Patient: 10 year old girl with 4 central cusps, doctor said to pay more attention, what causes it? Do I need to treat it? What should I pay attention to during the day? I look forward to your reply, thank you. Wang Minyong, Department of Pediatric Dentistry, Peking University Stomatology Hospital, Second Outpatient Department: This condition belongs to “malformed central cusp”, which is mostly seen in the newly erupted premolar teeth. When the central cusp is accidentally broken, the pulp will be exposed, which will cause pulp infection and affect the development of the root (the root of the newly erupted permanent tooth is not completed, and it takes 2-3 years to develop). It is not yet medically possible to clearly distinguish whether there is pulp protrusion in the central cusp, so aggressive treatment of all central cusps is clinically recommended to prevent accidents. The current primary treatment is to reinforce the elevated cusps to prevent accidental fracture.