Managing carious lesions: consensus recommendations on terminology

TY - JOUR

T1 - Managing carious lesions

T2 - consensus recommendations on terminology

AU - Innes, N.P.T.

AU - Frencken, J.E.

AU - Bjørndal, L.

AU - Maltz, M.

AU - Manton, D.J.

AU - Ricketts, D.

AU - Van Landuyt, K.

AU - Banerjee, A.

AU - Campus, G.

AU - Doméjean, S.

AU - Fontana, M.

AU - Leal, S.

AU - Lo, E.

AU - Machiulskiene, V.

AU - Schulte, A.

AU - Splieth, C.

AU - Zandona, A.

AU - Schwendicke, F.

PY - 2016/5

Y1 - 2016/5

N2 - Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided. Dental caries is the name of the disease, and the carious lesion is the consequence and manifestation of the disease—the signs or symptoms of the disease. The term dental caries management should be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereas carious lesion management controls the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions’ clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1) selective removal of carious tissue—including selective removal to soft dentine and selective removal to firm dentine; 2) stepwise removal—including stage 1, selective removal to soft dentine, and stage 2, selective removal to firm dentine 6 to 12 mo later; and 3) nonselective removal to hard dentine—formerly known as complete caries removal (technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.

AB - Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided. Dental caries is the name of the disease, and the carious lesion is the consequence and manifestation of the disease—the signs or symptoms of the disease. The term dental caries management should be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereas carious lesion management controls the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions’ clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1) selective removal of carious tissue—including selective removal to soft dentine and selective removal to firm dentine; 2) stepwise removal—including stage 1, selective removal to soft dentine, and stage 2, selective removal to firm dentine 6 to 12 mo later; and 3) nonselective removal to hard dentine—formerly known as complete caries removal (technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.

KW - dental caries

KW - excavation

KW - minimally invasive dentistry

KW - caries management

KW - stepwise caries removal

KW - nomenclature

U2 - 10.1177/0022034516639276

DO - 10.1177/0022034516639276

M3 - Article

C2 - 27099357

SN - 0895-9374

VL - 28

SP - 49

EP - 57

JO - Advances in Dental Research: an E-Supplement to Journal of Dental Research

JF - Advances in Dental Research: an E-Supplement to Journal of Dental Research

IS - 2

ER -