Skip to main content
SpringerLink
Log in

Removing or Controlling?

  • Chapter
  • First Online:
Management of Deep Carious Lesions

Abstract

A changing understanding of the disease dental caries has initiated a paradigm shift in the management of caries and carious lesions. Instead of merely removing the symptoms of the disease (i.e., the carious lesion), the aim of any therapy is to manage the disease. Noninvasive (biofilm control, remineralization, dietary interventions) and microinvasive strategies (sealants, caries infiltration) can either prevent new lesions or inactivate existing ones, or both. Traditionally, these strategies have been used to inactivate only non-cavitated carious lesions. New evidence shows that in some cases, they can also be applied to cavitated carious lesions. More often, for cavitated lesions, invasive strategies involving the placement of a restoration are needed. As restorations have a limited lifespan, their placement should be postponed as far as possible.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Institutional subscriptions

References

  1. Loesche WJ. Clinical and microbiological aspects of chemotherapeutic agents used according to the specific plaque hypothesis. J Dent Res. 1979;58(12):2404–12.

    Article  PubMed  Google Scholar 

  2. Black GV. Part 1 pathology of hard tissues of the teeth: oral diagnosis. Part III treatment of caries. Operative dentistry. 7. London: Medico-Dental Publishing; 1936.

    Google Scholar 

  3. Marsh PD. Dental plaque as a biofilm and a microbial community—implications for health and disease. BMC Oral Health. 2006;6(S1):S14.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Fejerskov O, Nyvad B, Kidd EA. Pathology of dental caries. In: Fejerskov O, Kidd EAM, editors. Dental caries: the disease and its clinical management. 2. Oxford: Blackwell Munksgaard; 2008. p. 20–48.

    Google Scholar 

  5. Ekstrand K, Zero DT. Die Ökologie der Mundhöhle. In: Meyer-Lueckel H, Ekstrand K, Paris S, editors. Karies—Wissenschaft und Klinische Praxis. 1. Stuttgart: Thieme; 2012. p. 4–22.

    Google Scholar 

  6. Harris R, Gamboa A, Dailey Y, Ashcroft A. One-to-one dietary interventions undertaken in a dental setting to change dietary behaviour. Cochrane Database Syst Rev. 2012;3:Cd006540.

    Google Scholar 

  7. Riley P, Moore D, Ahmed F, Sharif MO, Worthington HV. Xylitol-containing products for preventing dental caries in children and adults. Cochrane Database Syst Rev. 2015;3:Cd010743.

    Google Scholar 

  8. Sheiham A, James WP. Diet and dental caries: the pivotal role of free sugars reemphasized. J Dent Res. 2015;94(10):1341–7.

    Article  PubMed  Google Scholar 

  9. Sheiham A, Watt RG. The common risk factor approach: a rational basis for promoting oral health. Community Dent Oral Epidemiol. 2000;28(6):399–406.

    Article  PubMed  Google Scholar 

  10. Schwendicke F, Stolpe M. Taxing sugar-sweetened beverages: impact on overweight and obesity in Germany. BMC Public Health. 2017;17(1):88.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Schwendicke F, Thomson WM, Broadbent JM, Stolpe M. Effects of taxing sugar-sweetened beverages on caries and treatment costs. J Dent Res. 2016;95(12):1327–32.

    Article  PubMed  Google Scholar 

  12. Kumar S, Tadakamadla J, Johnson NW. Effect of toothbrushing frequency on incidence and increment of dental caries: a systematic review and meta-analysis. J Dent Res. 2016;95(11):1230–6.

    Article  PubMed  Google Scholar 

  13. Marinho V, Higgins J, Sheiham A, Logan S. Fluoride toothpastes for preventing dental caries in children and adolescents. Cochrane Database Syst Rev. 2005(3).

    Google Scholar 

  14. Poklepovic T, Worthington HV, Johnson TM, Sambunjak D, Imai P, Clarkson JE, et al. Interdental brushing for the prevention and control of periodontal diseases and dental caries in adults. Cochrane Database Syst Rev. 2013;12:Cd009857.

    Google Scholar 

  15. Riley P, Lamont T. Triclosan/copolymer containing toothpastes for oral health. Cochrane Database Syst Rev. 2013;12:Cd010514.

    Google Scholar 

  16. James P, Parnell C, Whelton H. The caries-preventive effect of chlorhexidine varnish in children and adolescents: a systematic review. [Review]. Caries Res. 2010;44(4):333–40.

    Article  PubMed  Google Scholar 

  17. Yengopal V, Mickenautsch S. Caries preventive effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP): a meta-analysis. Acta Odontol Scand. 2009;67(6):321–32.

    Article  PubMed  Google Scholar 

  18. Raphael S, Blinkhorn A. Is there a place for tooth mousse in the prevention and treatment of early dental caries? A systematic review. BMC Oral Health. 2015;15(1):113.

    Article  PubMed  PubMed Central  Google Scholar 

  19. Schwendicke F, Paris S, Stolpe M. Detection and treatment of proximal caries lesions: milieu-specific cost-effectiveness analysis. J Dent. 2015;43(6):647–55.

    Article  PubMed  Google Scholar 

  20. Schwendicke F, Stolpe M, Meyer-Lueckel H, Paris S. Detecting and treating occlusal caries lesions: a cost-effectiveness analysis. J Dent Res. 2015;94(2):272–80.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Baelum V, Heidmann J, Nyvad B. Dental caries paradigms in diagnosis and diagnostic research. Eur J Oral Sci. 2006;114(4):263–77.

    Article  PubMed  Google Scholar 

  22. Schwendicke F. Kariesexkavation—wie viel Kariesfreiheit muss sein? Deutsche Zahnärztl Zeitung. 2015;70(2):89–97.

    Google Scholar 

  23. Ahovuo-Saloranta A, Forss H, Walsh T, Hiiri A, Nordblad A, Makela M, et al. Sealants for preventing dental decay in the permanent teeth. Cochrane Database Syst Rev. 2013;3:Cd001830.

    Google Scholar 

  24. Schwendicke F, Jäger AM, Paris S, Hsu L-Y, Tu Y-K. Treating pit-and-fissure caries: a systematic review and network meta-analysis. J Dent Res. 2015;94(4):522–33. pii: 0022034515571184.

    Article  PubMed  Google Scholar 

  25. Dorri M, Dunn S, Sabbah W, Schwendicke F. Proximal sealing for managing dental decay in primary and permanent teeth. Cochrane Database Syst Rev. 2015.

    Google Scholar 

  26. Paris S, Hopfenmuller W, Meyer-Lueckel H. Resin infiltration of caries lesions. J Dent Res. 2010;89(8):823–6.

    Article  PubMed  Google Scholar 

  27. Featherstone JDB, Barrett-Vespone NA, Fried D, Kantorowitz Z, Seka W. CO2 laser inhibition of artificial caries-like lesion progression in dental enamel. J Dent Res. 1998;77(6):1397–403.

    Article  PubMed  Google Scholar 

  28. Fried D, Murray MW, Featherstone JDB, Akrivou M, Dickenson KM, Duhn C, et al., editors. Dental hard tissue modification and removal using sealed TEA lasers operating at l=9.6 μm and 10.6 μm. Lasers in dentistry V proceedings of the SPIE meeting. Bellingham: San Jose; 1999.

    Google Scholar 

  29. Hu XL, Ho B, Lim CT, Hsu CS. Thermal treatments modulate bacterial adhesion to dental enamel. J Dent Res. 2011;90(12):1451–6.

    Article  PubMed  Google Scholar 

  30. Song F, Koo H, Ren D. Effects of material properties on bacterial adhesion and biofilm formation. J Dent Res. 2015;94(8):1027–34.

    Article  PubMed  Google Scholar 

  31. Schwendicke F, Frencken JE, Bjorndal L, Maltz M, Manton DJ, Ricketts D, et al. Managing carious lesions: consensus recommendations on carious tissue removal. Adv Dent Res. 2016;28(2):58–67.

    Article  PubMed  Google Scholar 

  32. Kidd EAM, Fejerskov O. What constitutes dental caries? Histopathology of carious enamel and dentin related to the action of cariogenic biofilms. J Dent Res. 2004;83(4 Suppl):C35–C8.

    Article  PubMed  Google Scholar 

  33. Ricketts DN, Ekstrand KR, Kidd EA, Larsen T. Relating visual and radiographic ranked scoring systems for occlusal caries detection to histological and microbiological evidence. Oper Dent. 2002;27(3):231–7.

    PubMed  Google Scholar 

  34. Oong EM, Griffin SO, Kohn WG, Gooch BF, Caufield PW. The effect of dental sealants on bacteria levels in caries lesions. J Am Dent Assoc. 2008;139(3):271–8.

    Article  PubMed  Google Scholar 

  35. Santamaria RM, Innes NP, Machiulskiene V, Evans DJ, Splieth CH. Caries management strategies for primary molars: 1-Yr randomized control trial results. J Dent Res. 2014;93(11):1062–9.

    Article  PubMed  PubMed Central  Google Scholar 

  36. Lo EC, Schwarz E, Wong MC. Arresting dentine caries in Chinese preschool children. Int J Paediatr Dent. 1998;8(4):253–60.

    Article  PubMed  Google Scholar 

  37. Mijan M, de Amorim RG, Leal SC, Mulder J, Oliveira L, Creugers NH, et al. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. Clin Oral Investig. 2014;18(4):1061–9.

    PubMed  Google Scholar 

  38. Gruythuysen R. Non-restorative cavity treatment. Managing rather than masking caries activity. Ned Tijdschr Tandheelkd. 2010;117(3):173–80.

    Article  PubMed  Google Scholar 

  39. Wierichs RJ, Meyer-Lueckel H. Systematic review on noninvasive treatment of root caries lesions. J Dent Res. 2014;94(2):261–71.

    Article  PubMed  Google Scholar 

  40. Bertassoni LE, Habelitz S, Kinney JH, Marshall SJ, Marshall GW Jr. Biomechanical perspective on the remineralization of dentin. Caries Res. 2009;43(1):70–7.

    Article  PubMed  PubMed Central  Google Scholar 

  41. Habelitz S, Marshall GW Jr, Balooch M, Marshall SJ. Nanoindentation and storage of teeth. J Biomech. 2002;35(7):995–8.

    Article  PubMed  Google Scholar 

  42. Kinney JH, Balooch M, Haupt DL, Marshall SJ, Marshall GW. Mineral distribution and dimensional changes in human dentin during demineralization. J Dent Res. 1995;74(5):1179–84.

    Article  PubMed  Google Scholar 

  43. Kinney JH, Marshall SJ, Marshall GW. The mechanical properties of human dentin: a critical review and re-evaluation of the dental literature. Crit Rev Oral Biol Med. 2003;14(1):13–29.

    Article  PubMed  Google Scholar 

  44. Bakhshandeh A, Qvist V, Ekstrand K. Sealing occlusal caries lesions in adults referred for restorative treatment: 2–3 years of follow-up. Clin Oral Investig. 2012;16(2):521–9.

    Article  PubMed  Google Scholar 

  45. Hesse D, Bonifacio CC, Mendes FM, Braga MM, Imparato JC, Raggio DP. Sealing versus partial caries removal in primary molars: a randomized clinical trial. BMC Oral Health. 2014;14:58.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Yoshiyama M, Doi J, Nishitani Y, Itota T, Tay FR, Carvalho RM, et al. Bonding ability of adhesive resins to caries-affected and caries-infected dentin. J Appl Oral Sci. 2004;12(3):171–6.

    Article  PubMed  Google Scholar 

  47. Yoshiyama M, Tay FR, Doi J, Nishitani Y, Yamada T, Itou K, et al. Bonding of self-etch and total-etch adhesives to carious dentin. J Dent Res. 2002;81(8):556–60.

    Article  PubMed  Google Scholar 

  48. Yoshiyama M, Tay FR, Torii Y, Nishitani Y, Doi J, Itou K, et al. Resin adhesion to carious dentin. Am J Dent. 2003;16(1):47–52.

    PubMed  Google Scholar 

  49. Innes N, Evans D, Stirrups D. The Hall technique; a randomized controlled clinical trial of a novel method of managing carious primary molars in general dental practice: acceptability of the technique and outcomes at 23 months. BMC Oral Health. 2007;7(1):18.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Schwendicke F, Gostemeyer G, Blunck U, Paris S, Hsu LY, Tu YK. Directly placed restorative materials: review and network meta-analysis. J Dent Res. 2016;95(6):613–22.

    Article  PubMed  Google Scholar 

  51. Brantley C, Bader J, Shugars D, Nesbit S. Does the cycle of rerestoration lead to larger restorations? J Am Dent Assoc. 1995;126(10):1407–13.

    Article  PubMed  Google Scholar 

  52. Fernandez E, Martin J, Vildosola P, Oliveira Junior OB, Gordan V, Mjor I, et al. Can repair increase the longevity of composite resins? Results of a 10-year clinical trial. J Dent. 2015;43(2):279–86.

    Article  PubMed  Google Scholar 

  53. Qvist V. Longevity of restorations: the ‘death spiral’. In: Fejerskov O, Kidd EAM, editors. Dental caries: the disease and its clinical management. 2. Oxford: Blackwell Munksgaard; 2008. p. 444–55.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Operative and Preventive Dentistry, Charité—Universitätsmedizin Berlin, Berlin, Germany

    Falk Schwendicke

Authors
  1. Falk Schwendicke
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Falk Schwendicke .

Editor information

Editors and Affiliations

  1. Department for Operative and Preventive Dentistry, Charité Centre for Dental Medicine, Berlin, Germany

    Falk Schwendicke

Rights and permissions

Reprints and permissions

Copyright information

© 2018 Springer International Publishing AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Schwendicke, F. (2018). Removing or Controlling?. In: Schwendicke, F. (eds) Management of Deep Carious Lesions. Springer, Cham. https://doi.org/10.1007/978-3-319-61370-3_1

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-61370-3_1

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61369-7

  • Online ISBN: 978-3-319-61370-3

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation