Pediatric restorative dentistry tips
What follows is a brief overview of the Hall technique for stainless steel crowns and the Forte strip crown using glass ionomer on the anterior teeth.
The key to managing child patients is to do minimally invasive dental techniques. Doing so is going to help avoid traumatizing them and help maintain trust.
You don’t want to get a perfect stainless steel crown at the expense of creating a patient who’s fearful to come into the dentist for a lifetime.
Hall technique for stainless steel crowns
With the stainless steel crowns, for children you should use the Hall technique. The first appointment involves placing the SDF (silver diamine fluoride). This helps to kill decaycausing bacteria. Then wait one to two months to make sure the decay has been arrested.
If necessary, you may need to reapply the SDF another time. But once you’re sure the decay has been arrested and the tooth is still vital you can place a stainless steel crown without any tooth preparation.
If the occlusion is a little bit high from the stainless steel crown, you can just let it settle. However, if there not is enough interproximal space to place the stainless steel crown, you can try to flatten the interproximals of the crown with the Howe plier.
Or place an orthodontic spacer between the teeth for one to five days and then have the patient return.
Once that’s done cement the stainless steel crown with glass ionomer cement. The glass ionomer cement is moisture friendly. It’s fluoride releasing and by sealing this primary tooth with a stainless steel crown, the glass ionomer cement should starve any bacteria that’s in there.
This is, of course, as long as the tooth is vital. If it is you can use this to help maintain the space until the permanent tooth comes in. Which means you won’t need do a lot of pulpectomies.
Forte Strip Crown for anterior teeth
This technique uses plastic crown formers on the anterior baby teeth.
First, try on the plastic strip crown, get the right size and adjust the length by trimming the plastic to follow the gum level to make sure it fits.
Second, remove most of the decay with a slow-speed handpiece, which may not require anesthesia. Then place the conditioner that comes with the glass ionomer and put the glass ionomer in the plastic crown and put it on the tooth.
We know glass ionomer sets up over time, so you can leave the plastic crown former on the tooth up to a week to let the glass ionomer cement get harder.
The patient should come back a week later and then you can use an explorer to remove the clear plastic crown former and then adjust and polish the tooth as needed.
These two techniques are effective methods of doing an anterior strip crown and a stainless steel crown in the posterior with no anesthesia and minimal tooth preparation.