Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document

Scope and purpose: The guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.

Methodology: The guidance development is based on three reviews(1,2,3) and an interim seminar and workshop organised by the European Academy of Paediatric Dentistry in Brussels in May 2015.

Review and updating: No indication of a review or update schedule is given.

Recommendations: Seven recommendations on caries detection and diagnosis, four recommendations on caries risk assessment and 11 on the management of the early carious lesion were made and they are briefly summarised in the table below.

Research Recommendations:

Caries detection and diagnosis

There is a need for more research in the primary dentition because most of the available studies consider only the permanent dentition. Radiograph subtraction studies need to be conducted. Ongoing evaluation of new methods and devices. There is a need for well-designed prevention studies on early childhood caries which will provide sufficient and strong evidence of the cost-effectiveness. There is a significant need to bring the knowledge and learning to regular dental practice, to all the paediatric health care providers, the children and their parents.

Caries risk assessment

Clinical trials to assess the validity of models and single risk factors, as well as the role of confounding factors (eg age, lifestyle, socio-economy and socio-demography), for predicting caries. Further quantitative and qualitative health professional and parents would be helpful to identify perceptions and barriers to carrying out a CRA and to deliver a risk-based preventive care that could bridge the social inequalities in dental health. More research on the implementation of risk-based caries prevention and to establish the cost-effectiveness of such strategies.