A note on carious dentine removal

Just a spot where you can get caught out when clearing dentine removal. Make sure you have removed all enamel overlying the carious dentine and also have a clear DEJ before you switch to a slow speed for carious dentine removal. It is easy to get focussed once you have switched to the slow speed on the depth of the cavity while you risk failing to clear carious dentine at the DEJ.

The other day I was preparing a wide, shallow class 1 carious lesions and in the name of "conservative dentistry" I failed to clear some enamel overlying the carious dentine. the slow speed round bur was clearing carious dentine well but there was one "island" of dark tooth that was not being cleared. It was easy enough to recognise by cleaning and drying the tooth and recognising that there was still some translucent material overlying the dentine. Switching back to a high speed diamond to clear this and clear the enamel margins to a clean DEJ allowed me to complete the preparation well.

It is important to have a systematic approach to everything you do in dentistry. Working concentrically outside to in i.e clearing DEJ at enamel margins then clearing dentine circumferentially working yor way in towards the pulpal floor works of me.