Pediatric Dentistry · single question

What is the best treatment for extensive occlusal surface caries involving tooth 'K' (primary maxillary left first molar) in a cooperative 5-year-old?

  1. Stainless steel crown
  2. Amalgam restoration
  3. Silver diamine fluoride only
  4. Extraction
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Correct answer: A. Stainless steel crown

For extensive caries involving a primary molar, the stainless steel crown (SSC) is the treatment of choice. Primary molars with extensive decay, multi-surface caries, or post-pulpotomy teeth require SSCs because they restore the entire coronal surface, provide excellent longevity, and protect the remaining tooth structure better than any direct restoration. Research consistently demonstrates that SSCs have significantly higher success rates than amalgam or composite for primary molars with extensive decay. Amalgam is acceptable for smaller, single-surface lesions but is inferior to SSCs for extensive caries. Silver diamine fluoride arrests caries but does not restore form or function.

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