cost-effective and well-accepted technique in community pediatric dentistry.

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use.

✅ Benefits of the SMART technique

° Effective caries arrest in primary teeth.
° Reduces pain and anxiety in pediatric patients.
° Low-cost and suitable for underserved populations.
° Preserves tooth structure and prolongs tooth survival.
° Minimally invasive and conservative.

✅ Drawbacks of the SMART technique

° Permanent black staining of carious lesions due to SDF.
° Potential parental concerns about esthetics.
° Limited effectiveness in deep caries with pulpal involvement.
° Requires regular clinical follow-up.

📌 Recommended Article :

Dental Article 🔽 Top Benefits of Chemical Caries Removal in Children and Patients with Dental Anxiety ... Modern dentistry increasingly embraces minimally invasive approaches that prioritize preserving healthy tooth structure and enhancing the patient experience.

✅ Comparative table: SMART vs. ART

Aspect	SMART	ART
Caries control	High, due to SDF antimicrobial effect	Moderate, depends on seal quality
Esthetics	Limited, black staining occurs	Better, no dark discoloration
Application	Simple, no anesthesia or drill	Simple, no anesthesia or drill
Cost	Low	Low

💬 Discussion
The SMART technique has shown high effectiveness in controlling caries in pediatric patients, especially in underserved communities with limited access to dental services. Its main limitation is esthetics due to black staining, which can cause parental concerns. However, its efficacy, affordability, and minimally invasive nature make it a valuable tool in modern pediatric dentistry.

📌 Recommended Article :

Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress.

✍️ Conclusions
The SMART technique is a safe, effective, and accessible clinical option for managing caries in children. It offers significant benefits in public health dentistry, particularly in resource-limited settings, though its esthetic limitations and follow-up requirements must be considered.

📚 References

✔ Crystal, Y. O., & Niederman, R. (2019). Evidence-Based Dentistry Update on Silver Diamine Fluoride. Dental Clinics of North America, 63(1), 45–68. https://doi.org/10.1016/j.cden.2018.08.011
✔ Horst, J. A., Ellenikiotis, H., & Milgrom, P. L. (2016). UCSF Protocol for Caries Arrest Using Silver Diamine Fluoride: Rationale, Indications, and Consent. Journal of the California Dental Association, 44(1), 16–28. PMID: 26897901
✔ Seifo, N., Robertson, M., MacLean, J., Blain, K., Grosse, S., Milne, R., Seeballuck, C., & Innes, N. P. T. (2020). The use of silver diamine fluoride (SDF) in dental practice. British Dental Journal, 228, 75–81. https://doi.org/10.1038/s41415-020-1203-9

📌 More Recommended Items

► Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed
► Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application
► Severe early childhood caries: an integral approach

Webinar: Minimally Invasive Dentistry - Dra. Aisha Mohamed

In pediatric dentistry, minimally invasive approaches emphasize a preventive philosophy supported by early risk assessment and tailored care. Advances in diagnostics allow clinicians to identify caries lesions at their earliest stages, enabling interventions that stop or slow progression without the need for extensive drilling or removal of tooth structure.

📌 Recommended Article :

Dental Article 🔽 White Spot Lesions in Orthodontics: Causes, Prevention, and Treatment Options ... This article explores the definition, characteristics, etiology, prevention, and treatment options for WSLs based on the most recent scientific literature.

Non-invasive options such as fluoride therapies, sealants, and behaviorally guided oral hygiene strategies form the foundation of this model, while minimally invasive techniques, including selective caries removal or atraumatic restorative treatments, provide solutions when intervention is required.

Advertisement

By reducing patient anxiety, improving cooperation, and safeguarding dental development, minimally invasive dentistry not only addresses disease but also empowers families with knowledge and practices that promote long-term oral health.

📌 Recommended Article :

Dental Article 🔽 Silver Diamine Fluoride in Pediatric Dentistry: Clinical Guide 2025 ... Its topical application allows the arrest of carious lesions without the need for invasive procedures, making it especially useful in children with high caries risk, behavioral challenges, or limited access to dental care.

This patient-centered perspective ensures that treatment in pediatric dentistry is both scientifically sound and aligned with the unique needs of growing children.

📌 Watch webinar: "Minimally invasive dentistry in pediatric dentistry - Dra. Aisha Mohamed"

Youtube/ The Kenya Association of Paediatric Dentists

📌 More Recommended Webinars

► Webinar: Dental Treatment: Vital Pulp Therapy for Primary Teeth
► Space Maintainers: Benefits and Types - Webinar
► Webinar: Pediatric dentistry and home based oral care - Dr. Silvia Sabatini and Dr. Luis Karakowsky

Top Benefits of Chemical Caries Removal in Children and Patients with Dental Anxiety

Modern dentistry increasingly embraces minimally invasive approaches that prioritize preserving healthy tooth structure and enhancing the patient experience.

📌 Recommended Article :

Video🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

In this context, chemical caries removal (CCR) has emerged as a safe, effective alternative to traditional drilling—especially valuable in pediatric dentistry and for patients with dental anxiety or phobia. This technique allows clinicians to eliminate decayed dentin without rotary tools, reducing discomfort, fear, and the need for local anesthesia.

Advertisement

✅ What Is Chemical Caries Removal?
CCR is a conservative, non-invasive technique that uses enzymatic or oxidizing agents to soften infected dentin, allowing its manual removal without mechanical drilling. Common products include Carisolv®, Papacárie Duo®, Brix3000®, and Carie-Care™, which have proven effective in clinical studies.

✅ Why Is CCR Ideal for Children and Anxious Patients?

1. Avoids the dental drill
The sound and vibration of a dental drill often trigger anxiety in children and phobic adults. CCR eliminates the need for rotary instruments.
2. Often requires no local anesthesia
Recent studies show that chemical agents can remove caries painlessly, making injections unnecessary in many cases (Elgalaid et al., 2022).
3. Increases treatment acceptance
Minimally invasive techniques result in a more relaxed experience, improving cooperation in young children and anxious patients (Ghasempour et al., 2020).
4. Preserves healthy tooth structure
Most CCR products act selectively on infected dentin, aligning with the principles of minimally invasive dentistry.
5. Creates a calm clinical environment
Less noise and vibration help maintain a soothing atmosphere, reducing stress for both patient and provider.

📌 Recommended Article :

PDF 🔽 Molar incisor hypomineralisation: Definition, diagnosis and clinical management ... In comparison, the metabolism of a drug in a child is different from that of an adult, so the administration of an antibiotic should be taking into account the diagnosis, age and weight of the pediatric patient

✅ Latest Scientific Evidence
Recent clinical research highlights CCR’s effectiveness and patient acceptance:

° Elgalaid et al. (2022) found that Carisolv® significantly lowered anxiety and pain perception in children compared to conventional methods.
° Ghasempour et al. (2020) reported high satisfaction rates using Brix3000® among children aged 4–7 years.
° Santos et al. (2021) confirmed the safety and effectiveness of Papacárie Duo® in patients with mild to moderate dental anxiety.

📌 Recommended Article :

PDF 🔽 Alternative for the rehabilitation of pediatric patients with early childhood caries ... We share the oral rehabilitation of a pediatric patient affected by early childhood caries, using a functional appliance aesthetically appropriate for the patient

✅ Clinical Guidelines

° Indications: Ideal for shallow to moderate dentin caries without pulpal involvement.
° Contraindications: Avoid in deep lesions near the pulp or sclerotic dentin.
° Chair time: Slightly longer than conventional drilling, but often compensated by improved cooperation.
° Restoration options: Compatible with adhesive and bioactive restorative materials.

📌 Recommended Article :

PDF 🔽 Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation ... In comparison, the metabolism of a drug in a child is different from that of an adult, so the administration of an antibiotic should be taking into account the diagnosis, age and weight of the pediatric patient

💬 Discussion
Chemical caries removal represents a paradigm shift in managing caries in vulnerable populations. Its patient-friendly and drill-free nature allows for a less traumatic and more empathetic experience. The ability to reduce fear and discomfort during treatment makes CCR especially valuable in pediatric and behavioral dentistry. It also fosters better long-term dental relationships by building trust from an early age.

💡 Conclusion
Chemical caries removal is a powerful tool for modern dentistry, particularly when treating children and patients with dental phobia. Backed by recent evidence, its use promotes a more comfortable, conservative, and effective dental care experience. CCR should be considered a standard part of the clinical toolkit when aiming for anxiety-free dental visits.

📚 References

✔ Elgalaid, M. A., Alshoraim, M. A., Alhazmi, Y. F., & Alahmari, R. A. (2022). A randomized clinical trial comparing Carisolv and rotary instruments in caries removal: anxiety and pain perception in pediatric patients. BMC Oral Health, 22, 333. https://doi.org/10.1186/s12903-022-02458-4

✔ Ghasempour, M., Yeganeh, P., & Golkari, A. (2020). Comparison of the effectiveness of Brix3000 and conventional methods in caries removal in children. Journal of Dentistry for Children, 87(3), 151–156.

✔ Santos, A. P., Freire, M. C. M., Oliveira, B. H., & Paiva, S. M. (2021). Effectiveness of Papacárie Duo in minimally invasive treatment of dental caries in anxious children: a randomized clinical trial. Pediatric Dentistry, 43(4), 259–265.

✔ Lussi, A., & Schaffner, M. (2019). Advances in minimally invasive caries removal: Chemo-mechanical agents. In Mount, G. J. & Hume, W. R. (Eds.), Preservation and Restoration of Tooth Structure (3rd ed., pp. 97–104). Wiley-Blackwell.

📌 More Recommended Items

► Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application
► Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide
► How well do fluoride treatments work at preventing tooth decay?

Chemical Caries Removal: Drill-Free Technique, Materials, and Clinical Application

Chemical caries removal is a minimally invasive technique that allows for the selective elimination of decayed dentin without the use of a dental drill.

📌 Recommended Article :

Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress

The procedure involves softening infected dentin using a chemical agent, which is then gently removed with manual instruments. This approach reduces pain, anxiety, and the need for local anesthesia, making it ideal for pediatric, geriatric, and anxious patients.

Advertisement

✅ How Does This Technique Work?
The chemical agents dissolve denatured collagen fibers found in infected dentin, leaving healthy dentin intact. The gel is applied directly to the carious lesion, allowed to act for a few minutes, and then the softened tissue is scraped away with hand excavators.

✅ Leading Commercial Products
Here are the most widely used products for chemical caries removal:

1. Carisolv®
➤ Composition: Amino acids (lysine, leucine, glutamate), sodium hypochlorite (0.5%), and a gel carrier.
➤ Mechanism of Action: Sodium hypochlorite breaks down denatured collagen, while amino acids buffer the solution for selective tissue removal.
➤ Advantages: Tissue-selective action, reduced need for anesthesia, well-tolerated by patients.
➤ Disadvantages: Unpleasant odor, longer procedure time compared to traditional methods.

2. Papacárie Duo®
➤ Composition: Papain, chloramine, toluidine blue, and thickening agents.
➤ Mechanism of Action: Papain, an enzyme from papaya, breaks down the protein matrix in decayed dentin. Chloramine enhances the antimicrobial effect.
➤ Advantages: Biocompatible, anti-inflammatory, gentle enzymatic action.
➤ Disadvantages: Less effective in dry or deep lesions, moderately priced.

3. Brix3000®
➤ Composition: Highly purified papain (3,000 U/mg) with EBE (Encapsulated Buffered Emulsion) technology.
➤ Mechanism of Action: Targets and hydrolyzes denatured collagen with high specificity and enhanced stability.
➤ Advantages: Fast-acting, high enzymatic activity, easy-to-use syringe.
➤ Disadvantages: Higher cost, supervision recommended in extensive lesions.

4. Carie-Care™
➤ Composition: Papain, chloramine, clove oil (eugenol), and natural extracts.
➤ Mechanism of Action: Similar to Papacárie, with an added calming effect from clove oil.
➤ Advantages: Affordable, mild analgesic and antiseptic properties.
➤ Disadvantages: Variable effectiveness depending on lesion texture.

📌 Recommended Article :

PDF 🔽 Severe early childhood caries: an integral approach ... Treatment will depend on the extent of the injuries and requires interdisciplinary management to achieve successful rehabilitation. In these cases the cooperation of the parents is necessary

✅ Clinical Guidelines for Use

° Ensure relative isolation to prevent contamination.
° Apply only to infected dentin.
° Use hand excavators to remove softened tissue.
° Visually and tactilely assess the remaining dentin to avoid overexcavation.
° Rinse with saline after the procedure.

✅ Clinical Advantages

° Minimally invasive and conservative.
° Reduces or eliminates the need for dental drills and anesthesia.
° Excellent for children, elderly, and anxious patients.
° Preserves healthy tooth structure.
° Compatible with bioactive restorative approaches.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

✅ Potential Disadvantages

° Longer chair time compared to rotary methods.
° Higher cost for certain products.
° May be less effective on hard or sclerotic lesions.
° Requires careful visual and tactile evaluation.

💬 Discussion

Multiple studies support chemical caries removal as a conservative alternative in restorative dentistry. Enzymatic agents such as papain and oxidizers like sodium hypochlorite have demonstrated effectiveness in dissolving infected dentin without compromising healthy tissue. Despite limitations such as longer procedure times and availability, this technique aligns with modern principles of minimally invasive dentistry and is gaining wider acceptance.

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use

💡 Conclusion

Chemical caries removal is a significant advancement in conservative dentistry, offering a drill-free, painless option for removing decayed tissue. While it does not fully replace mechanical methods, its integration into clinical practice provides a more comfortable and tissue-preserving approach for managing dental caries.

📚 References

✔ Abdelaziz, K. M., & Hassan, M. I. (2018). Efficacy of papain gel (Papacárie®) and Carisolv® in caries removal in primary teeth: A randomized clinical trial. Journal of Clinical Pediatric Dentistry, 42(5), 353–359. https://doi.org/10.17796/1053-4625-42.5.10

✔ Bussadori, S. K., Castro, L. C., & Galvão, A. C. (2005). Papain gel: A new chemo-mechanical caries removal agent. Journal of Clinical Pediatric Dentistry, 30(2), 115–119. https://doi.org/10.17796/jcpd.30.2.u025q822j424u5g6

✔ Koch, G., Poulsen, S., Espelid, I., & Haubek, D. (2017). Pediatric dentistry: A clinical approach (3rd ed.). Wiley Blackwell.

✔ Maragakis, G. M., Hahn, P., & Hellwig, E. (2001). Clinical evaluation of Carisolv® for removing carious dentin and effect on restorative materials and bonding. American Journal of Dentistry, 14(1), 58–60.

✔ Lussi, A., & Hellwig, E. (2019). Alternatives to drilling: Chemomechanical caries removal. In Mount, G. J., & Hume, W. R. (Eds.). Preservation and Restoration of Tooth Structure (3rd ed., pp. 95–104). Wiley-Blackwell.

📌 More Recommended Items

► Atraumatic Restorative Treatment - Step-by-step procedure manual
► Anterior dental esthetics in primary teeth - Oral Rehabilitation
► Medications for Pulp Capping in Primary Teeth: Indications, Composition, and Clinical Management

Medications for Pulp Capping in Primary Teeth: Indications, Composition, and Clinical Management

Pulp capping in primary teeth is a conservative procedure aimed at preserving pulp vitality following an accidental or intentional pulp exposure during caries removal.

📌 Recommended Article :

Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress

Its success largely depends on the material or medication used, which must be biocompatible, promote tissue repair, and provide an adequate marginal seal. With advances in biomaterials, the range of available products has expanded, making it essential to understand their properties, advantages, and limitations for proper clinical application.

Advertisement

✅ Main Medications Used

1. Calcium Hydroxide (Ca(OH)₂)

➤ Composition: Pure calcium hydroxide or formulated with hardening agents (e.g., Dycal®).
➤ Indications: Small pulp exposures without prolonged bleeding, in vital primary teeth.
➤ Advantages:
° Stimulates reparative dentin formation.
° Antibacterial properties.
° Easy to handle.
➤ Disadvantages:
° Soluble in oral fluids.
° Poor sealing ability.
° Fragile under mechanical stress.
➤ Handling: Apply a thin layer over the exposure, followed by a protective material such as resin-modified glass ionomer (RMGI).

📌 Recommended Article :

Video 🔽 Dental Treatment: Pediatric Vital Pulp Therapy - Webinar ... Good biocompatible materials are currently available to help us preserve dental pulp

2. Mineral Trioxide Aggregate (MTA)

➤ Composition: Calcium, silicate, and aluminum oxides. Commercial examples: ProRoot® MTA, MTA Angelus®.
➤ Indications: Direct pulp capping in vital pulps, small pulp perforations.
➤ Advantages:
° High biocompatibility.
° Excellent sealing ability.
° Stimulates dentin bridge formation.
➤ Disadvantages:
° High cost.
° Long setting time (~2–4 hours).
° Difficult to manipulate.
➤ Handling: Mix with sterile distilled water and apply over the pulp; allow complete setting before final restoration.

📌 Recommended Article :

Video 🔽 Pulp Cap and Pulpotomy in Pediatric Trauma Cases ... We share an interesting video that shows us how to perform a pulpotomy step by step, indicating the materials and the steps that we must follow

3. Biodentine®

➤ Composition: Calcium oxide, tricalcium silicate, zirconium oxide (radiopacifier).
➤ Indications: Modern alternative to MTA for direct pulp capping.
➤ Advantages:
° Faster setting time (~12 minutes).
° Biocompatible.
° Better mechanical properties than MTA.
➤ Disadvantages:
° High cost.
° May require training for proper handling.
➤ Handling: Applied directly to the exposure with a spatula, no intermediate layer needed.

📌 Recommended Article :

PDF 🔽 Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth ... The treatment will depend on the vitality of the pulp, in case it is a vital tooth, pulp capping and pulpotomy can be performed. In non-vital teeth, pulpectomies are performed

4. Zinc Oxide Eugenol (ZOE)

➤ Composition: Zinc oxide mixed with eugenol.
➤ Indications: Indirect pulp capping only (not for direct use) due to cytotoxicity risks.
➤ Advantages:
° Sedative effect on pulp tissue.
° Easy handling.
Disadvantages:
° Cytotoxic if in direct contact with the pulp.
° Inhibits polymerization of resin composites.
➤ Handling: Used as a base in deep cavities with no pulp exposure.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

5. Resin-Modified Glass Ionomer (RMGI)

➤ Composition: Polyalkenoic acid, fluoroaluminosilicate glass, hydrophilic resin (HEMA).
➤ Indications: Intermediate layer over medications like Ca(OH)₂ or MTA.
➤ Advantages:
° Excellent adhesion to dentin.
° Fluoride release.
° Good mechanical resistance.
➤ Disadvantages:
° Should not be used alone in direct contact with pulp.
➤ Handling: Apply with microbrush or spatula, light-cure, and proceed with final restoration.

📌 Recommended Article :

Dental Article 🔽 Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide ... This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use

💡 Conclusion
Choosing the appropriate medication for pulp capping in primary teeth should consider factors such as exposure size, pulp vitality, the material's ability to stimulate dentinogenesis, handling properties, and cost. While calcium hydroxide remains widely used, materials like MTA and Biodentine offer significant advantages in sealing ability and biocompatibility. Using an additional protective layer, such as RMGI, improves treatment longevity and reduces microleakage risk. Continuous education in modern biomaterials is essential for achieving predictable and successful outcomes in pediatric dentistry.

📚 References

✔ Aguilar, P., & Linsuwanont, P. (2011). Vital pulp therapy in vital permanent teeth with cariously exposed pulp: A systematic review. Journal of Endodontics, 37(5), 581–587. https://doi.org/10.1016/j.joen.2010.12.004

✔ Fuks, A. B. (2008). Vital pulp therapy with new materials for primary teeth: New directions and treatment perspectives. Journal of Endodontics, 34(7 Suppl), S18–S24. https://doi.org/10.1016/j.joen.2008.02.028

✔ Murray, P. E., García-Godoy, F., & Hargreaves, K. M. (2007). Regenerative endodontics: A review of current status and a call for action. Journal of Endodontics, 33(4), 377–390. https://doi.org/10.1016/j.joen.2006.09.013

✔ Nowicka, A., Lipski, M., Parafiniuk, M., Sporniak-Tutak, K., Lichota, D., Kosierkiewicz, A., … & Buczkowska-Radlińska, J. (2013). Response of human dental pulp capped with biodentine and mineral trioxide aggregate. Journal of Endodontics, 39(6), 743–747. https://doi.org/10.1016/j.joen.2013.01.005

✔ Rodd, H. D., Waterhouse, P. J., Fuks, A. B., Fayle, S. A., & Moffat, M. A. (2006). Pulp therapy for primary molars. International Journal of Paediatric Dentistry, 16(s1), 15–23. https://doi.org/10.1111/j.1365-263X.2006.00774.x

📌 More Recommended Items

► Atraumatic Restorative Treatment - Step-by-step procedure manual
► Severe early childhood caries: an integral approach
► Pulpotomy and pulpectomy procedures. ndications and Differences

Glass Ionomer Cement in Pediatric Dentistry: Benefits, Uses, and Step-by-Step Application Guide

Glass ionomer cement (GIC) is a widely used dental material in pediatric dentistry due to its strong adhesion, fluoride release, and biocompatibility.

📌 Recommended Article :

Video 🔽 Use of Silver Diamine Fluoride (SDF) - General Guide on its application ... It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment

This article explores its characteristics, advantages, disadvantages, clinical applications, and a step-by-step guide for proper use.

Advertisement

Characteristics of Glass Ionomer Cement
Glass ionomer cement consists of a powder and a liquid that, when mixed, form a rigid, adhesive matrix. The powder contains fluoroaluminosilicate glass, while the liquid consists of polyalkenoic acids in an aqueous solution. This composition enables chemical bonding to the tooth structure and sustained fluoride release, aiding in enamel remineralization and cavity prevention.

Benefits of Glass Ionomer Cement in Pediatric Dentistry
1. Fluoride Release: Provides long-term fluoride release, strengthening enamel and reducing the risk of cavities.
2. Chemical Adhesion: Bonds directly to enamel and dentin without the need for acid etching, simplifying clinical procedures.
3. Biocompatibility: Well-tolerated by dental and soft tissues, minimizing adverse reactions.
4. Thermal Expansion Similar to Natural Teeth: Reduces the risk of marginal leakage and ensures long-lasting adaptation.

📌 Recommended Article :

Video 🔽 Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages ... This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress

Disadvantages of Glass Ionomer Cement
1. Lower Mechanical Strength: Less resistant to wear and occlusal forces compared to composite resins.
2. Aesthetic Limitations: While improved, its translucency and color range may not fully match natural tooth appearance.
3. Moisture Sensitivity During Placement: Requires proper moisture control to prevent property alterations.

Uses of Glass Ionomer Cement in Pediatric Dentistry
° Restorations for Primary Teeth: Ideal for Class I, II, and V cavities in deciduous teeth due to its adhesion and fluoride release.
° Pit and Fissure Sealants: Used as a sealant in newly erupted permanent molars to prevent cavities.
° Liners and Bases: Serves as a protective base under restorations, providing thermal and chemical insulation.
° Cementation of Pediatric Crowns: Used for cementing stainless steel crowns on primary teeth.

📌 Recommended Article :

PDF 🔽 Severe early childhood caries: an integral approach ... Treatment will depend on the extent of the injuries and requires interdisciplinary management to achieve successful rehabilitation. In these cases the cooperation of the parents is necessary

Step-by-Step Application of Glass Ionomer Cement
1. Cavity Preparation: Remove decayed tissue and clean the cavity without overextending margins.
2. Conditioning: Apply 10% polyacrylic acid for 10-15 seconds to enhance adhesion, then rinse and gently dry without dehydrating.
3. Mixing the Material: Follow the manufacturer’s recommended powder-to-liquid ratio, mixing until a homogeneous consistency is achieved.
4. Placement: Apply the glass ionomer cement into the prepared cavity, ensuring proper adaptation and avoiding air bubbles.
5. Initial Setting: Allow the material to set according to manufacturer instructions while protecting it from moisture and desiccation.
6. Finishing and Polishing: Once set, refine the restoration, adjust occlusion, and polish for improved aesthetics and longevity.

Conclusion
Glass ionomer cement is a valuable material in pediatric dentistry due to its adhesive properties, fluoride release, and biocompatibility. While it has some limitations in mechanical strength and aesthetics, its benefits for cavity prevention and ease of use make it a preferred choice for various pediatric dental applications.

References
1. Croll, T. P., & Nicholson, J. W. (2002). Glass ionomer cements in pediatric dentistry: Review of the literature. Pediatric Dentistry, 24(5), 423-429. Recuperado de
2. Berg, J. H. (2002). Glass ionomer cements. Pediatric Dentistry, 24(5), 430-438. Recuperado de
3. Sikka, N., & Brizuela, M. (2024). Glass Ionomer Cement. En StatPearls. StatPearls Publishing

📌 More Recommended Items

► Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review
► How to Apply: Clinpro Sealant - Step by step
► What are the causes of white spots on teeth?

Use of Silver Diamine Fluoride (SDF) - General Guide on its application

Silver diamine fluoride (SDF) is a topical medicine that is used to stop the advance of caries and in cases of dentin hypersensitivity. It can be used in both primary and permanent dentition.

📌 Recommended Article:

Article PDF 🔽 Fluoride Varnish in the Prevention of Dental Caries in Children and Adolescents: A Systematic Review ... Fluoride varnish is easy to apply, offers greater absorption of minerals on the teeth, and is very safe, unlike other topical fluoride treatments (gels and rinses).

It offers several advantages such as its easy application, low cost, it avoids the use of dental anesthetics, and it can be applied in places that do not have dental equipment.

Advertisement

We share a complete guide on the benefits, advantages, and procedure for the application of Silver Diamino fluoride (SDF) in the treatment of cavities and dental sensitivity.

📌 More recommended items

► How to Apply: Clinpro Sealant - Step by step
► What are the causes of white spots on teeth?
► Fluoride varnish application in children

📌 Watch the video "The General Dentists Guide to Using Silver Diamine Fluoride"

Youtube/ Elevate Oral Care

Atraumatic Restorative Treatment - Indications, Advantages and Disadvantages

The atraumatic restorative treatment is a dental procedure that consists of removing the carious tissue but using manual instruments, and sealing the cavity with an adhesive material.

This technique is very useful when it is necessary to attend to oral health needs in hard-to-reach areas. The pediatric patient also generates less anxiety and stress.

Advertisement

We share a video where he talks about the advantages, indications and contraindications of atraumatic restorative treatment. We thank the YouTube channel, Dr. Teeth.

RECOMMENDED VIDEO
Atraumatic Restorative Treatment (ART) for dental caries : Step by step

You may also like :
► Atraumatic Restorative Treatment in Dentistry
► Anterior dental esthetics in primary teeth - Oral Rehabilitation
► Esthetic restoration of deciduous anterior teeth using prefabricated zirconia crowns: A case report

Source: Youtube / Dr. Teeth

Severe early childhood caries: an integral approach

It is considered early childhood caries, when the carious process affects one or more primary teeth in children under 06 years of age. This infection is of multifactorial etiology, transmissible and of rapid development.

Treatment will depend on the extent of the injuries and requires interdisciplinary management to achieve successful rehabilitation. In these cases the cooperation of the parents is necessary.

Enlaces Patrocinados

We share a comprehensive article that covers severe early childhood caries and the comprehensive approach recommended for these cases.

RECOMMENDED ARTICLE
ORAL REHABILITATION of a child with dentinogenesis imperfecta

👉 Read and download the full article in PDF👈

Losso EM, Tavares MC, Silva JY, Urban Cde A. Severe early childhood caries: an integral approach. J Pediatr (Rio J). 2009;85(4):295-300:

You may also like :
► Pharmacologic management for pediatric dental patients
► Atraumatic Restorative Treatment (ART) for dental caries : Step by step
► Oral characteristics of newborns - PDF

How well do fluoride treatments work at preventing tooth decay?

There is no doubt that prevention is the best way to avoid a number of diseases such as tooth decay. The recommendations for oral care are to brush your teeth daily, have a balanced diet and visit the dentist.

We invite you to our English-only dental publishing groups

🎯 WhatsApp Group All Odontology
🎯 Telegram Group All Odontology
🎯 Facebook Group All Odontology

In the dental office, procedures are performed that prevent the presence of cavities, such as the use of fluoride.

Advertisement

We share a video from the Osmosis channel that explains in detail the benefits of fluoride in preventing tooth decay.

RECOMMENDED VIDEO
Are dental x-rays safe? They are necessary?

You may also like :
► Why do Dentists take X-Rays?
► Do you need x ray for braces? Why?
► Radiographic Techniques for the Pediatric Patient

Source: Youtube/ Osmosis