Removal of an occlusal tooth sealant to treat dental caries

November 5, 2008 11:57 am Published by

My first patient today needed a bonding on tooth #2.

The patient presented with an occlusal sealant underlied by black staining and caries. The patient was anesthetized with carbocaine and the procedure was started. The cavity was excavated; and as I proceeded the cavity got deeper and deeper. The patient was informed that the decay is extensive and that there are also cavities on other teeth in the mouth as was seen in the x-ray. The patient however decided to wait for her insurance before she started her other restorations. 

The decay was excavated the bonding was completed. The bonding was redone due to a void on the distal of the restoration. Once the restoration was completed occlusion was checked and adjusted.

I have learned many things. There were a number of unexpected challenges; working in an unfamiliar operatory was a challenge for me despite having been on the clinic floor for over a year. Light curing, taking pictures, chair positioning, patient communication and hand pieces were all new to me and made the procedure much more challenging. I am used to finishing a bonding procedure in about 45 minutes, but it took me about 2.5 hours today and that was quite surprising. The tooth I was working on was the second molar and visibility, moisture control and drilling all became even harder and increased the amount of time it took me to complete the procedure.

H.A., New York University College of Dentistry, Patient 3

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