Skip to main page content
Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
, 13 (4), 209-17

Dental Caries: A Complete Changeover, PART III: Changeover in the Treatment Decisions and Treatments


Dental Caries: A Complete Changeover, PART III: Changeover in the Treatment Decisions and Treatments

Usha Carounanidy et al. J Conserv Dent.


Comprehensive management of dental caries should involve the management of disease as well as the lesion. Current decision making process in cariology is influenced by numerous factors such as the size/ depth/ activity of the carious lesion and age/ the caries risk status of the patient. Treatment decisions should involve planning the non-operative/ preventive treatment for non-cavitated or early cavitated lesions and also formulating operative treatment for cavitated lesions. Apart from these two responsibilities, a clinician should also be knowledgeable enough to decide when not to interfere in the caries dynamics and how frequently to recall the patient for follow-ups. The non-operative treatment prescriptions vary in dose, intensity and mode of delivery according to the caries risk status. Minimal invasion and maximal conservation of tooth structure has become the essence of current operative treatments. This part of the series elaborates on the paradigm shift in the management of dental caries.

Keywords: Antimicrobials; CPP-ACP; caries vaccine; chlorhexidine; fissure sealant; fluoride; minimal intervention; nonoperative treatment; operative treatment; prevention; probiotic; remineralization; restoration; slow fluoride releasing device; treatment decision.

Conflict of interest statement

Conflict of Interest: None declared.


Figure 1
Figure 1
Treatment decision tree for a non cavitated pit and fissure lesion. (Adapted and modified)[8] The treatment decision is influenced by the activity of the lesion, the risk status and the age of the patient. The decisions include non-operative treatment, operative treatment and follow-up period
Figure 2
Figure 2
Contemporary ICDAS-enabled, patient-centered caries management framework. The treatment decision is influenced by the nature of the lesion and risk status of the patient[9]

Similar articles

See all similar articles

Cited by 7 PubMed Central articles

See all "Cited by" articles


    1. Usha C, Sathyanarayanan R. Dental caries: A complete changeover (Part 2) J Conserv Dent. 2009;12:87–100. - PMC - PubMed
    1. Black GV. Pathology of the hard tissues of the teeth. Vol. 1. Chicago, II: Medico-Dental Publishing Co; 1908. Operative dentistrty.
    1. Massler M. Pulpal reactions to dental caries. Int Dent J. 1967;17:441–60. - PubMed
    1. Young DA, Featherstone JD, Roth JR. Curing the silent epidemic: Caries management in the 21st century and beyond. J Calif Dent Assoc. 2007;35:681–5. - PubMed
    1. Kidd EA, Fejerskov O. The control of disease progression: Non-operative treatment. In: Fejerskov O, Kidd E, Nyvad B, Baelum V, editors. Dental caries: The disease and its clinical management. 2nd ed. San Francisco, US: Blackwell Munksgaard Ltd; 2008. pp. 252–5.