Article: Volume 47 Number 10 Page 841 - November 2020

  Dent Update 2020; 47: 841-847  Read article

Caries Management:  Minimally invasive selective caries removal put into practice

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Abstract: Dental caries remains a significant health problem globally, causing morbidity in those affected and consuming health resources. The management of caries consumes considerable finances both for individuals and the public purse. The scientific understanding of the dental caries process has evolved considerably over the last four decades with a move towards a minimum intervention oral care (MIOC) approach to managing patients. The minimally invasive operative intervention that retains demineralised, caries-affected dentine under a well-sealed restoration in order to avoid instrumentation close to the pulp, has shown clinical efficacy in treating individual teeth, as part of the MIOC framework. However, implementation of the selective caries removal approach in deep lesions is still not thought to be practised routinely by clinicians both globally, and in the UK. This article discusses some of the issues that may account for this and describes a case study using this operative strategy.

Clinical relevance: Restoring deep carious lesions can be a challenge, but using selective caries removal approaches will help minimise the adverse effects of pulp trauma.

Author notes: Bhupinder Dawett, BDS, MDPH, Doctoral Research Fellow, School of Clinical Dentistry, University of Sheffield, Sarah Young, BSc (Hons), BDS, MJDF, RCS(Eng), GDP, Hafren House Dental Practice, Alfreton, Derbyshire, Chris Deery, BDS, MSc, FDS RCSEd, PhD, FDS(Paed Dent) RCSEd, FDS, RCS(Eng), FHEA, Dean, Professor/Honorary Consultant in Paediatric Dentistry, School of Clinical Dentistry, University of Sheffield and Avijit Banerjee, BDS, MSc, PhD(Lond), LDS, FDS(Rest Dent), FDS RCS(Eng), FHEA, Professor of Cariology and Operative Dentistry/Honorary Consultant and Clinical Lead, Restorative Dentistry, Faculty of Dentistry, Oral and Craniofacial Sciences, King’s College London, UK.

Objective: To describe the use of minimally invasive, selective caries removal interventions to treat deep carious lesions in teeth and implications for practice.