Dental caries in the second millennium

This historical review of dental caries diagnosis and management is based on information obtained from reports published between 1839 and 1965 and forty textbooks on caries diagnosis and management published since the nineteenth century. The history of understanding of any disease or condition in humans has passed through two distinct eras. The first, which lasted until the twentieth century and may still be ongoing today, is the "observational" era. The second, which has developed and revolutionized our understanding of the causes and treatments of all diseases, is the "scientific" era. During the observational era, treatments of oral or dental problems were based on neither biological nor scientific principles. Rather, experimentation without validation was, and to a lesser extent during the last fifty years is still, common. In terms of disease management, dental practice is still in the gray years of the "restorative era" and in the midst of the "preventive era" where the emphasis would soon shift towards early detection of biological markers of diseases and prevention of their initiation and progression. This review has found that most contemporary questions on caries diagnosis and management have been debated since the middle of the nineteenth century. There is a need for a comprehensive research program to provide scientifically based information to assist dental practitioners in caries detection, diagnosis, and management.