PAEDIATRIC DENTISTRY - 3rd Ed. (2005)

417H

Fig. 9.4 Hidden caries⎯although the

occlusal surface looks mostly intact it

hides extensive caries.

418H

Fig. 9.5 Caries has been removed. The

size of the cavity emphasizes the extent

of the lesion.

9.5.1 Who will benefit?

Not every fissure will become carious if it is not sealed. Therefore, each tooth for
each child must be assessed on its own merits. The clinician must assess the risk
factors for that tooth developing pit or fissure caries. As a general guide to who will
benefit, review the British Society for Paediatric Dentistry Policy Document (Nunn et
al., 2000).

The main beneficiaries are:

1. Children and young people with medical, intellectual, physical, and sensory
   impairments, such that their general health would be jeopardized by either the
   development of oral disease or the need for dental treatment. In such children all
   susceptible sites in both the primary and permanent dentitions should receive
   consideration.


2. All susceptible sites on permanent teeth should be sealed in children and young
   people with caries in their primary teeth (dmfs = 2 or more).


3. Where occlusal caries affects one permanent molar, the operator should seal the
   occlusal surfaces of all the other molars.


4. If the anatomy of the tooth is such that surfaces are deeply fissured, then these
   should be sealed.