A paradigm shift in the treatment of caries.
This paper presents a shift in the paradigm for treating dental caries from a surgical to a medical approach. Two key points are essential to understanding caries. First, caries is a bacterial infection caused by specific bacteria. Second, before cavitation, caries is a reversible multifactoral process. Two features, caries activity and caries risk, provide a diagnosis and prognosis leading to a treatment plan. Patients receive treatment using a medical model consisting of four steps: bacterial control; reduction of risk levels for at-risk patients; reversal of active sites by remineralization; and follow-up and maintenance.
Steinberg
Steven
S
University of Illinois, Chicago College of Dentistry, USA.
D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use; D003731:Dental Caries / Q000382:microbiology / Q000517:prevention & control / Q000628:therapy*; D003732:Dental Caries Activity Tests; D003733:Dental Caries Susceptibility; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control; D003793:Dental Restoration, Permanent / Q000379:methods; D005500:Follow-Up Studies; D006801:Humans; D010347:Patient Care Planning; D011379:Prognosis; D018570:Risk Assessment; D013290:Streptococcal Infections / Q000517:prevention & control / Q000628:therapy; D013295:Streptococcus mutans / Q000502:physiology; D017001:Tooth Demineralization / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy; D014089:Tooth Remineralization / Q000379:methods
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents