Very Dental: Rethinking Decay Removal with Dr. Melissa Seibert

Alan welcomes back Dr. Melissa Seibert to talk about caries removal. While academics and researchers don't find the idea of incomplete caries removal controversial, many clinicians just can't get their head around it! Melissa drops a LOT of knowledge on us in this episode!

Key takeaways:

• Selective caries removal is a well-substantiated approach to caries management that involves removing only the infected dentin while leaving affected dentin behind. This can help to preserve healthy tooth structure and avoid pulpal exposure.
• Magnification and light are essential for accurate caries diagnosis. Melissa emphasizes the importance of "sharp eyes and a dull explorer."
• Radiographs are crucial for monitoring caries progression and making informed decisions about treatment.
• SDF can be a valuable tool for arresting caries in both children and adults.
• Sealants, especially glass ionomer sealants, can be effective in preventing caries, but proper isolation is essential.
• The sandwich technique is an older technique that is not as commonly used today.
• Vital pulp therapy is a topic that will be explored in a future episode.

Some links from the show:

• Elevated GP: theelevatedgp.com - Melissa's website with on-demand dental content and a journal club.
• Bioclear
• GC Fuji Triage

Episode Index:

• 02:02 The Birth of Elevated GP

• 05:28 Selective Caries Removal Debate

• 08:31 Approaches to Caries Removal

• 14:35 The Importance of Magnification and Light

• 21:23 Exploring Conservative Options: SDF in Adults

• 21:49 Challenges and Considerations with SDF

• 23:00 Sealants: Best Practices and Controversies

• 27:25 Selective Caries Removal: Techniques and Opinions

• 29:58 Bonding and Margins: Ensuring Success

• 37:25 The Role of Silver Diamine Fluoride in Caries Excavation

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