A paradigm shift in the treatment of caries

This paper presents a shift in the paradigm for treating dental caries from a surgical to a medical approach. Two key points are essential to understanding caries. First, caries is a bacterial infection caused by specific bacteria. Second, before cavitation, caries is a reversible multifactoral process. Two features, caries activity and caries risk, provide a diagnosis and prognosis leading to a treatment plan. Patients receive treatment using a medical model consisting of four steps: bacterial control; reduction of risk levels for at-risk patients; reversal of active sites by remineralization; and follow-up and maintenance.