Minimum intervention dentistry principles and objectives

Minimum intervention dentistry (MID) is the modern medical approach to the management of caries, utilizing caries risk assessment, and focusing on the early prevention and interception of disease. Moving the focus away from the restoration of teeth allows the dentist to achieve maximum intervention, with minimal invasive treatments. The four core principles of MID can be considered to be: (1) Recognition - early identification and assessment of potential caries risk factors through lifestyle analysis, saliva testing and using plaque diagnostic tests; (2) Reduction - to eliminate or minimize caries risk factors by altering diet and lifestyle habits and increasing the pH of the oral environment; (3) Regeneration - to arrest and reverse incipient lesions, using appropriate topical agents including fluorides and casein phosphopeptides-amorphous calcium phosphates (CPP-ACP); (4) Repair - when cavitation is present and surgical intervention is required, conservative caries removal is carried out to maximize the repair potential of the tooth and retain tooth structure. Bioactive materials are used to restore the tooth and promote internal healing of the dentine. Effective implementation of MID involves integrating each of these four elements into patient assessment and treatment planning. This review paper discusses the key principles of MID as a philosophy of patient care, and the practical objectives which flow into individual patient care.