Recent developments in dental materials have significantly improved pediatric dental care. Dr. Josh Wren will discuss the latest trends in pedodontics in his upcoming CE Webinar, Pediatric Dentistry: An Update, on July 26, 2016. We sat down with Dr. Josh Wren for an interview and sneak preview of his webinar topics.
- When did you start using bioactive dental materials? What were you using before?
Like many pediatric dentists, I’ve been a long time user of traditional composites, GIs, RMGIs and stainless steel crowns. I first learned about bioactive materials during a visit to PULPDENT with a group from Dentaltown. After doing some additional research on the subject, I decided to start using bioactive materials in my own dental practice.
- Do you talk to your patients and their parents about bioactive dental materials?
I definitely talk to the parents about the material to help them make the proper decision for their child. Parents are very impressed with the material once it has been explained. At a recent appointment I told a father that the ACTIVA BioACTIVE-RESTORATIVE material I was using to restore his 5-year-old’s tooth contained the same minerals as tooth enamel and that there was a constant transfer of ions between the tooth and the material. It turned out that this father was a chemist, and we talked for 30 minutes about ACTIVA’s underlying chemistry, and I sent him home with some additional literature.
- Do you use Silver Diamine Fluoride (SDF) in your practice? What has been the reaction from patients and their parents?
That’s been a very hot topic in the dental community and the media. I’ve probably used it on 350-400 teeth. We talk to the parents about SDF quite a bit, and the informed consent documentation must state that SDF will turn the tooth black where there is active decay. The rate of acceptance of SDF has been really high once we’ve explained what our goals are. In some cases I present SDF as a temporary caries arresting medication and not as a definitive treatment.
- There’s been a lot of talk about bulk filling in the dental community. Do you bulk fill? What recommendations would you give to dentists doing bulk fills on pediatric patients?
I have always liked doing bulk fills on primary teeth. I like PULPDENT’s recommended approach which is to have an initial 2mm base layer and then bulk fill the remainder. The idea is to minimize polymerization shrinkage and reduce the thermal effect of the reaction and curing light. If you’re close to the pulp, it just makes sense that you don’t want to heat up the pulp with the material cure.
- What is your approach to restoring primary and permanent teeth? Is there any difference in your technique or choice of material?
I take a similar approach to both. The goal first and foremost is to restore form and function to the tooth, and the final variable is esthetics. We’re fighting an uphill battle, especially with all the sugary foods and drinks kids are consuming nowadays, and bioactive materials have a big role to play. ACTIVA’s continuous release of minerals makes the enamel stronger and helps form a barrier – it’s not so much a bonded restoration as a sealed restoration.
I’m restoring permanent teeth with ACTIVA as well, whether they are Class I, Class II or Class V. I like to use EMBRACE WetBond Pit & Fissure Sealant for PRRs and small pit and fissure lesions.
About Dr. Josh Wren
Dr. Wren is a board-certified pediatric dentist who founded Wren Pediatric Dentistry in 2007 in Brandon, Mississippi. He is an online and live speaker for www.dentaltown.com where he also serves as the moderator of the pediatric dental forum. Dr. Wren is the Mississippi Representative to the Southeastern Society of Pediatric Dentistry. He founded Pediatric Dental Seminars to educate dentists on all topics related to pediatric dentistry. www.pediatricdentalce.com