Caries management: is the "seal the deal"?

A barrier to providing sealants has been the concern about inadvertently sealing over caries, but today the management of dental caries has evolved from the domain of techniques based on complete removal of carious tissue prior to tooth restoration or sealant, to include a range of techniques where some, or even all caries is sealed in beneath restorations, sealants or infiltrants. There is a significant, and growing, evidence base supporting these techniques as caries management strategies for children and adolescents. These techniques are not new but build on earlier concepts and research. These concepts offer a real way forward and departure from invasive restorative treatments. Some issues, however, are not completely resolved, and future solutions may herald a new era of restorative dentistry, perhaps with the concept of filling with no drilling since the "seal is the deal". These techniques and issues will be considered in the New Zealand context.