{"type":"rich","version":"1.0","provider_name":"Transistor","provider_url":"https://transistor.fm","author_name":"Protrusive Dental Podcast","title":"Maintain or Extract? First Permanent Molars of Poor Prognosis - PDP279","html":"","width":"100%","height":180,"duration":3186,"description":"Your patient is nine years old. One first permanent molar is crumbling — the others look fine. Does it stay, or does it go?\nIs that broken-down first permanent molar really down to poor brushing — or is it Molar Incisor Hypomineralisation?\nWhen is the right time to take a first permanent molar out — and how do you read it off the X-ray?\nAnd how do you tell a parent their child needs an adult tooth removed — without losing them?\nFirst permanent molars of poor prognosis are one of the genuine head-scratchers of general practice — full of ifs, buts and timing. In this episode Jaz sits down with Dr Nicole Sturzenbaum, a paediatric dentist and the owner and clinical director of Toothbeary in Richmond, London, to work through the whole decision: getting the diagnosis right (molar-incisor hypomineralisation versus caries), reading the extraction window off an OPG, the restorative ladder from sealant to stainless steel crown, when to bring in the orthodontist, and how to handle the conversation with anxious parents. There’s no one-size-fits-all answer — but there is a clear way to think about it.\n\nProtrusive Dental Pearl: Painless Polishing for Anxious Kids\n\nThe mechanical clean is what frightens children (and plenty of adults) — the scaler, the bristle brush, the gritty prophy paste. For the polishing part, a colourless plaque-dissolving foam gel does the job without any of it. It fizzes wherever there is plaque, so you can hand the child a mirror and show them exactly where to brush; it leaves the teeth satin-smooth, reduces gingival inflammation, and is painless and non-invasive.\nTwo caveats: it does not remove calculus — you still need a hand or ultrasonic scaler for that — and you should agitate the gel gently at the gingival margin for the full effect. It is especially useful for orthodontic and adolescent patients because it reaches the nooks around brackets, which is where post-orthodontic white-spot lesions start.\nProduct: Magic3 (3% hydrogen peroxide,...","thumbnail_url":"https://img.transistorcdn.com/hLSIeRiYSp0oTfIk0BzEukFutShD18hH3f6fq4QHsWw/rs:fill:0:0:1/w:400/h:400/q:60/mb:500000/aHR0cHM6Ly9pbWct/dXBsb2FkLXByb2R1/Y3Rpb24udHJhbnNp/c3Rvci5mbS9lZmM0/ZTNjYzdiZDJhNGFj/MzBiYmU2NTUwNmM2/NzQ2My5wbmc.webp","thumbnail_width":300,"thumbnail_height":300}