Large posterior resin composite restorations and all-ceramic crowns should be restricted largely to critical aesthetic situations. Dent Clin North Am 2005; 49: 701–723. When sufficient gingival embrasure space is present, then interdental bristle brushes of various diameters can be used to convey fluoride toothpastes or casein-derived remineralisation pastes to the lesion sites. British Dental Journal, 2012; 213(5):211-220: en: dc.identifier.issn: 0007-0610: en: ... based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. both the prevention and treatment of dental caries in children and adolescents in Ireland. An important contribution of the dental services to the decline in caries was a change in the diagnostic and treatment criteria. However, the median survival time for the extensive amalgams was much lower, at 14.6 years. The concepts of 'minimal intervention' or 'minimally invasive' restorative dentistry do not appear to be well understood or accepted. Dental Caries Part 2: Conception to Age Three 13. Clinical studies were included when at least 20 restorations could be followed-up for at least 24 months. Eur J Oral Sci 2001; 109: 14–19. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth. As part of the evidence-based approach to care, these clinical recommendations should be integrated with the practitioner's professional judgment and the patient's needs and preferences. The focus of the recommendations is early identification of high caries risk children in order to initiate early preventive measures. Principles of preventive dentistry, 320. both the prevention and treatment of dental caries in children and adolescents in Ireland. Gender approached significance (p = 0.08). Dentistry is well recognized as a profession interested in and highly involved with prevention of oral diseases including, but not limited to, dental caries, periodontal disease, excessive tooth wear, and other occlusal conditions. Clinical manifestations of dental caries process, 328. However, clinical studies indicate that composite but not glass-ionomer tunnel restorations might be a promising alternative. After adjusting for confounding variables the difference in the DMFS increment between the control and study groups remained significant (mean difference 1.7; p < 0.001). Quality evaluation of dental restorations. 3rd edn. McConnachie I. Seven general dental practitioners examined a total of 332 occlusal surfaces in 240 patients. Quintessence Int 1992; 23: 307–315. seen in children [5]. What is the difference between the surgical model and the medical model for the management of caries? Treatment patterns for caries have been shown to reflect high rates of restorative services. Dental caries is a major public health problem globally and is the most widespread noncommunicable disease (NCD). Root surface caries, and softened root surfaces caused by tooth erosion, will remineralise using fluoride varnish and/or casein-derived remineralisation pastes. Join ResearchGate to find the people and research you need to help your work. ISSN 1476-5373 (online), Root Caries Part 2: the Restorative Challenge, KISS principle and non AGP dentistry for pandemic periods and beyond, Clinical Assessment of a New Caries Activity Test Using Dental Plaque Acidogenicity in Children under Three Years of Age, Restorative treatment for initial, cavitated and gross coronal carious lesions, Treatment of caries in relation to lesion severity: Implications for minimum intervention dentistry. The avoidance of a restoration, with its attendant drawbacks, also points to a therapeutic role for fissure sealants for established small non-cavitated carious pit and fissure lesions in erupted teeth. When examining the margins of restorations, a 'catch' by a sharp dental explorer is often erroneously considered to provide grounds for their replacement even when secondary caries is not detected. This approach to chronic disease management increases the likelihood that patients will receive appropriate and personalized preventive and therapeutic care. Dawson A S, Makinson O F. Dental treatment and dental health. Acidic fruits and beverages became widely available due to economic prosperity. Part 2. ental caries and assessment of risk D Part 3.eriodontal disease and assessment P of risk. Efficacy was independent of age, gender, medical concerns, fluoride history, or previous history of dental caries, in a population of patients attending for treatment in private dental practices, in a variety of locations, on a relatively short-term basis (two years). Preventive Dentistry Can Be a Win-Win Situation Gordon J. Christensen, DDS, MSD, PhD. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. The assessment and management of fissured tooth surfaces receives special attention. Models of service rates adjusted for age, gender, insurance status and reason for visit showed that compared to the reference category of initial caries lesions, there were lower rates [Rate Ratio, 95% CI] of adhesive anterior restorative services [0.57, 0.34-0.95] and lower rates of adhesive posterior restorations [0.56, 0.40-0.79] for gross lesions. McIntyre J. Dental hygienists play a significant role in the assessment of a patient’s individual caries risk. Br Dent J 2012; 213: 55–66. Worthington H (eds). Preventive and treatment planning for dental caries. J Dent Res 2008; 87: 344–348. When should preventive-resin restorations be used? SHCN: Special health care needs. The concept 'Minimally Invasive Dentistry' can be defined as maximal preservation of healthy dental structures. Non-operative caries control should be used whenever possible. MID in its widest sense may be divided into three components: Non-intervention: for example, monitoring of unerupted impacted teeth, posterior tooth extraction spaces, caries in the primary dentition, and less-than-ideal restorations, Prevention: for example, control of dental plaque microorganisms and erosive acids, use of fluorides and casein-derived remineralisation pastes, pit and fissure sealants, occlusal splints and sports mouthguards, control of tongue thrusting and digit sucking habits when indicated, and extraction of selected grossly carious posterior molar teeth in appropriate circumstances during the mixed dentition. At what stage in caries progression should restorations be considered? The lowest correlation was observed for performances in pedodontics lecture and clinical courses (r= 0.38 and 0.29 in Group I and II, respectively, p<0.01). Type Article Author(s) K. Yip, R. Smales Date 2012-9 Volume 213 Issue 5 Page start 211 Page end 220 DOI 10.1038/sj.bdj.2012.774 Web address Results: Caries Risk or have had a filling placed within the previous 12 months. Objectives: Age (p < 0.001), health status (p = 0.005), baseline risk (p < 0.001) and fluoride history (p < 0.001) were all independent significant predictors of two-year DMFS increment. Preventive dental care is an important part of whole person health, so many dental plans cover it. Surface discolouration may be due to the intake of particular foods, drinks or medicines, and simple polishing of the restoration may solve or improve this situation. Objectives: While pit and fissure lesions may become arrested, it is difficult to prove that such arrest has occurred and that active caries progression has ceased. This belief is largely based upon the concept that the removal of all carious tissue followed by meticulous restoration of the tooth is the treatment of choice for dental caries. In other words, the primary treatment objective should be to manage the disease by nonoperative measures, while repair of destroyed tissue should come second. Barriers were identified to the delivery of CRA and the provision of comprehensive preventive care by the dentists and other healthcare professionals. What are the problems in deciding whether to replace amalgams having faulty margins? This study was carried out on 428 adults (242 female, 186 male) 20 years of age and older, who attended the Department of Operative Dentistry, Department of Oral Diagnosis and Oral Radiology, Knowing which factors influence restoration longevity can help clinicians make sound treatment decisions. (18) The goal of this project is to create a Practice Based Research Network with 30 researcher dentists calibrated on the administration of a caries risk assessment and the treatment modalities recommended based on the caries risk assessment results (Caries Management … Caries of enamel, 330. Better aesthetics than when using amalgam, Prevention of caries in adjacent pits and fissures. alternate dental caries preventive programs, including the option of using no preventive program at all. However, the clinicians involved were generally unaware of the faults in their new restorations, for they assessed them all as being satisfactory, with approximately 90% being excellent in all respects. Abstract Currently a range of systems and classifications are used by clinicians, epidemiologists and clinical research workers to sub-divide carious lesions into different grades. On the other hand, preventive measures can remove or partially remove the causes, thereby reducing the risks for future caries recurrence at the same site or elsewhere in the mouth. Correlations between academic achievements in lecture and laboratory, lecture and clinical, and laboratory and clinical courses were analyzed using Spearman's rank correlation. When clinically practicable, large direct placement restorations should be placed initially in preference to indirect restorations. Children are exposed to intense marketing of these acidic products, which are widely available in supermarkets and school canteens. This paper focuses on describing minimally invasive dentistry in cariology from a conceptual perspective, relating to clinical caries diagnosis, restorative intervention thresholds and operative procedures, with special reference to survival of tunnel and slot restorations and to repair vs. replacement of defective restorations. Yet restorations are not permanent and do not cure caries, as the causes remain. Depending on the age of the patient and the extent of active caries, fluoride toothpastes containing from 1,000-5,000 ppm fluoride can be used. B. However, the final selection decision should be based largely on the most cost-effective evidence available from long-term clinical studies undertaken in general dental practices. Approximately 80% of restorations survived for five years. 3.4.5 Assessing the Risk of Pain or Sepsis Developing Before Exfoliation 14 3.4.6 Assessing Plaque Levels 17 3.5 Caries Risk Assessment 18 4 Defining Needs and Developing a Personal Care Plan 19 5 Managing Pain (if present) 21 6 Caries Prevention 23 6.1 Motivating and Action Planning 24 6.2 Toothbrushing with Fluoride Toothpaste 26 Codes 1 and 2 for enamel caries and Code 1 for root caries record the visual changes in intact surfaces caused by demineralisation, which are amenable to repair by remineralisation (Table 2, Part 2).2. Early theories of caries aetiology, 322. Investigate the impact of quality improvement efforts on subsequent design and delivery of preventive care. However, there were no significant differences found in the cost-effectiveness of using either resin composites or glass-ionomer cements to restore Class III preparations, or between using either of these two materials, or amalgams, to restore Class V preparations. The purpose of this article was to summarize and discuss the available information concerning the tunnel technique and the clinical success of tunnel restorations. Historically, clinicians have restoratively intervened at an early stage because of concern that caries will progress unless completely removed and a restoration placed. There was 100% compliance with the protocol for preventive plans. Dent Mater 2007; 23: 1461–1467. However, despite the increased loss of sound tooth structure that occurs during the replacement of resin composites, relatively few are repaired or even refurbished. Aust Dent J 2008; 53: 306–313. For instance, Massachusetts' General Law states that both private and public schools must have 900 and 990 h in a school year for elementary and secondary schools, respectively. Reviews and maintenance of restorations. The mouthrinses were used for 60 sec, three times/day for 5 days, and supragingival plaque was collected and analyzed for F. The dentifrices were rinsed as a water slurry for 60 sec four times/day for 14 days in an in situ model. Beauchamp J, Caufield P W, Crall J J et al. This has improved subsequent prescription of age specific evidence-based preventive care appropriate to the risk status of that individual. • The most important part in the treatment of disease is caries prevention. There are several conditions that usually indicate when a restoration is required. These reasons may be patient-, dentist- or material-related. Oral diagnosis and treatment planning: part 5. However, since the signs and symptoms of dental caries are the result of a disease process, our treatment should aim at arresting the disease process before repair of destroyed tissue is needed [27]. The former rates may well be much higher than the latter for reasons largely unrelated to strictly defined criteria for restoration replacement. With the increasing prevalence of root caries of varying complexity, clinicians will face challenges in deciding how best to manage such lesions. FDI Commission Project 1-97, Minimally Invasive Dentistry - concepts and techniques in cariology, Oral diagnosis and treatment planning: Part 2. There is an obvious tendency in dental practice to place more full crowns than may be necessary. We present a clinically oriented review of the literature on the role of saliva in the upper gastrointestinal tract and review the many problems associated with lack of saliva. There were no statistically significant differences between the groups in the incidence of toothaches (p = 0.1) or number of treatment visits required (p = 0.35). glass-ionomers) or corrosion products (cf. and assessment of risk Part 5.reventive and treatment P planning for dental caries. Supplemental printed information should be appropriately written and illustrated for the age and level of understanding of the patient/parent. In this, the second of two papers on the relationships between dental treatment and dental health, the philosophical basis of Minimum Intervention Dentistry is presented. However, it is essential that the fissures be cleaned of all debris, using air polishing, air abrasion, lasers or fissurotomy burs. There is a fairly large range of generic materials available for direct placement and indirect placement dental restorations, with numerous and constantly changing branded products marketed, often with no controlled clinical trials having been undertaken. (Mild responses should be observed for several weeks to determine if the reaction is self-limiting). Therefore, new methods for increasing the accuracy of diagnosis have been sought for years. Changes in risk status, fluoride history, number of emergency visits and toothaches, along with demographic variables such as age, gender, health problems, and the location of the dental practice attended were measured. The panel concluded that sealants are effective in caries prevention and that sealants can prevent the progression of early noncavitated carious lesions. Pitts N B, Longbottom C. Preventive Care Advised (PCA)/Operative Care Advised (OCA) - categorising caries by the management option. This paper reviews the efficacy of an intensive, preventive-based, non-invasive approach to the management of dental caries within a randomized controlled trial. British Dental Journal, Sep 2012 K. Yip, R. Smales. (A series of articles by five authors). 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