Contemporary Cosmetic Dentistry – Part II: Arresting Marginal Caries

Video Transcript:

Hi there, I'm Dr. Susan McMahon. I'm a clinician from Pittsburgh Pennsylvania.

People are definitely living longer, which is a great thing, right? Especially as we're all aging, it's a great thing that everyone's living longer. But because of that, people that I've restored 20 years ago, are now aging into a more mature place in their life, let's say. And oftentimes, patients that are, say in their 60s 70s 80s years old, have dentistry that might be 25 years old, and they're not always in a position to replace it at this point. They're also sometimes can be going through medical issues. And we will find that we're getting recurrent decay, root caries, because as our population ages there's just going to be more root caries, there's going to be saliva that is not as robust as it once was. And we're going to see changes in their salivary content from medicines are taking and from treatments they're having, there's just more root caries. So we're seeing I'm seeing a lot of it.

And there's a couple of things I really am excited about treating these root caries with, I like for many of these patients, I want to try to maintain their dentistry and do the best thing I can to clean up these caries, there are some really conservative things we can do to restore these patients. Hopefully let them hang on to their dentistry as long as possible and get a result that we're confident with. So I like when I have a patient that's maybe a whole mouthful of crown and bridge, even PFM crown and bridge that I put in 20, 25 years ago, and we're starting to see those little sticks under the margin or you know, actual margins where our whole explorer just kind of sinks under that margin.

I want to try to save that for them. So I am taking that, spooning that out, sometimes round buring that out, sometimes taking a laser exposing a little tissue, getting underneath that decay, and then using the Riva Aqua product to really arrest the decay inside there. Because you can't always see underneath the crown, right? You can't, you can't see the whole depth of the restoration. But you can be pretty confident when you scrub it with the Riva Star Aqua that you're going to arrest the decay, and then you use the potassium iodide because you know I'm in a cosmetic practice and my patients care about the way they look. They care about the outcome of that they care about having black teeth, so the Aqua is going to give us that dark staining when we use the SDF on that on the caries for the caries arrestent, we're gonna get black, that's what we're hoping for to get the black caries arrested solid dentin and you're gonna see some black cementum too.

So when we scrub it with the potassium iodide, it takes away most of the blackness but when you scrub it, you have to remember you've got to scrub till you see the white precipitate. If you just scrub a little bit, you're not going to get the same results. You got to scrub scrub scrub a little bit longer till that white precipitate comes and then you know it's going to be much more esthetic. And then then we cover it with you're gonna get these traditional glass Ionomer to do that, so I'm using the Riva Self-Cure on top of that. Triturate it, and use the self cure, and it's really nice restoration to help these people keep their dentistry longer, get through whatever medical treatment they might need to get through and arrest caries for them.