title: Clinical decision-making for caries management in primary teeth.
abstract: The aim of this review of clinical decision-making for caries management in primary teeth is to integrate current knowledge in the field of cariology into clinically usable concepts and procedures to aid in the diagnosis and therapy of dental caries in primary teeth. The evidence for this paper is derived from other manuscripts of this conference, computer and hand searches of scientific articles; and policy statements of councils or commissions of various health organizations. Current evidence regarding the carious process and caries risk assessment allows the practitioner to transcend traditional surgical management of dental caries in primary teeth. Therapy can focus on patient-specific approaches that include disease monitoring and preventive therapies supplemented by restorative therapies. The type and intensity of these therapies should be determined utilizing data from clinical and radiograph examinations as well as information regarding caries risk status; evidence of therapy outcomes; assessment and reassessment of disease activity; natural history of caries progression in primary teeth; and preferences and expectations of guardians and practitioners. Changes in the management of dental caries will require health organizations and dental schools to educate students, practitioners, and patients in evidence- and risk-based care.
authors.affiliation: Department of Pediatric Dentistry, University of Maryland Dental School, Baltimore, 21201, USA. ntinanoff@dental.umaryland.edu
authors.forename: N
authors.initials: N
authors.lastname: Tinanoff
authors.forename: J M
authors.initials: JM
authors.lastname: Douglass
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003657:Decision Making; D003731:Dental Caries / Q000175:diagnosis / Q000628:therapy*; D003793:Dental Restoration, Permanent; D019422:Dietary Sucrose; D018450:Disease Progression; D019317:Evidence-Based Medicine; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D007223:Infant; D009910:Oral Hygiene; D010895:Pit and Fissure Sealants; D018570:Risk Assessment; D012307:Risk Factors; D014094:Tooth, Deciduous
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D019422:Dietary Sucrose; D010895:Pit and Fissure Sealants; D005459:Fluorides