Traditional operative treatment options

Operative intervention should be avoided, whenever possible, by adopting a preventive approach. Timely management of early caries can lead to arrest and possibly remineralization of the lesion rendering operative intervention unnecessary. The dentist must judge when the tooth tissue has become sufficiently demineralized to allow bacterial ingress leading to irreversible changes in the tissue. Once a decision has been made to restore a tooth, the clinician must decide, from a series of traditional operative treatment options, what materials should be used in the restoration and what preparation will achieve good retention and best preservation of tooth structure. With the development of new adhesive materials and a more conservative approach, a new era of minimally invasive dentistry has dawned. Improvements in the properties of composite materials have made them the choice for coronal aesthetic restorations: for posterior restorations involving load-bearing occlusal surfaces, amalgam is still the most commonly used material in UK dental practice; glass ionomer materials also have a place in minimally invasive dentistry - patterns of use differing in different counties. The numbers of studies investigating minimal caries removal are relatively limited; there are still scope and need for research in this field.