Management of Patients with Poor Prognosis First Permanent Molars Beyond 'Ideal' Timing

The management of compromised first permanent molars is a common clinical conundrum in paediatric dentistry. Extensive guidance exists which supports the timed extraction of severely affected molars presenting at 8-10 years to allow favourable eruption of unaffected second permanent molars. However, treatment planning becomes more of a challenge when this window of opportunity is missed. In these situations, we are left with a tooth of guarded long-term prognosis in a patient where access and cooperation can be challenging. Delays to routine care as a result of the COVID-19 pandemic are likely to make this a more common clinical presentation so this article aims to discuss management options for these patients.