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Evidence-Based Approaches and Considerations for Nonrestorative Treatments in Modern Caries Management
TAKE-HOME MESSAGE
- Dental caries requires a lifelong management approach, and changes in risk factors over time demand age- and site-specific management strategies. Although caries treatment has been traditionally focused on restoring advanced cavitated lesions, nonrestorative interventions are effective in halting caries progression and preventing new lesions. These include the application of fluorides and sealants, nonrestorative caries treatments, antimicrobials, calcium-based strategies, and biomimetics.
- Modern caries management strategies should incorporate nonrestorative interventions into a continuum that includes both preventive and restorative care. Clinicians must ensure emerging interventions are supported by robust evidence for safety and efficacy.
abstract
This abstract is available on the publisher's site.
Access this abstract now Full Text Available for ClinicalKey SubscribersBACKGROUND
A high level of scientific evidence supports several nonrestorative strategies for the control of caries, with the goal of reducing progression of mineral loss and arresting existing lesions. The authors provide an overview of evidence for nonrestorative caries control and considerations in the decision making for selecting nonrestorative options.
TYPES OF STUDIES REVIEWED
The authors discuss findings from existing reviews, systematic reviews, and evidence-based guidelines (particularly from the American Dental Association) describing the effectiveness of nonrestorative strategies available in the US market for remineralization and arrest of caries lesions.
RESULTS
Studies support a wide range of products for arresting caries lesions, such as fluorides, sealants, infiltration resins, and chlorhexidine varnish, among others, depending on the tooth surface, primary or permanent dentition, and whether lesions are noncavitated or cavitated. Decisions should be based on appropriate detection, diagnosis, and risk assessment.
CONCLUSIONS AND PRACTICAL IMPLICATIONS
Effective nonrestorative strategies should be used to manage active, noncavitated caries lesions in primary and permanent teeth, and can be considered for managing active cavitated lesions when restorative intervention is not feasible. These lesion-centered interventions should be part of the required overall management of the caries disease process and existing modifiable risk variables at the patient level. They must be monitored over time and reapplied periodically, as needed.
Additional Info
Evidence-based approaches and considerations for nonrestorative treatments within modern caries management: Integrating science into practice
J Am Dent Assoc 2024 Nov 02;[EPub Ahead of Print], M Fontana, C Gonzalez-Cabezas, LMA TenutaFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.