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Preservation of the First Permanent Molar

Protecting the First Permanent Molar

The first permanent molar teeth can be protected before, during and after their eruption into the oral cavity. It is therefore important to have established a safe oral environment into which these teeth will erupt and be maintained in for the future. Instilling intensive preventive measures is paramount to ensure that these teeth remain caries-free. The first permanent molar is most susceptible to developing dental caries within the first 2 years after eruption.

Prior to Eruption

• Regular and effective good oral hygiene practices.
• Establishing good dietary regimes.
• Regular daily fluoride applications from tooth brushing and additional products as indicated depending on caries risk assessment.

During Eruption

• Maintaining oral hygiene and dietary practices.
• Fissure sealing at-risk teeth (especially first permanent molars) as soon as possible on eruption depending on caries risk.
• Use of glass ionomer cements (GIC) for sealing first permanent molars which are partially erupted in individuals at risk of caries.

Post-Eruption

• Maintaining oral hygiene and dietary practices.
• Careful monitoring and review of all teeth is essential to ensure that there is no new caries development or progression of lesions.

Use of Fluorides

Chapters 11–14 on preventive care and fluorides give more information on the use of fluorides for caries prevention:

• twice daily brushing with toothpastes containing 1000–1450 ppm F;
• daily fluoride rinse (225 ppm F);
• fluoride varnish (22 600 ppm F) professional applications 2–4 times yearly.

Fissure Sealants

Fissure sealants have been used to prevent occlusal caries in first permanent molars for over 50 years. Bisphenol-α-glycidyl meth­acrylate (bis-GMA) resin is the most effective sealant. The caries preventive success of sealants is due to the establishment of a tight seal,/>

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