Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Oct;229(7):474-482.
doi: 10.1038/s41415-020-2220-4.

When to intervene in the caries process? A Delphi consensus statement

Avijit Banerjee  1 , Christian Splieth  2 , Lorenzo Breschi  3 , Margherita Fontana  4 , Sebastian Paris  5 , Michael Burrow  6 , Felicity Crombie  7 , Lyndie Foster Page  8 , Patricia Gatón-Hernández  9 , Rodrigo A Giacaman  10 , Neeraj Gugnani  11 , Reinhard Hickel  12 , Rainer A Jordan  13 , Soraya Leal  14 , Edward Lo  6 , Hervé Tassery  15 , William Murray Thomson  8 , David J Manton  16 , Falk Schwendicke  5
Affiliations

When to intervene in the caries process? A Delphi consensus statement

Avijit Banerjee et al. Br Dent J. 2020 Oct.

Abstract

Objectives To define an expert Delphi consensus on when to intervene in the caries process and existing carious lesions.Methods Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference.Results Lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations may be placed for form, function, aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated lesions which are cleansable. Cavitated lesions which are not cleansable usually require minimally invasive management. In specific circumstances, mixed interventions may be applicable. Occlusally, cavitated lesions confined to enamel/non-cavitated lesions extending radiographically into deep dentine may be exceptions. Proximally, cavitation is hard to assess tactile-visually. Most lesions extending radiographically into the middle/inner third of dentine are assumed to be cavitated. Those restricted to the enamel are not cavitated. For lesions extending radiographically into the outer third of dentine, cavitation is unlikely. These lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds.Conclusions Comprehensive diagnosis is the basis for systematic decision-making on when to intervene in the caries process and existing lesions.

PubMed Disclaimer

References

    1. Sackett D L, Rosenberg W M C, Gray J A M, Haynes R B, Richardson W S. Evidence based medicine: what it is and what it isn't. BMJ 1996; 312: 71-72.
    1. Frencken J E, Innes N P, Schwendicke F. Managing Carious Lesions: Why Do We Need Consensus on Terminology and Clinical Recommendations on Carious Tissue Removal? Adv Dent Res 2016; 28: 46-48.
    1. Innes N P, Frencken J E, Schwendicke F. Don't Know, Can't Do, Won't Change: Barriers to Moving Knowledge to Action in Managing the Carious Lesion. J Dent Res 2016; 95: 485-486.
    1. Frencken J E, Peters M C, Manton D J, Leal S C, Gordan V V, Eden E. Minimal intervention dentistry for managing dental caries - a review: report of a FDI task group. Int Dent J 2012; 62: 223-243.
    1. Schwendicke F, Frencken J E, Bjorndal L et al. Managing Carious Lesions: Consensus Recommendations on Carious Tissue Removal. Adv Dent Res 2016; 28: 58-67.

Publication types