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Occlusion is the last assessment to make for a fully seated crown. Articulating foils and shim stock are needed to check for occlusion. Both crown and adjacent teeth should hold shim stock firmly in the intercuspal position (ICP).A large flame shaped diamond bur is used to reduce high areas. Once ICP has been re-established the excursions can be checked preferably with a different coloured foil. Occasionally, it may be necessary to adjust the tooth opposing a restoration to avoid crown perforation or exposure of rough opaque porcelain.

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Tooth decay may be even worse than originally thought.Sadly, dental caries (cavities) in young children is commonly untreated. In addition to causing damage and loss of teeth, a new study has found that it can stunt a child’s growth.

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The study was published online on February 17 in the journal Pediatrics by researchers at King Fahad Armed Forces Hospital (Jeddah, Saudi Arabia) and University College London (London, United Kingdom).

The researchers note that dental caries in young children represents a significant public health problem. And they wanted to explore the relationship between oral health and growth after previous studies failed to show definitive evidence one way or the other. In this study, the researchers looked at the dental decay and the correlation between height and weight in Saudi Arabian children.

The study group comprised schoolchildren aged six to eight years who attended military primary schools in Jeddah, Saudi Arabia. Their caries status was evaluated with the DMFT (decayed, missing, filled, teeth) index for their primary teeth. Height and weight were evaluated with using z scores of height-for-age (HAZ), weight-for-age (WAZ), and BMI-for-age (BAZ) calculated by World Health Organization (WHO) standardized procedures. (A z score measures the reliability of data.) The relationships between dental caries and HAZ, WAZ, and BAZ were subjected to statistical analysis.

Included in the final evaluation were 417 of the 436 eligible schoolchildren with complete data were included, marking a response rate of 95.6%. Their average DMFT index was 5.7 ± 4.2. The investigators found an inverse linear relationship between caries status and children’s HAZ, WAZ, and BAZ and significantly lower anthropometric outcomes (growth) for children at each consecutive group with higher levels of caries. (An inverse linear relationship means that the higher the caries status, the lower the z scores were in a straight line relationship.)

Even when some secondary factors, like demographics and social values, were factored in, the correlation between decay and stunted growth still existed.

The authors concluded that the inverse linear association between dental caries and all anthropometric outcomes suggests that higher levels of untreated dental caries are associated with poorer growth in children. More research is necessary to confirm this study’s findings.

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