Management of primary molar infraocclusion in general practice

Statement of the problem: Infraoccluded primary molars can be managed in general dental practice but clinicians need to understand when intervention is necessary.

To review the current literature on infraocclusion in primary molars, and to demonstrate diagnosis and management strategies for general dental practitioners.

Current literature was sourced via PubMed search using multiple key words. Relevant articles are summarised within the article. Different management strategies will be illustrated using a section of cases of differing severities and age at diagnosis. All interventions, including conservative management, restorative, and surgical management will be reviewed. The importance of early diagnosis, continued monitoring, and interdisciplinary team work will be emphasised.

Infraocclusion of primary molars is a common clinical finding, which can be diagnosed both clinically and radiographically. The severity of infraocclusion is classified according to the relationship of the occlusal surface of the tooth relative to adjacent teeth. The age of the child at diagnosis and rate of infraocclusion play a pivotal role in case management. The majority of primary molar teeth exfoliate naturally when the permanent successor is present, however active intervention may be required in some cases. Possible management techniques include extraction, restoration, and luxation of these teeth.

All children in the mixed and primary dentition should be assessed for infraocclusion of primary molars, particularly mandibular molars. Accurate dental records are essential to assess the severity and monitor the rate of progression of infraocclusion so that the condition can be appropriately managed.