title: Managing caries: the need to close the gap between the evidence base and current practice.
abstract: Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.
authors.affiliation: Department of Operative and Preventive Dentistry, Charité - Universitätsmedizin Berlin, Aßmannshauser Str. 4-6, 14199 Berlin, Germany.
authors.forename: F
authors.initials: F
authors.lastname: Schwendicke
authors.affiliation: Université Clermont1, UFR d'Odontologie; Centre de Recherche en Odontologie Clinique EA 4847, 2 rue de Braga, 63,100 Clermont-Ferrand, France.
authors.forename: S
authors.initials: S
authors.lastname: Doméjean
authors.affiliation: Dundee Dental Hospital, Park Place, Dundee, DD1 4HR;
authors.forename: D
authors.initials: D
authors.lastname: Ricketts
authors.affiliation: University of Michigan, School of Dentistry, 1,011 N. University D 2391, Ann Arbor, MI 48109 1078, USA.
authors.forename: M
authors.initials: M
authors.lastname: Peters
mesh_terms: D003731:Dental Caries / Q000601:surgery / Q000628:therapy*; D003793:Dental Restoration, Permanent / Q000379:methods; D055094:Evidence-Based Dentistry; D006801:Humans; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D019239:Practice Patterns, Dentists'