How is dental caries managed?

From the Guidelines

Dental caries is managed through a combination of preventive measures, early intervention, and restorative treatments, with the primary approach involving maintaining good oral hygiene by brushing twice daily with fluoride toothpaste, as recommended by the Centers for Disease Control and Prevention 1. The management of dental caries involves several key components, including:

• Preventive measures: brushing twice daily with fluoride toothpaste, flossing daily, and having regular dental check-ups every six months
• Early intervention: remineralization using fluoride treatments such as prescription-strength toothpaste, fluoride varnish applications, or daily use of fluoride mouth rinses
• Restorative treatments: removal of decayed tissue and placement of fillings, crowns, root canal therapy, or extraction in severe cases
• Dietary modifications: reducing frequency of sugar consumption and avoiding acidic beverages
• Dental sealants: providing additional protection for molars with deep grooves This comprehensive approach addresses caries at all stages, as the disease process involves bacterial acids dissolving tooth mineral structure, which can be reversed in early stages but requires mechanical intervention once cavitation occurs 1. The use of fluoride is a critical component of dental caries management, as it has been shown to be safe and effective in preventing and controlling dental caries when used appropriately 1. It is essential to note that the management of dental caries should be tailored to the individual's risk level, with additional fluoride measures or other preventive measures recommended for persons at high risk for dental caries 1.

From the Research

Management of Dental Caries

Dental caries, a preventable disease, can be managed through various approaches. The key to effective management lies in a combination of preventive measures, non-invasive strategies, and personalized care plans.

• Preventive Measures:
  • Water fluoridation and the use of fluoridated toothpaste have been shown to decrease caries incidence 2, 3.
  • Controlling the intake and frequency of fermentable sugars and removing dental plaque using effective fluoridated toothpaste are crucial in reducing the burden of dental caries 4.
• Non-invasive Strategies:
  • The Caries Management System is a ten-step non-invasive strategy that aims to arrest and remineralize early lesions, considering the patient's risk, lesion status, and clinical management 2.
  • Minimal Intervention Dentistry (MID) focuses on managing carious lesion development and progression by moving away from the 'surgical' care approach and embracing a more preventive and less invasive approach 4.
• Personalized Care Plans:
  • The International Caries Detection and Assessment System (ICDAS) provides clinical criteria and codes for personalized comprehensive caries management, enabling effective treatment planning based on patient-level risk information and monitoring 5.
  • Topical fluoride application, particularly through fluoride toothpaste, represents a cost-effective and safe means to reduce the risk of dental caries in children and adolescents 3.
• Shift from Restorative to Preventive Management:
  • Traditional restorative treatment has shortcomings, and there is a need for dentists to manage carious lesions by preventive means as much as possible 6.
  • A preventive approach can lead to better long-term health outcomes and reduce the need for restorative therapy 2, 4, 6.