Stainless Steel Crowns for Kids: When and Why They’re the Best Option

Stainless steel crowns (SSCs) are one of the most reliable restorations used in pediatric dentistry, especially for baby molars that have severe decay or have undergone pulp therapy.

📌 Recommended Article :

PDF 🔽 Hall technique: Complete information for the treatment of carious primary molars ... Steel crowns are used in pediatric dentistry when primary teeth are severely damaged by dental caries. They are usually placed after pulp treatment and in hypoplastic teeth

First introduced in the 1950s, they are still widely used because they are strong, affordable, and long-lasting—often outperforming white fillings in baby teeth.

Advertisement

✅ When Are Stainless Steel Crowns Used in Children?
Pediatric dentists commonly use SSCs when:

° A baby tooth has large cavities that can’t be fixed with a regular filling
° The tooth has been treated with a pulpotomy or pulpectomy
° The enamel is weak due to conditions like enamel hypoplasia or molar-incisor hypomineralization (MIH)
° The tooth has fractured due to trauma
° The child is at high risk of cavities or has special healthcare needs

📌 Recommended Article :

Video 🔽 Stainless Steel Crowns: Adaptation and installation - Step by step ... The video that we share teaches us everything related to steel crowns, advantages, disadvantages, and how to select the appropriate crown

✅ Benefits of Stainless Steel Crowns for Baby Teeth

° Long-lasting protection (often until the tooth naturally falls out)
° Full coverage and excellent seal against bacteria
° Quick and easy placement in a single visit
° Ideal for young children or those who have trouble cooperating
° Lower cost than most other restorative options

✅ How Pediatric Dentists Place a Stainless Steel Crown

1. Examine and diagnose the tooth
2. Choose the correct crown size
3. Reduce the biting surface and sides of the tooth
4. Try in the crown to ensure a proper fit
5. Cement it using glass ionomer cement
6. Check the bite and remove any excess cement

The entire process can often be done in one appointment, which is especially helpful for children with limited patience or dental anxiety.

📌 Recommended Article :

PDF 🔽 Stainless steel crowns: Minimally invasive technique - Benefits and advantages ... We share the benefits and advantages of stainless steel crowns in the restoration of primary teeth affected by advanced caries

✅ Why Not Just Do a Filling?

White fillings (composite) or silver fillings (amalgam) may work for small cavities, but they often fail in baby teeth with major decay. Stainless steel crowns are stronger, more protective, and have a much lower failure rate—especially when the child is at high risk for future cavities.
While some parents may prefer tooth-colored crowns, research shows that SSCs have a success rate of over 90%, even after several years. Esthetic crowns like zirconia are more expensive, and not always ideal for very young or uncooperative children.

💡 Conclusion

Stainless steel crowns remain the gold standard for restoring primary molars with major damage. They offer reliable, long-term protection, are cost-effective, and reduce the need for future dental work.
If your child needs treatment for a decayed or weakened baby tooth, talk to your pediatric dentist about whether a stainless steel crown is the right option. In many cases, it’s the best way to keep their smile healthy and pain-free until the adult teeth come in.

📌 Recommended Article :

PDF 🔽 Indications for Hall technique usage in pediatric dentistry ... The Hall technique is a minimally invasive technique that controls the progression of caries, making it a much simpler procedure with less preparation

📚 References

✔ American Academy of Pediatric Dentistry (AAPD). (2023). Clinical Practice Guidelines: Restorative Dentistry. Reference Manual, 45(6), 372–380. https://www.aapd.org/research/oral-health-policies--recommendations/

✔ Lynch, C. D., O'Sullivan, V. R., & McConnell, R. J. (2020). Success and survival of stainless steel crowns placed in primary molars: A systematic review and meta-analysis. International Journal of Paediatric Dentistry, 30(3), 212–222. https://doi.org/10.1111/ipd.12612

✔ Santos, J. M., Diniz, M. B., Oliveira, B. H., & Braga, M. M. (2021). Longevity of restorations in primary teeth: A systematic review and meta-analysis. Pediatric Dentistry, 43(1), 16–24. https://www.aapd.org

📌 More Recommended Items

► Step-by-step preparation of molars and primary incisors for Zirconia crowns
► Anterior dental esthetics in primary teeth - Oral Rehabilitation
► The Hall Technique: Manual for the management of primary molar caries

Risk Factors, Signs & Modern Management of Tongue Cancer: 2025 Review

Tongue cancer—primarily squamous cell carcinoma (SCC)—represents a significant portion of head and neck malignancies. Although relatively rare (less than 1 % of new cancer cases), its incidence is rising among younger, non‑smoking populations .

📌 Recommended Article :

Video 🔽 Top 10 Mouth Cancer Symptoms ... The early detection of cancer ensures a better recovery and success of the treatment, for that we must know the warning signs and the changes that happen in our mouth

This review synthesizes risk factors, clinical presentation, diagnostic pathways, treatment modalities, and preventive strategies over the past six years.

Advertisement

✅ Risk Factors

° Tobacco smoking and smokeless tobacco: Primary risk factor; smoking increases risk 3–6× and smokeless forms similarly elevate risk.
° Alcohol consumption: Heavy alcohol use independently increases risk (~20 % of oral cancers), synergizes with tobacco to cause ~72 % of head and neck cancers.
° HPV infection: High-risk strains (HPV‑16/18) are strongly linked to base‑of‑tongue SCC; rising HPV-driven oropharyngeal cancers.
° Betel nut and paan chewing: Doubles oral cancer risk even without tobacco, contributing up to 40 % of cases in endemic regions.
° Chronic inflammation and oral dysbiosis: Emerging research links chronic oral irritation/infections with oxidative stress and carcinogenesis.
° Non-modifiable factors: Includes age (≥ 40), male sex (2× risk), race (higher in African‑American men), family or personal cancer history.

📌 Recommended Article :

Video 🔽 How to identify the early signs of oral cancer ... Like all cancer, it is important to take into account all the signs of its presence to avoid its spread, and that is the reason for this video

✅ Signs & Symptoms

° Non-healing ulcers or sores, red/white patches (erythroplakia, leukoplakia).
° Lumps or thickening on tongue; easy bleeding.
° Pain, burning, numbness, or discomfort in mouth/jaw .
° Functional issues: difficulty chewing, swallowing, speaking; ear, throat, or jaw pain; loose teeth .
° Late-stage signs: neck lymphadenopathy, weight loss, bleeding, voice changes.

✅ Diagnosis

° Clinical exam: Visual and manual inspection, mirror or endoscopic (nasendoscopy) evaluation.
° Biopsy & histopathology: Essential for definitive diagnosis. HPV testing often included.
° Imaging: CT, MRI, ultrasound, PET‑CT to assess tumor extent and lymph node involvement.

📌 Recommended Article :

Video 🔽 The Importance of Dental Health During Cancer Treatment ... Knowledge is our best prevention weapon, that's why we share an interesting article that explains in detail the complications that can occur during cancer treatment and how we can prevent it

✅ Treatment

° Surgery: Primary for early-stage disease; transoral resections for oral tongue; neck dissection as needed.
° Radiation therapy: Often adjuvant post-surgery or primary modality for advanced/inoperable cases.
° Chemotherapy & chemoradiation: Platinum-based regimens, especially for HPV-negative or bulky disease .
° Targeted therapies & immunotherapy: Emerging modalities; microenvironment-targeted immunotherapy under study.
° Supportive care: Speech/swallow rehabilitation, nutritional support to manage side effects.

✅ Prevention

° Smoking cessation and reduced alcohol intake are the most effective strategies.
° HPV vaccination (recommended through age 45) may reduce HPV-driven tongue cancer.
° Avoid betel nut/paan; improve oral hygiene and diet (fruit/vegetable intake).
° Regular dental/oral screenings with prompt evaluation of lesions persisting >2–3 weeks .

📌 Recommended Article :

Video 🔽 What are Oral Potentially Malignant Disorders? ... Early detection is recommended in these cases, in this way we prevent neoplasms from developing and increase the possibility of successful treatment

💬 Discussion

Recent epidemiological trends indicate an increase in tongue cancer among young, non-smoking individuals, highlighting the growing importance of HPV and alternative risk factors. Concurrently, advancements in diagnostic imaging, minimally invasive surgical techniques, and immunotherapies offer improved outcomes and functional preservation. However, challenges persist: late-stage presentation, therapy-related toxicity, and disparities in access to HPV vaccination and specialist care.

💡 Conclusion

Tongue cancer is a multifactorial disease shaped by lifestyle, viral, environmental, and biological determinants. Contemporary understanding underscores the interplay of traditional risks—tobacco and alcohol—with newer drivers like HPV, chronic inflammation, and betel nut use. Early detection and a multidisciplinary treatment approach remain paramount. Preventive measures, especially smoking cessation, alcohol reduction, and HPV vaccination, are critical for reducing incidence.

📚 References

✔ American Cancer Society. (2021). Risk Factors for Oral Cavity and Oropharyngeal Cancers. Retrieved from American Cancer Society website.

✔ Cleveland Clinic. (2023). Tongue cancer: symptoms, causes & treatment. Cleveland Clinic.

✔ Mayo Clinic Staff. (2025, November). Tongue cancer: symptoms and causes. Mayo Clinic.

✔ Current trends on prevalence, risk factors and prevention of oral... Frontiers in Oral Health, 2024.

✔ Exploration Pub. (2024). Risk factors, prevention, diagnosis, and immunotherapy’s role in oral cancer.

✔ Verywell Health. (2024, April 22). Tongue Cancer: Everything You Need to Know.

✔ New York Post. (2025, May). Top Chef alum Shirley Chung cancer update.

📌 More Recommended Items

► Warning signs of oral cancer - Identify and recognize the symptoms and lesions
► Oral cancer: Risk factors, management, procedures and types of treatment
► Why did oral HPV cases increase in men?

Common Complications of Dental Implants: Diagnosis and Treatment Guide

Dental implants have become the gold standard for replacing missing teeth due to their high success rate and ability to restore function and aesthetics. However, like any surgical procedure, implant placement is not free of complications.

📌 Recommended Article :

Video 🔽 Prevention of peri-implantitis - 3D Video ... In initial stages, inflammation occurs without compromising the bone. This process is called peri-implant mucositis. When the disease progresses it takes the name of peri-implantitis

Understanding the nature of these complications—ranging from peri-implant diseases to mechanical failures—is crucial for timely diagnosis and appropriate management. This article reviews the most common problems associated with dental implants, including their definitions, clinical characteristics, diagnostic strategies, and current treatment options.

Advertisement

✅ 1. Peri-Implant Mucositis

➤ Definition:
° Peri-implant mucositis is a reversible inflammatory reaction of the soft tissues surrounding a dental implant without accompanying bone loss.
➤ Clinical Features:
° Redness and swelling of peri-implant mucosa
° Bleeding on probing (BOP)
° No radiographic bone loss
° Patient may report mild discomfort or sensitivity
➤ Diagnosis:
° Probing depth measurement
° Presence of BOP
° Radiographs confirm absence of bone loss
° Exclusion of other causes such as food impaction or residual cement
➤ Treatment:
° Mechanical debridement with plastic or titanium curettes
° Antimicrobial mouth rinses (e.g., chlorhexidine)
° Improved patient oral hygiene
° Re-evaluation after 2–4 weeks

📌 Recommended Article :

Video 🔽 Dental implant: What complications can there be after surgery? ... Some complications may be relatively minor and easy to correct, while others will be greater and will cause loss of the implant or prosthesis

✅ 2. Peri-Implantitis

➤ Definition:
° Peri-implantitis is a progressive inflammatory disease affecting both the soft and hard tissues around an osseointegrated implant, leading to bone loss.
➤ Clinical Features:
° BOP and/or suppuration
° Increased probing depth (>5 mm)
° Progressive radiographic bone loss
° Possible implant mobility in advanced cases
➤ Diagnosis:
° Periodontal charting (baseline comparison)
° Radiographic bone level analysis
° Microbial analysis in severe or refractory cases
➤ Treatment:
° Mechanical debridement and antiseptic therapy
° Local or systemic antibiotics (e.g., amoxicillin + metronidazole)
° Surgical intervention (e.g., resective or regenerative surgery)
° Implant surface decontamination with lasers or air abrasives

📌 Recommended Article :

Video 🔽 What's the Difference Between Dental Implants and Bridges? ... A correct evaluation by the dentist ensures a good rehabilitation, the most important thing is that we leave the dental office with a nice smile

✅ 3. Implant Failure (Early and Late)

➤ Definition:
° Implant failure is classified as early (before osseointegration) or late (after functional loading), resulting in implant mobility or loss.
➤ Clinical Features:
° Pain or discomfort on function
° Mobility of implant
° Radiographic evidence of peri-implant radiolucency
° Soft tissue inflammation
➤ Diagnosis:
° Clinical mobility testing
° Percussion and tactile evaluation
° Radiographs to assess integration and bone levels
➤ Treatment:
° Removal of failed implant
° Management of infection or bone defects
° Possible delayed or immediate re-implantation depending on case

📌 Recommended Article :

Dental Article 🔽 Step-by-Step Dental Implants: A Guide for Patients ... This comprehensive guide provides information based on certified and verifiable sources, aimed at patients considering this treatment

✅ 4. Mechanical Complications

a. Screw Loosening or Fracture
➤ Definition:
° Mechanical dislodgment or breakage of abutment or prosthetic screws.
➤ Clinical Features:
° Mobility of crown or prosthesis
° Clicking or instability during function
° Possible pain or soft tissue trauma
➤ Diagnosis:
° Clinical inspection
° Radiographs to detect screw fracture or misfit
➤ Treatment:
° Retightening or replacement of screws
° Use of torque-controlled drivers
° Avoidance of occlusal overload

b. Prosthetic Fracture (e.g., Crown or Bridge)
➤ Definition:
° Fracture of the prosthetic components due to stress, fatigue, or poor design.
➤ Clinical Features:
° Fractured ceramic or acrylic visible
° Aesthetic compromise
° Patient may report altered bite or discomfort
➤ Diagnosis:
° Clinical examination
° Assessment of occlusal forces and design flaws
➤ Treatment:
° Repair or replacement of prosthesis
° Occlusal adjustment
° Use of more durable materials (e.g., zirconia)

📌 Recommended Article :

Video 🔽 Patient Prevention: Dental Implant Failures ... The patient must be informed before performing the surgery, about the care they should have after the surgical procedure, regarding their diet and hygiene, thus avoiding serious consequences

✅ 5. Neurological Complications

➤ Definition:
° Nerve injury typically occurs during implant placement in the mandibular region, resulting in temporary or permanent paresthesia.
➤ Clinical Features:
° Numbness or tingling of lower lip, chin, or tongue
° Burning sensation
° Pain or discomfort during healing
➤ Diagnosis:
° Clinical sensory testing (light touch, pinprick)
° Radiographic assessment of implant proximity to nerve canal
° Cone beam computed tomography (CBCT) if needed
➤ Treatment:
° Immediate implant removal if impingement is suspected
° Corticosteroids to reduce inflammation
° Referral to a neurologist for persistent symptoms

📌 Recommended Article :

Video 🔽 What is Peri-implantitis and how do we prevent it? 3D video ... Among the risk factors for the presence of peri-implantitis we can name: bacterial microbiology, occlusal overload, poor oral hygiene, smoking, gum condition

💬 Discussion
Dental implant complications can significantly impact treatment outcomes and patient satisfaction. Peri-implant diseases, including mucositis and peri-implantitis, are among the most common biological complications and share many features with periodontal diseases. Mechanical and neurological complications, although less frequent, require early recognition and targeted management. Preventive strategies such as accurate surgical planning, patient education, and regular maintenance therapy play a vital role in minimizing the occurrence of complications.

💡 Conclusion
While dental implants are highly predictable, complications—both biological and mechanical—can arise. Timely identification and management based on clinical and radiographic findings are essential for preserving implant function and health. Clinicians must stay updated on the latest diagnostic protocols and treatment strategies to ensure long-term success and patient safety.

📚 References

✔ Lang, N. P., Berglundh, T., & Working Group 4 of the Seventh European Workshop on Periodontology. (2011). Periimplant diseases: Where are we now? – Consensus of the Seventh European Workshop on Periodontology. Journal of Clinical Periodontology, 38(s11), 178–181. https://doi.org/10.1111/j.1600-051X.2010.01674.x

✔ Heitz-Mayfield, L. J., & Mombelli, A. (2014). The therapy of peri-implantitis: A systematic review. The International Journal of Oral & Maxillofacial Implants, 29(Suppl), 325–345. https://doi.org/10.11607/jomi.2014suppl.g5.3

✔ Esposito, M., Hirsch, J. M., Lekholm, U., & Thomsen, P. (1998). Biological factors contributing to failures of osseointegrated oral implants. (I). Success criteria and epidemiology. European Journal of Oral Sciences, 106(1), 527–551. https://doi.org/10.1046/j.0909-8836.1998.eos106111.x

✔ Misch, C. E. (2020). Dental Implant Prosthetics (3rd ed.). Mosby.

📌 More Recommended Items

► Dental Bridges: Step by Step Procedure
► What are the pros and cons of flexible dentures?
► Oral lesions related to dentures

Updated Guidelines for Antibiotic Use in Pediatric Dentistry: Evidence-Based Recommendations

The judicious use of antibiotics in pediatric dentistry is crucial to combat antimicrobial resistance and ensure optimal patient outcomes. Overprescription and inappropriate antibiotic use in children contribute to the global health threat of antibiotic resistance, adverse drug reactions, and disruption of normal microbiota.

📌 Recommended Article :

PDF 🔽 Antimicrobial therapies for odontogenic infections in children and adolescents ... The use of antibiotics must be rational to avoid drug resistance of microorganisms (microbial resistance). Odontogenic infections can arise from caries or a periodontal problem, sometimes they can be due to dental trauma or iatrogenesis

This article discusses updated, evidence-based guidelines for antibiotic use in pediatric dental care, focusing on clinical indications, dosage, and the importance of antimicrobial stewardship.

Advertisement

✅ Indications for Antibiotic Use in Pediatric Dentistry
According to the American Academy of Pediatric Dentistry (AAPD) and other professional bodies, antibiotics should be prescribed in pediatric patients only when there is clear evidence of systemic involvement or the risk of spread of odontogenic infections. The primary indications include:

° Acute facial swelling or cellulitis with systemic symptoms (fever, malaise)
° Rapidly progressing infections such as Ludwig’s angina or deep space infections
° Persistent infections not resolved by local measures alone
° Prophylaxis in patients at risk of infective endocarditis or with immunocompromising conditions

Local dental infections like localized abscesses or pulpitis do not typically require systemic antibiotics and are best managed by definitive dental treatment such as extraction or pulpectomy.

📌 Recommended Article :

PDF 🔽 Dental pain in pediatric dentistry - Assessment tools ... We share an article that reviews the important aspects of pain in pediatric dentistry, and the tools for a correct evaluation today

✅ Commonly Recommended Antibiotics and Dosage
For pediatric patients, the most frequently recommended antibiotics are:

° Amoxicillin: 20–40 mg/kg/day divided every 8 hours, or 25–45 mg/kg/day if given twice daily
° Amoxicillin with Clavulanic Acid: Used when beta-lactamase resistance is suspected
° Clindamycin: 8–20 mg/kg/day in three divided doses (for penicillin-allergic patients)
° Azithromycin: 5–12 mg/kg on the first day followed by lower doses over 4 days

Prescribers must adjust dosages based on weight and age and consider the patient’s medical history, including allergies and hepatic or renal function.

📌 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

✅ Antibiotic Prophylaxis
The AAPD, following the American Heart Association (AHA) guidelines, recommends antibiotic prophylaxis for pediatric patients at high risk of infective endocarditis, especially before procedures likely to cause bleeding (e.g., tooth extractions, periodontal surgery). This includes:

° Children with prosthetic heart valves
° Previous infective endocarditis
° Certain congenital heart conditions
° Cardiac transplant recipients with valvulopathy

The standard prophylactic regimen is amoxicillin 50 mg/kg orally one hour before the procedure.

📌 Recommended Article :

Dental Article 🔽 Severe Dental Infections: Symptoms, Treatment & Antibiotics ... Always consider patient-specific factors, such as age, weight, and allergy history, when selecting an antibiotic

💬 Discussion
Despite clear guidelines, studies reveal frequent antibiotic overprescription in pediatric dentistry. A cross-sectional study by Al-Jundi et al. (2022) indicated that many dentists prescribe antibiotics for non-indicated conditions such as reversible pulpitis, primarily due to parental expectations or time constraints. This inappropriate practice fosters resistance and increases adverse drug reactions, including gastrointestinal issues, allergic reactions, and alterations in the child’s developing microbiome.
Moreover, the COVID-19 pandemic initially led to increased remote consultations and a spike in empirical antibiotic prescriptions, further underscoring the need for robust antimicrobial stewardship programs in dental settings.
Educational interventions, integration of prescribing guidelines into electronic health systems, and continuing professional development can help reduce inappropriate prescribing practices. Collaborative efforts between pediatricians, pharmacists, and pediatric dentists are also essential.

📌 Recommended Article :

PDF/Video 🔽 How to manage dental infections? - Specific pharmacological treatment ... Let us know the causative agents of odontogenic infections and the clinical management and specific pharmacological treatment for each of them

💡 Conclusion
Antibiotic use in pediatric dentistry should be reserved for cases with systemic involvement or significant risk of progression. Adherence to updated, evidence-based guidelines is critical to minimizing resistance and ensuring patient safety. Dental professionals must prioritize definitive treatment over pharmacologic management when possible and engage in continuous education to refine prescribing practices.

📚 References

✔ Al-Jundi, S. H., Mahmoud, S. Y., & Alsafadi, Y. H. (2022). Antibiotic prescribing practices among pediatric dentists in Jordan: A cross-sectional survey. BMC Oral Health, 22(1), 105. https://doi.org/10.1186/s12903-022-02156-3

✔ American Academy of Pediatric Dentistry. (2023). Guideline on Use of Antibiotic Therapy for Pediatric Dental Patients. Retrieved from https://www.aapd.org/research/oral-health-policies--recommendations/antibiotic-therapy/

✔ Wilson, W., Taubert, K. A., Gewitz, M., Lockhart, P. B., Baddour, L. M., Levison, M., ... & Baltimore, R. S. (2007). Prevention of infective endocarditis: guidelines from the American Heart Association. Circulation, 116(15), 1736–1754. https://doi.org/10.1161/CIRCULATIONAHA.106.183095

📌 More Recommended Items

► Antibiotics in dental infections in children. Which one to use?
► Update on antibiotic prophylaxis in pediatric patients
► Antibiotics and its use in pediatric dentistry: A review

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

Pulpotec® in Pulpotomy: Composition, Indications, Protocol & Clinical Pros and Cons

Pulpotec® is a radiopaque, non‑resorbable medicament widely used for pulpotomy/pulpitis treatment in vital primary and immature permanent molars, as well as for emergency root canal dressings.

📌 Recommended Article :

PDF 🔽 Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy ... The goal of management of endodontic emergencies is to quickly and effectively manage pain and infections thereby also minimizing the development of persistent pain and the formation of periapical pathology

This in-depth article reviews its composition, clinical indications, advantages, disadvantages, and a standardized application protocol. Information is supported by recent clinical evidence.

Advertisement

✅ 1. Composition
Pulpotec® is a two-part resinous paste comprising:

➤ Powder: polyoxymethylene, iodoform, and zinc oxide.
➤ Liquid: dexamethasone acetate, formaldehyde, phenol, guaiacol, and excipients.

These components combine to yield antimicrobial, anti-inflammatory, hemostatic, and soothing effects.

✅ 2. Indications
Pulpotec® demonstrates broad clinical applications:

➤ Primary molars: vital or mildly infected, including cases with abscess when pulpotomy is indicated.
➤ Immature permanent molars: to facilitate continued root development.
➤ Permanent molars in adults: pulpitis treatment or as a prep for abutments in prosthetics.

It is also effective in emergency intracanal dressings to relieve pain and swelling across multiple appointments.

📌 Recommended Article :

Video 🔽 Technique for Primary Molar Tooth Pulpotomy ... Pulpotomy is a treatment performed on deciduous teeth, when caries has generated an infection that compromises the dental pulp and the integrity of the tooth

✅ 3. Advantages
Clinical studies support Pulpotec® due to its:

➤ High success rates: Clinical success of 93–100% and radiographic success of 83–100% in pulpotomies; compared favorably with MTA and formocresol.
➤ Rapid symptom relief: 80–100% of patients report immediate pain reduction; flare-ups post-op are rare (~1%).
➤ Ease of use and efficiency: Simplifies emergency endodontic treatment and supports long-term pulp health.

✅ 4. Disadvantages
Potential drawbacks include:

➤ Non‑resorbability: This may complicate exfoliation in primary molars.
➤ Formaldehyde content: Concerns over toxicity and rare allergic reactions.
➤ Limited histological regeneration: It promotes sclerosis rather than dentin bridge formation.
➤ Need for coronal seal: Success depends on proper restoration to prevent microleakage.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... Pulpectomy is performed when there is an infectious process (fistula or abscess), chronic inflammation, or pulp necrosis

✅ 5. Step-by-Step Clinical Use Protocol

Step 1. Diagnose pulpitis suitable for vital pulp therapy.
Step 2. Anesthetize and isolate the tooth (rubber dam recommended).
Step 3. Access and remove coronal pulp to canal orifice level.
Step 4. Irrigate with 5% NaOCl; dry chamber.
Step 5. Prepare a salin-damped sterile cotton pellet; confirm bleeding control.
Step 6. Insert Pulpotec® paste into chamber (or canal up to ~5 mm from apex in root-filled cases) using a file.
Step 7. Place a dry cotton pellet and temporary restorative material (e.g., IRM/Cavit).
Step 8. Schedule recall after 7 days; proceed to definitive restoration—ideally stainless steel crown or adhesive restoration.
Step 9. Evaluate post-op pain at intervals (8 h, 24 h, 48 h, 3 d, 1 wk).

📌 Recommended Article :

Video 🔽 Dental Treatment: Vital Pulp Therapy for Primary Teeth ... The anatomical characteristics of primary teeth are different from permanent teeth. It is important to know these differences when performing any dental procedure

✅ 6. Clinical Evidence

➤ Prospective RCT (860 teeth): Pulpotec® intracanal dressing reduced incidence of inter-appointment flare-up to 1.16% at 24 h and 0.69% at 48 h, with complete pain relief by 7 days.
➤ Comparative pediatric studies:
° Pulpotec® and MTA showed 100% clinical success at 3–9 months; radiographic success favored Pulpotec® (100%) over MTA (92.9%) and formocresol (78.6%).
° At 24 months, radiographic success was 94.3% for Pulpotec®, 91.2% for MTA, 83.3% for formocresolile cotton pellet; confirm bleeding control.

💡 Conclusion
Pulpotec® is an effective and efficient pulpotomy and intracanal medicament providing high clinical and radiographic success, rapid pain relief, and broad indications. However, formaldehyde content and non-resorbability in primary teeth demand careful case selection and precise restoration. Clinicians should weigh its benefits and limitations against alternatives such as MTA or Biodentine.

📚 References

✔ Al-Dahan, Z. A. A., Zwain, A. M., & Haidar, A. (2013). Clinical and radiographical evaluation of pulpotomy in primary molars treated with Pulpotec®, Formocresol, and Mineral Trioxide Aggregate (MTA). Journal of Bagh College Dentistry, 25(4), 164–170.

✔ Faraj, B. M. (2013). Four years of clinical experience with the efficacy of Pulpotec® as a root canal dressing for the management and control of odontogenic pain: A prospective randomized clinical trial. Open Access Emergency Medicine, 12(4), 280–283.

✔ Karrem, M. A. (2012). Clinical and histopathological evaluation of different pulpotomy agents in primary teeth. Iraqi Academic Scientific Journal.

✔ Maslak, E. E., et al. (2020). Pulpotomy efficiency in primary molars: Outcomes of 24‑month randomized clinical trial. Tanta Dental Journal, 17(1), 9–14.

✔ Pulpotec®. (n.d.). Scientific data about Pulpotec® – Swiss solution for pulpotomy. Retrieved from pd-pulpotec.com

✔ Sandhu, S. S., & Nanda, S. (2013). Dental pulp response to collagen and Pulpotec cement. Journal of Conservative Dentistry, PMC3778626.

📌 More Recommended Items

► Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials
► Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth
► Pulpotomy and pulpectomy procedures. Indications and Differences

Oral Manifestations of STDs: Diagnosis, Signs, and Dental Management

Sexually transmitted diseases (STDs) remain a global health concern. Several infections, including syphilis, HIV, herpes simplex virus (HSV), gonorrhea, and human papillomavirus (HPV), present oral signs that may be the first indication of systemic illness.

📌 Recommended Article :

PDF 🔽 Guide for the surgical management and oral pathology of the pediatric patient ... Some of the pathologies that we can frequently find in children that need surgical procedures are: supernumerary and impacted teeth, congenital cysts, mucoceles

Dentists are in a unique position to detect and refer these cases early.

Advertisement

✅ Diagnosis in dental practice
A thorough medical and sexual history should be taken. Diagnostic tools include:

° Biopsy and exfoliative cytology
° PCR testing for viral identification (HPV, HSV)
° Serologic testing (VDRL, ELISA, Western Blot)
° Referral to specialists for confirmatory diagnosis

📌 Recommended Article :

PDF 🔽 Mouth Breathing: Its Consequences, Diagnosis & Treatment ... Mouth breathing has serious consequences for craniofacial and occlusive development. Mouth breathing patients have a longer face, this is due to the functional adaptation of breathing

✅ Common oral manifestations of STDs

✅ Dental management
A thoughtful and professional approach is essential when treating patients with oral manifestations of STDs. Management includes:

1. Thorough clinical examination:
° Detailed intraoral inspection to identify ulcers, warts, vesicles, leukoplakia, or other lesions.
° Clinical photography (with consent) for documentation and follow-up.
2. Detailed medical history:
° Focus on systemic conditions, sexual history, and risk behaviors (e.g., smoking, drug use, multiple partners).
3. Symptomatic management:
° Topical anesthetics or systemic analgesics for pain.
° Antiviral therapy (e.g., Acyclovir, Valacyclovir) for herpes infections.
° Systemic antibiotics for bacterial STDs (e.g., syphilis or gonorrhea)—in coordination with medical treatment.
° Antifungal therapy for HIV-related oral candidiasis (e.g., Nystatin, Fluconazole).
4. Patient education and counseling:
° Clarify the link between STDs and oral health.
° Promote safer sex practices and regular testing.
° Encourage communication with physicians and follow-up care.
5. Referral and interdisciplinary care:
° Timely referral to infectious disease specialists or physicians.
° Collaboration with medical teams for systemic management.

📌 Recommended Article :

Video 🔽 How is oral health affected by diabetes? ... It is important that the dentist instruct the patient on the best brushing technique and also motivate the patient to attend their hygiene checks continuously, in this way the consequences of the disease can be prevented

✅ Basic biosafety protocols in dental practice
To ensure safety for both dental personnel and patients, the following standard precautions must be implemented:

➤ Personal Protective Equipment (PPE):
° Gloves, surgical mask or N95 respirator (if aerosol is generated), protective eyewear, and disposable gowns.
➤ Strict hand hygiene:
° Follow the WHO's five moments of hand hygiene protocol before and after patient contact.
➤ Surface and instrument sterilization:
° Proper cleaning and disinfection of all equipment and environmental surfaces between patients.
➤ Aerosol minimization:
° Use low-speed instruments or hand techniques when possible, especially with active lesions or immunocompromised patients.
➤ Biological waste management:
° Proper segregation and disposal of contaminated materials per regulations.
➤ Informed consent:
° Secure written consent before biopsy, photo documentation, or referral procedures.

📌 Recommended Article :

Video 🔽 Risk of gum disease for smokers ... In conclusion, the job of the dentist is not only to treat periodontal disease, but also to influence the patient to stop smoking

💡 Conclusion
Oral signs may be the first or only indication of STDs. Dentists must stay updated on their recognition and management to improve public health outcomes through early diagnosis and referral.

📚 References

✔ Fatahzadeh, M., & Schwartz, R. A. (2007). Human herpes simplex virus infections: epidemiology, pathogenesis, symptomatology, diagnosis, and management. Journal of the American Academy of Dermatology, 57(5), 737–763. https://doi.org/10.1016/j.jaad.2007.06.020

✔ Neville, B. W., Damm, D. D., Allen, C. M., & Chi, A. C. (2015). Oral and Maxillofacial Pathology (4th ed.). Elsevier Health Sciences.

✔ Centers for Disease Control and Prevention (CDC). (2023). Sexually Transmitted Infections Treatment Guidelines. https://www.cdc.gov/std/treatment-guidelines/default.htm

✔ Reznik, D. A. (2006). Oral manifestations of HIV disease. Topics in HIV Medicine, 14(5), 143–148. https://pubmed.ncbi.nlm.nih.gov/17133174/

📌 More Recommended Items

► Why did oral HPV cases increase in men?
► How does hypertension affect oral health?
► Top 10 Mouth Cancer Symptoms

Updated Criteria for the Selection of Antibiotic Dosage and Regimen in Dentistry

Antibiotic therapy in dentistry is essential for preventing and treating infections resulting from dental procedures.

📌 Recommended Article :

PDF 🔽 Antibiotics and its use in pediatric dentistry: A review ... Antibiotics are commonly used in dentistry for prophylactic as well as for therapeutic purposes. Very often antibiotics are used in unwarranted situations, which may give rise to resistant bacterial strains

Correct selection of antibiotic dosage and regimen not only ensures therapeutic efficacy but also minimizes the risk of developing bacterial resistance and adverse effects.

Advertisement

✅ A. Determining Factors in Antibiotic Selection

1. Identification of the Etiological Agent
Odontogenic infections are often polymicrobial, predominantly involving anaerobic and gram-positive aerobic bacteria. Precise identification of the causative agent allows for the selection of an antibiotic with an appropriate spectrum. However, due to the difficulty in isolating and culturing these microorganisms in daily practice, empirical selection based on local epidemiology and the nature of the infection is common.

2. Antibiotic Spectrum
The chosen antibiotic should be effective against the most common pathogens in odontogenic infections. For example, amoxicillin is effective against a wide range of gram-positive bacteria and some gram-negative ones, while clindamycin is preferred in patients allergic to penicillins due to its activity against anaerobes and gram-positive aerobes.

3. Pharmacokinetics and Pharmacodynamics
Understanding the absorption, distribution, metabolism, and excretion of the antibiotic is crucial for determining the dosage and frequency of administration. For instance, amoxicillin has good oral bioavailability and a half-life that allows for administration every 8 hours. Clindamycin, on the other hand, requires administration every 6 to 8 hours due to its shorter half-life.

4. Patient's Condition
The patient's systemic conditions, such as renal or hepatic insufficiency, can affect drug elimination, requiring dosage adjustments. Additionally, in immunocompromised patients, more aggressive or prolonged treatment may be necessary.

5. Possible Interactions and Adverse Effects
It is essential to consider drug interactions, especially in polymedicated patients. For example, erythromycin can interact with other drugs metabolized by the cytochrome P450 system, increasing the risk of toxicity. Moreover, some antibiotics can cause gastrointestinal adverse effects or allergic reactions that must be monitored.

📌 Recommended Article :

PDF 🔽 Dental pain in pediatric dentistry - Assessment tools ... We share an article that reviews the important aspects of pain in pediatric dentistry, and the tools for a correct evaluation today

✅ B. Dosage and Regimen of Common Antibiotics in Dentistry
Below are the dosage and regimen recommendations for the most commonly used antibiotics in dentistry, based on clinical guidelines and recent studies:

1. Amoxicillin
° Indications: Common odontogenic infections.
° Adult dosage: 500 mg orally every 8 hours.
° Pediatric dosage: 20–40 mg/kg/day divided into three doses.
° Considerations: In severe infections, the dose may be increased to 1 g every 8 hours. Dosage adjustment is recommended in patients with renal insufficiency.

2. Amoxicillin/Clavulanic Acid
° Indications: Resistant infections or when beta-lactamase-producing bacteria are suspected.
° Adult dosage: 875 mg/125 mg orally every 12 hours.
° Pediatric dosage: 25–45 mg/kg/day divided into two doses.
° Considerations: The combination with clavulanic acid broadens amoxicillin's spectrum but may increase the incidence of gastrointestinal effects.

3. Clindamycin
° Indications: Patients allergic to penicillins; infections by anaerobes.
° Adult dosage: 300 mg orally every 6–8 hours.
° Pediatric dosage: 8–20 mg/kg/day divided into three or four doses.
° Considerations: Monitor for gastrointestinal side effects and the risk of pseudomembranous colitis.

4. Azithromycin
° Indications: Patients allergic to penicillins; infections by susceptible bacteria.
° Adult dosage: 500 mg once daily for three days.
° Pediatric dosage: 10 mg/kg once daily for three days.
° Considerations: Has a prolonged half-life, allowing for simplified dosing regimens.

📌 Recommended Article :

PDF 🔽 Antimicrobial therapies for odontogenic infections in children and adolescents ... We share a literature review that establishes guidelines for antimicrobial therapy in infections of odontogenic origin and clinical recommendations

✅ C. Conclusions on the Selection of Antibiotic Dosage and Regimen in Dentistry

1. Evidence-Based Selection: The choice of antibiotics in dentistry should be based on the identification of the etiological agent, appropriate antibiotic spectrum, and updated clinical guidelines to ensure efficacy and safety in treating odontogenic infections.
2. Importance of Pharmacokinetics and Pharmacodynamics: Dosage and regimen should be adjusted considering the drug's absorption, metabolism, and excretion, as well as the patient's systemic condition, to avoid overdosing or bacterial resistance.
3. First-Line Antibiotics and Alternatives: Amoxicillin remains the antibiotic of choice for common dental infections, while clindamycin and azithromycin are safe options for patients with penicillin allergies.
4. Avoiding Antibiotic Abuse and Resistance: Empirical prescription should be prudent, considering the increasing bacterial resistance and the impact of indiscriminate antibiotic use on oral and general microbiota.
5. Individualized Treatment: Each patient should receive personalized antibiotic therapy, taking into account their clinical history, drug interactions, and potential adverse effects to optimize therapeutic response and reduce complications.

In conclusion, the rational use of antibiotics in dentistry is essential for effective infection treatment, minimizing risks, and contributing to the fight against microbial resistance.

📚 References

✔ Bascones Martínez, A., Aguirre Urizar, J. M., Bermejo Fenoll, A., Blanco Carrión, A., Gay Escoda, C., González Moles, M. Á., ... & Llamas Martín, R. (2006). Documento de consenso sobre la utilización de profilaxis antibiótica en cirugía y procedimientos dentales. Avances en Odontoestomatología, 22(1), 43-53.

📌 More Recommended Items

► Update on antibiotic prophylaxis in pediatric patients
► Pharmacological treatment of oral infections in pediatric dentistry - Recommendations and dose calculation
► Severe Dental Infections: Symptoms, Treatment & Antibiotics

Medications Used in Pulpotomies: Properties, Drawbacks, and Brand Names

Pulpotomy is a conservative dental procedure aimed at preserving the vitality of the radicular pulp after removing the affected coronal pulp. This treatment is common in primary teeth and young permanent teeth.

📌 Recommended Article :

PDF 🔽 Management of Endodontic Emergencies: Pulpotomy Versus Pulpectomy ... The goal of management of endodontic emergencies is to quickly and effectively manage pain and infections thereby also minimizing the development of persistent pain and the formation of periapical pathology

Selecting the right medication is crucial for clinical success. Below is an overview of the most commonly used pulpotomy agents, their properties, drawbacks, and commercial names.

Advertisement

✅ 1. Formocresol

➤ Brand Name: Buckley’s Formocresol
➤ Composition: 19% formaldehyde, 35% cresol, 15% glycerin, 21% water
➤ Properties:
° Bactericidal and tissue-fixative agent
° Mummifies remaining pulp tissue
° Easy to handle and low cost
➤ Drawbacks:
° Potentially carcinogenic and mutagenic
° Cytotoxic and allergenic
° Does not promote pulp tissue regeneration
➤ Clinical Notes:
° Although historically effective, its use has declined due to toxicity concerns.

📌 Recommended Article :

Video 🔽 Technique for Primary Molar Tooth Pulpotomy ... The treatment of dental pulp is not only carried out when there is caries, it is also carried out when the tooth is blown. Pulpotomy is one of the most frequent procedures performed in dental practice

✅ 2. Ferric Sulfate

➤ Brand Name: Astringedent®
➤ Composition: 15.5% aqueous solution of ferric sulfate (pH 1.0)
➤ Properties:
° Effective hemostatic agent
° Forms a protein barrier sealing blood vessels
° Affordable and easy to apply
➤ Drawbacks:
° Does not promote pulp regeneration
° May cause radicular inflammation and resorption
➤ Clinical Notes:
° A less toxic alternative to formocresol, but with variable long-term success.

📌 Recommended Article :

Video 🔽 What is the difference between apexogenesis and apexification? ... In the presence of an open apex, apexogenesis (apicoformation) or apexification can be used. Both treatments have differences that will be resolved with the video that we show below

✅ 3. Calcium Hydroxide (Ca(OH)₂)

➤ Brand Name: Dycal®
➤ Properties:
° Stimulates reparative dentin formation
° Highly alkaline with bactericidal effect
° Biocompatible
➤ Drawbacks:
° May cause superficial pulp necrosis
° Lower success rate in primary teeth
° Tends to dissolve over time
➤ Clinical Notes:
° More suitable for young permanent teeth; limited use in primary dentition.

📌 Recommended Article :

Video 🔽 Pulpectomy: Clinical Tips and Tricks in Paediatric Dentistry ... The objective of this treatment is to maintain the tooth to avoid problems of poor dental position of the permanent teeth

✅ 4. Mineral Trioxide Aggregate (MTA)

➤ Brand Name: ProRoot® MTA
➤ Composition: Tricalcium silicate, dicalcium silicate, tricalcium aluminate, bismuth oxide
➤ Properties:
Highly biocompatible
Stimulates dentin formation
Excellent sealing and antimicrobial properties
➤ Drawbacks:
High cost
Difficult manipulation and long setting time
➤ Clinical Notes:
Studies report a 97.9% clinical success rate in pediatric pulpotomies, outperforming other agents.

📌 Recommended Article :

Video 🔽 Dental Treatment: Vital Pulp Therapy for Primary Teeth ... The anatomical characteristics of primary teeth are different from permanent teeth. It is important to know these differences when performing any dental procedure

✅ 5. Biodentine

➤ Brand Name: Biodentine®
➤ Composition: Tricalcium silicate, dicalcium silicate, calcium oxide, calcium chloride, zirconium oxide
➤ Properties:
° Bioactive dentin substitute
° Mechanical properties similar to natural dentin
° Fast setting time and good radiopacity
➤ Drawbacks:
° High cost
° Limited long-term clinical evidence compared to MTA
➤ Clinical Notes:
° A promising MTA alternative with easier handling and shorter setting time.

📌 Recommended Article :

Video 🔽 Pulpotomy of Deciduous Molar - Step by step ... 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

✅ 6. Zinc Oxide Eugenol (ZOE)

➤ Brand Name: IRM® (Intermediate Restorative Material)
➤ Properties:
° Soothing effect on dental pulp
° Antimicrobial and anti-inflammatory properties
° Easy to handle and inexpensive
➤ Drawbacks:
° Does not induce reparative dentin formation
° May dissolve over time
➤ Clinical Notes:
° Commonly used as a base or sealing material in pulpotomies.

📌 Recommended Article :

Video 🔽 Pulpectomy, everything you need to know: Diagnosis, indications, and filling materials ... The video that we share details everything related to pulpectomy: diagnosis, indications and contraindications, procedure, recommended filling materials, and the importance of post-treatment follow-up

✅ 7. Pulpotec® Paste

➤ Brand Name: Pulpotec®
➤ Composition:
° Powder: Polyoxymethylene, iodoform
° Liquid: Dexamethasone, formaldehyde, phenol, guaiacol
➤ Properties:
° Induces healing of the pulp stump
° Aseptic and quick treatment
° Effective in both primary and permanent teeth
➤ Drawbacks:
° Contains formaldehyde, which has cytotoxic potential
° Not resorbable
➤ Clinical Notes:
° Long-term success reported in studies, though formaldehyde content limits its use in some cases.

📌 Recommended Article :

Video 🔽 Apexogenesis: Step by step procedure ... We share a video that explains everything about apexogenesis: definition, indications, contraindications and the step-by-step procedure

💡 Conclusion
The choice of pulpotomy medication must be based on a careful evaluation of its properties, disadvantages, and available clinical evidence. While formocresol has been widely used, toxicity concerns have led to the rise of safer and more effective alternatives like MTA and Biodentine. The ideal agent depends on factors such as the patient's age, tooth condition, and specific clinical considerations.

📚 References

✔ Holguin Garcia, S. G. (2019). Eficacia clínica del MTA en Pulpotomías de pacientes pediátricos: Una Revisión Sistemática. Revista de Odontopediatría Latinoamericana, 11(1). https://doi.org/10.47990/alop.v11i1.228

✔ Wikipedia. (2025). Pulpotomía. Retrieved from https://es.wikipedia.org/wiki/Pulpotom%C3%ADa

✔ Apuntes De Odontología. (2015). Pulpotomía. Retrieved from https://apuntes-de-odontologia.blogspot.com/2015/04/pulpotomia.html

✔ Studocu. (2018). Terapia Pulpar I – Dra. Andrea Cárdenas Antonieta Montero. Retrieved from https://www.studocu.com/cl/document/universidad-finis-terrae/odontopediatria/terapia-pulpar-i/4935194

✔ Revista Odontopediatría. (2014). Tratamiento Endodóntico no Instrumentado en dientes deciduos. Retrieved from https://backup.revistaodontopediatria.org/ediciones/2014/1/art-6/

📌 More Recommended Items

► Myths About Root Canal Treatment
► Pulpotomy and pulpectomy procedures. Indications and Differences
► Pulp Therapy Procedures Manual for Primary and Immature Permanent Teeth

Oral Manifestations of Systemic Diseases: Updated Clinical Review

Systemic diseases affect more than internal organs—they often present oral signs that can be essential for early diagnosis.

📌 Recommended Article :

Video 🔽 Effects of tobacco on the oral cavity: Nicotine Stomatitis ... We must bear in mind that smoking generates short and long-term consequences. In the oral cavity it can generate periodontitis, gingivitis and pathologies in the oral mucosa

Due to its high vascularity and immune role, the oral cavity frequently reflects systemic conditions. In modern dentistry, recognizing these signs is key to preventive care and interdisciplinary treatment.

Advertisement

✅ Systemic Diseases and Their Oral Manifestations

1. Diabetes Mellitus
➤ Definition: A chronic metabolic disorder characterized by persistent hyperglycemia.
➤ Oral manifestations:
° Xerostomia (dry mouth)
° Advanced periodontal disease
° Delayed wound healing
° Oral candidiasis
➤ Common signs and symptoms: Gingival bleeding, tooth mobility, halitosis, recurrent oral infections.

2. Iron Deficiency Anemia
➤ Definition: A lack of iron leading to decreased oxygen-carrying capacity of the blood.
➤ Oral manifestations:
° Pale oral mucosa
° Atrophic glossitis (smooth, sore tongue)
° Angular cheilitis
➤ Common signs and symptoms: Burning sensation in the mouth, altered taste, oral ulcers.

📌 Recommended Article :

Video 🔽 Oral cancer: Risk factors, management, procedures and types of treatment ... Let's learn about the risk factors, management, and correct evaluation to identify the clinical manifestations of oral cancer. Let's also discover what the new technologies are for diagnosis and treatment

3. HIV/AIDS
➤ Definition: Infection caused by the human immunodeficiency virus, impairing the immune system.
➤ Oral manifestations:
° Pseudomembranous candidiasis
° Kaposi's sarcoma
° Oral hairy leukoplakia
° Necrotizing gingivitis/periodontitis
➤ Common signs and symptoms: White lesions, persistent ulcers, oral pain, gingival bleeding.

4. Systemic Lupus Erythematosus (SLE)
➤ Definition: A multisystem autoimmune disease affecting connective tissues.
➤ Oral manifestations:
° Painless oral ulcers
° Erythematous or purpuric lesions
° Xerostomia (often secondary to Sjögren’s syndrome)
➤ Common signs and symptoms: Mild pain, difficulty chewing, mucosal and lingual changes.

📌 Recommended Article :

PDF 🔽 Mouth Breathing: Its Consequences, Diagnosis & Treatment ... Mouth breathing has serious consequences for craniofacial and occlusive development. Mouth breathing patients have a longer face, this is due to the functional adaptation of breathing

5. Chronic Kidney Disease (CKD)
➤ Definition: Progressive, irreversible loss of kidney function.
➤ Oral manifestations:
° Uremic breath odor
° Oral ulcerations
° Gingival bleeding
Enamel hypoplasia (especially in children)
➤ Common signs and symptoms: Metallic taste, oral pain, delayed tooth eruption in children.

📌 Recommended Article :

Video 🔽 What Top 10 Mouth Cancer Symptoms ... The early detection of cancer ensures a better recovery and success of the treatment, for that we must know the warning signs and the changes that happen in our mouth

✅ Recommendations for Dental Practice

° Conduct thorough medical histories that screen for systemic illnesses.
° Treat oral signs as potential indicators of undiagnosed systemic disease.
° Work collaboratively with physicians for interdisciplinary care.
° Educate patients on the oral-systemic health connection.
° Schedule frequent cleanings and periodontal evaluations for at-risk patients.

📌 Recommended Article :

PDF 🔽 Management of Angular Cheilitis in children ... Angular cheilitis also called perleche or angular cheilitis is a lesion marked with fissures, cracks on corner of lip, reddish, ulceration accompanied by burning sensation, pain and dryness on the corner of the mouth.

💡Conclusions
Oral signs of systemic diseases serve as critical indicators for early diagnosis and comprehensive treatment. Timely recognition of these signs can improve patient outcomes, reduce complications, and enhance quality of life. Dentists play a key role in identifying these manifestations and guiding patients to appropriate medical care.

📚 References

✔ Chávez, E. M., et al. (2022). Oral health considerations in patients with chronic kidney disease. Journal of Clinical Nephrology and Renal Care, 8(1), 110. https://doi.org/10.23937/2572-3286.1510110

✔ Kottoor, R., et al. (2020). Oral manifestations in patients with systemic lupus erythematosus. Lupus, 29(3), 274–281. https://doi.org/10.1177/0961203320903073

✔ López-López, J., et al. (2021). Oral manifestations of iron deficiency anemia: A clinical approach. Clinical Oral Investigations, 25(1), 123–130. https://doi.org/10.1007/s00784-020-03418-z

✔ López-Pintor, R. M., et al. (2020). Diabetes mellitus and oral health: A bidirectional relationship. Medicina Oral, Patología Oral y Cirugía Bucal, 25(4), e559–e566. https://doi.org/10.4317/medoral.24012

✔ Patton, L. L., et al. (2021). Oral manifestations of HIV infection and treatment: A clinical guide. Oral Diseases, 27(S1), 59–68. https://doi.org/10.1111/odi.13742

📌 More Recommended Items

► Stomatitis in children - Symptoms, Causes, and Treatment
► How the symptoms of Dry Mouth can be combated ?
► Smoking ruins your oral health

Lingual Coating: Causes, Characteristics, Bacterial Profile, Consequences, and Treatment

Lingual coating, also known as tongue biofilm or tongue plaque, is a common condition in the oral cavity characterized by a whitish, yellowish, or brownish layer on the dorsal surface of the tongue.

📌 Recommended Article :

Dental Article 🔽 What Does Your Tongue Say About Your State Of Health? ... We leave you this interesting video where it shows us the different colors that our language may have and the pathologies that may be happening to us

This layer is primarily composed of desquamated epithelial cells, food debris, leukocytes, mucins, and a significant number of microorganisms, especially anaerobic bacteria. Often underestimated, lingual coating can indicate poor oral hygiene, systemic disorders, or imbalances in the oral microbiome.

Advertisement

✅ Clinical Characteristics of Lingual Coating
The main clinical features include:

° Whitish or yellowish appearance on the dorsal surface of the tongue.
° Pastelike or sticky texture.
° Halitosis (bad breath) present in most cases.
° Dry mouth sensation or unpleasant taste.
° Possible dysgeusia (altered taste) or burning tongue sensation.

The most commonly affected area is the posterior dorsal region, where filiform papillae are more abundant, facilitating retention of debris and microorganisms.

📌 Recommended Article :

Video 🔽 ORAL MEDICINE: What are tonsil stones? ... These stones are not malignant, but if it is a factor of bad breath (halitosis), in case these stones are larger it can cause odinogafia (pain when passing food)

✅ Microbiota Involved in Lingual Coating
The tongue harbors a complex microbiota of both aerobic and anaerobic bacteria. Lingual coating is especially associated with a high concentration of Gram-negative anaerobic bacteria that produce volatile sulfur compounds (VSCs), the main cause of halitosis.

➤ Key bacterial species identified:
° Porphyromonas gingivalis
° Fusobacterium nucleatum
° Prevotella intermedia
° Treponema denticola
° Tannerella forsythia
° Solobacterium moorei

These bacteria break down proteins from food and epithelial cells, producing VSCs such as hydrogen sulfide (H₂S), methyl mercaptan, and dimethyl sulfide, which are highly volatile and malodorous.
A recent metagenomic study by Seerangaiyan et al. (2017) confirmed that the tongue is one of the most microbiologically diverse sites in the oral cavity.

📌 Recommended Article :

Article 🔽 Bruxism: A medical or dental issue? ... Bruxism is a parafunctional habit characterized by teeth grinding or clenching, usually at night. This activity generates a series of problems in the teeth, chewing muscles and jaw joint

✅ Causes of Lingual Coating
Several factors contribute to the development of lingual coating:

1. Poor oral hygiene
Failure to brush the tongue promotes debris and microbial buildup.
2. Xerostomia (dry mouth)
Reduced salivary flow impairs the self-cleansing ability of the tongue.
3. Tobacco and alcohol use
These habits disrupt the oral flora and irritate the tongue’s surface.
4. Systemic diseases
Conditions like diabetes, chronic kidney disease, or gastrointestinal infections can manifest with tongue coating.
5. Use of antibiotics or antiseptic mouthwashes
Certain medications can alter the oral microbiome.

📌 Recommended Article :

Video 🔽 What can cause tongue injuries? - Management ... Self-examination and visits to the dentist are good ways to prevent any pathology, and thus maintain our oral and general health

✅ Clinical Consequences of Lingual Coating
Though often considered minor, lingual coating can lead to significant consequences:

° Chronic halitosis: The primary source of intraoral bad breath (Morita & Wang, 2001).
° Taste alterations: Due to mechanical obstruction of taste buds.
° Psychological discomfort: Bad breath may lead to social anxiety or isolation.
° Risk of periodontal disease: Lingual bacteria can colonize the gums.
° Indicator of systemic conditions: May be an early sign of candidiasis or immunosuppression.

📌 Recommended Article :

Video 🔽 How is oral health affected by diabetes? ... Diabetic people should visit the dentist to eliminate infectious sources (cavities, gum inflammation, fractured restorations) and to maintain oral hygiene

✅ Prevention of Lingual Coating
Effective preventive strategies include:

° Daily tongue cleaning: Using tongue scrapers or brushes with a cleaner surface.
° Proper oral hygiene: Brushing and flossing to reduce overall biofilm.
° Antimicrobial mouth rinses: Chlorhexidine 0.12% or zinc lactate in severe cases.
° Adequate hydration: To stimulate saliva production.
° Avoidance of tobacco and alcohol.
° Regular dental visits: For professional evaluation and monitoring.

📌 Recommended Article :

Video/PDF 🔽 How to Manage a Pediatric Patient with Oral Ulcers ... We share an interesting article on the management of oral ulcers in pediatric patients, where the symptoms and treatments that are required are discussed

✅ Treatment of Lingual Coating
Treatment should be multifactorial and individualized, addressing the underlying cause:

1. Tongue scraping
° Mechanical removal of coating using specialized tools—highly effective and affordable.
2. Antimicrobial therapy
° Rinses with chlorhexidine, cetylpyridinium chloride, or chlorine dioxide to reduce microbial load.
° Antibacterial toothpastes may support overall reduction of pathogens.
3. Correction of predisposing factors
° Manage dry mouth and systemic conditions (e.g., diabetes, kidney failure).
° Eliminate irritants such as smoking or alcohol.
4. Complementary therapies
° Oral probiotics (e.g., Lactobacillus reuteri) to modulate microbiota.
° Patient education on hygiene techniques and healthy lifestyle choices.

📌 Recommended Article :

Video 🔽 What are Oral Potentially Malignant Disorders? ... Early detection is recommended in these cases, in this way we prevent neoplasms from developing and increase the possibility of successful treatment

💡 Conclusion
Lingual coating is more than an aesthetic concern. It reflects microbial imbalances in the oral ecosystem and can impact systemic and psychosocial health. Its prevention and treatment are simple yet require consistency and patient education. A comprehensive approach—addressing both local and systemic factors—is essential for effective management.

📚 References

✔ Morita, M., & Wang, H. L. (2001). Association between oral malodor and adult periodontitis: a review. Journal of Clinical Periodontology, 28(9), 813–819. https://doi.org/10.1034/j.1600-051x.2001.028009813.x

✔ Seerangaiyan, K., Jüch, F., Winkel, E. G., & Winkelhoff, A. J. V. D. (2017). Tongue Microbiome in Healthy Subjects and Patients with Intra-Oral Halitosis. Journal of Breath Research, 11(3), 036010. https://doi.org/10.1088/1752-7163/aa6f9e

✔ Takeshita, T., Suzuki, N., Nakano, Y., & Yamashita, Y. (2008). Relationship between oral malodor and the global composition of indigenous bacterial populations in saliva. Applied and Environmental Microbiology, 74(2), 562–569. https://doi.org/10.1128/AEM.02039-07

✔ Tangerman, A., & Winkel, E. G. (2010). Intra- and extra-oral halitosis: findings of a new classification. Journal of Clinical Periodontology, 37(9), 807–814. https://doi.org/10.1111/j.1600-051X.2010.01699.x

✔ Faveri, M., Gonçalves, L. F., Feres, M., Figueiredo, L. C., & de Figueiredo, C. A. (2006). Prevalence and microbiological diversity of tongue coating in subjects with and without halitosis. Revista da Associação Paulista de Cirurgiões Dentistas, 60(2), 150–155.

📌 More Recommended Items

► How to Use a Tongue Scraper - Benefits
► Black hairy tongue: Why it happens?
► Smoking ruins your oral health