Are we ready to move from operative to non-operative/preventive treatment of dental caries in clinical practice?
This review focuses on the clinical interactions between patients and the dental team, not on caries prevention at a public health level. Many dentists no longer take a narrow surgical view seeking to apply interventive treatment as a one-off event at a certain trigger point of disease severity and the evidence that caries is an initially reversible, chronic disease with a known multi-factorial aetiology is being appreciated more widely. The caries process should be managed over time in an individualized way for each patient. Very few individuals can be considered to be truly 'caries free' when initial lesions as well as more advanced dentine lesions are considered. It is now very clear that, by itself, restorative treatment of the disease does not 'cure' caries. The caries process needs to be managed, in partnership with patients, over the changing challenges of a lifetime. The answer to the question posed in the title should be, in many cases, that we are ready to move to non-operative/preventive care (if we have not done so already). However, this should be for appropriate stages of lesion extent and in patients who respond to advice on recall frequency and preventive behaviours.
Pitts
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Dental Health Services Research Unit and Centre for Clinical Innovations, University of Dundee, Dundee, UK. n.b.pitts@dundee.ac.uk
D032921:Consensus; D003731:Dental Caries / Q000175:diagnosis / Q000517:prevention & control*; D003814:Dentistry, Operative; D019317:Evidence-Based Medicine; D006801:Humans; D019239:Practice Patterns, Dentists'; D011313:Preventive Dentistry / Q000191:economics / Q000379:methods*; D012196:Review Literature as Topic