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Ask Dr. Yogindra Vasavada Your Own Question
Dr. Yogindra Vasavada
Dr. Yogindra Vasavada, Pediatrician
Category: Dental
Satisfied Customers: 3238
Experience:  M.D.(ped) passed at first attempt, in practice continuously for last 37 years. Certi. in Comp
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We have a two-part question, the first pertains to helping

Customer Question

We have a two-part question, the first pertains to helping us understand what our dentist said about our 6.5 year old daughter's recent cavities, which is "Em pt ta ll area with eating and touching, #S with DO caries and also T also, adv.; x-ray shows caries in close prox. to nerve."
We know what S & T refer to (her two premolars on the bottom row of HER right side of mouth). But what does "Em pt ta ll area" mean and what does "with DO caries" mean?
The second part requires this preface: a while back dentists though amalgam fillings posed no significant problem yet they seem to have been wrong. Now we are advised to put a stainless steel cap on tooth S for our daughter, but it leaches a bit of nickle and who knows what problems may one day be discovered to be related to stainless steel fillings. We understand ONLY removing S tooth and leaving a gap may pose a problem (correct us if we're wrong), but what what would be the downside of (while keeping EXTREMELY good care to minimize sweets and maximize flossing/brushing) waiting until she notices pain (to let the teeth exist for as long as possible) and then removing BOTH teeth S & T? Wouldn't that still allow her adult teeth to grow in to the best of their ability?
Submitted: 1 year ago.
Category: Dental
Expert:  Dr. Yogindra Vasavada replied 1 year ago.

Hello, Sorry about the problem.

Re first part, the words are just technical jargon and not relevant. There may be typing errors too. DO perhaps means distal occlusion.

Re second, if she has no pain and sensitivity to hot and cold, leaving the teeth alone is quite justifiable. Let them shed naturally according to set pattern of growth and take very good care meanwhile, as also after eruption of permanent molars.

Steel cap is not same as filling, and no risk of any seepage of nickel. Please go ahead with cap fitting.

Expert:  Dr. Yogindra Vasavada replied 1 year ago.

The words"Em pt.ta ll " are missing few words. Possibly dentist means Economically poor or mentally challanged child. In either case treatment should be as followed:

1. Treatment may need administration of IV sedation.

2. Pulpotomy with SS crowns, till these molar teeth exfoliate naturally and permanent premolars erupt.

3. If extraction of these deciduous teeth is must , space maintainer needs to be given to prevent maloccusion.