title: Changing concepts in cariology: forty years on.
abstract: The caries lesion is a sign or symptom resulting from numerous pH fluctuations in biofilms on teeth. The lesion may or may not progress and lesion progression can be controlled, slowed down or arrested. Control of the biofilm is the treatment of caries, the most important measure being to disturb the biofilm mechanically using a fluoride-containing toothpaste. The informed patient controls caries and the role of the dental professional is to advise how this should be done. This is the non-operative treatment of caries and it is worthy of payment. It should be mandatory as part of any operative treatment to ensure that the patient understands, and is able to perform, adequate plaque control.
  
  
  CONCLUSIONS
  It is very unfortunate that the current remuneration scheme (Unit of Dental Activity) in Health Service practice in England and Wales prevents practitioners adopting a modern biological approach to caries control.
authors.affiliation: King's College, London, UK.
authors.forename: Edwina
authors.initials: E
authors.lastname: Kidd
authors.forename: Ole
authors.initials: O
authors.lastname: Fejerskov
mesh_terms: D018441:Biofilms; D002327:Cariostatic Agents / Q000627:therapeutic use; D003657:Decision Making; D003695:Delivery of Health Care / Q000191:economics; D003729:Dental Care / Q000191:economics; D003731:Dental Caries / Q000175:diagnosis / Q000382:microbiology / Q000517:prevention & control*; D003773:Dental Plaque / Q000382:microbiology / Q000517:prevention & control; D003793:Dental Restoration, Permanent; D004032:Diet; D004739:England; D005459:Fluorides / Q000627:therapeutic use; D006801:Humans; D009910:Oral Hygiene / Q000379:methods; D010347:Patient Care Planning; D018570:Risk Assessment; D013218:State Dentistry / Q000191:economics; D017001:Tooth Demineralization / Q000209:etiology; D014089:Tooth Remineralization; D014852:Wales; D014987:Xerostomia / Q000150:complications
chemical_list: D002327:Cariostatic Agents; D005459:Fluorides