Gotjamanos T
School of Oral Health Sciences, University of Western Australia.
Aust Dent J. 1997 Dec;42(6):372-4. doi: 10.1111/j.1834-7819.1997.tb06080.x.
Differences in treatment rationale exist between dental practitioners with respect to the management of small carious lesions in primary teeth. Some do not consider it necessary to use a conventional restorative approach, preferring to apply topical fluoride and/or 'monitor' the lesion(s). This paper advocates the alternative approach which entails complete caries removal by mechanical means, the rationale being to eliminate the pool of cariogenic microorganisms and thereby protect sound teeth from succumbing to carious attack. A case is presented to illustrate the extent to which caries can progress and also involve other teeth if small cavitated lesions are simply treated by 'spot' application of fluoride. Clinical treatment of caries must be based on scientific knowledge of the microorganisms involved and an understanding of its transmissible and infectious nature.
在乳牙小龋损的处理方面，牙科医生的治疗理念存在差异。一些医生认为没有必要采用传统的修复方法，而是倾向于应用局部氟化物和/或“监测”龋损。本文提倡另一种方法，即通过机械手段彻底去除龋坏组织，其基本原理是消除致龋微生物池，从而保护健康牙齿免受龋蚀。文中给出了一个病例，以说明如果仅通过局部应用氟化物来治疗小的龋洞病变，龋病可能进展的程度以及累及其他牙齿的情况。龋病的临床治疗必须基于对所涉及微生物的科学认识以及对其传播性和感染性本质的理解。
