An 86-year-old nursing home resident with heavy plaque, calculus and limited dexterity has class V lesions on the mandibular incisors. Which restorative material is most appropriate?

Correct answer: A. Glass ionomer (or resin-modified glass ionomer)

• A. CORRECT. GLASS IONOMER is the material of choice for cervical and root-surface lesions in a high-caries-risk patient with poor hygiene. It bonds chemically to dentine without requiring a dry field, releases fluoride and recharges from toothpaste, and its thermal expansion is close to that of tooth structure. In a patient whose moisture control is difficult and whose caries risk is unlikely to fall, that combination outperforms aesthetics.
• B. Microfilled composite polishes beautifully and is aesthetically excellent, but it demands strict isolation and offers no fluoride release or caries protection.
• C. Amalgam requires mechanical retention, meaning removal of sound tooth structure to create undercuts in an already thin cervical wall. It also releases no fluoride.
• D. Nanohybrid composite has better physical properties than microfill but the same limitations here: technique sensitivity, moisture intolerance, and no anticariogenic effect.

Note: Resin-modified glass ionomer is often the practical compromise — it keeps the fluoride release and chemical bond while improving strength, wear resistance and aesthetics over conventional GI. In an institutionalised patient, also consider silver diamine fluoride to arrest the lesions first, then restore with GI where restoration is warranted.