To Treat or Not to Treat?: Clinical Dilemmas in Pediatric Dentistry

AI flags caries, but your clinical exam tells a different story. Is artificial intelligence improving diagnosis, or creating new uncertainty?

A cooperative child presents with early carious lesions, and parents request a non-invasive approach. Silver diamine fluoride is considered, but are we simply managing disease indefinitely? How do we balance disease management with definitive treatment?

A young patient struggles with dental care, and sedation is offered as a solution. Are we optimizing patient experience, or are children gradually losing coping skills while clinicians lose behavioral management skills?

Contemporary pediatric dentistry is increasingly shaped by these clinical dilemmas. As clinical presentations become more complex and technology continues to evolve, clinicians are challenged not only in what to do, but how to think. This case-based presentation explores real-world pediatric scenarios that extend beyond routine protocols, where behavioral, developmental, and social factors intersect with clinical risk. Participants will examine how integrated clinical reasoning, incorporating medical status, child development, temperament, family dynamics, and caries risk, guides appropriate thresholds for treatment, deferral, or referral. Attendees will leave with a practical, evidence-based framework to navigate uncertainty, learning not only what to do, but when to act, when to pause, and when innovation can be meaningfully integrated to improve outcomes.