An Agreed Terminology for Carious Tissue Removal

Area of Science:

• Dental Science
• Cariology
• Biofilm Research

Background:

• The understanding of dental caries has shifted from an infectious disease to a biofilm disease, prompting a move towards less invasive management strategies.
• Current recommendations for practitioners face challenges due to inconsistent terminology and definitions for carious lesions and management approaches across various documents.
• This lack of clear communication hinders the translation of evidence-based practices into clinical settings.

Purpose of the Study:

• To introduce and explain the International Caries Consensus Collaboration (ICCC) recommendations on terminology for dental caries and carious lesions.
• To improve communication and understanding among clinicians, researchers, educators, and patients regarding caries diagnosis and management.
• To establish standardized terms based on clinical consequences of the disease rather than histopathology.

Main Methods:

• The study outlines new terminology for dental caries and carious lesion management, differentiating between disease-level (dental caries) and tooth-level (carious lesion management) concepts.
• It defines three primary carious tissue removal options: selective removal (to soft and firm dentine), stepwise removal, and non-selective removal to hard dentine.
• The proposed terms are based on the clinical state of dentine (soft, leathery, firm, hard) to reflect the consequences of the disease.

Main Results:

• The ICCC recommendations provide a framework for consistent terminology in discussing dental caries.
• The proposed terms aim to bridge the gap between visual appearance and histopathology by focusing on clinical consequences.
• Three distinct carious tissue removal strategies are defined, with non-selective removal to hard dentine no longer being recommended.

Conclusions:

• Adoption of standardized ICCC terminology will enhance communication and understanding of dental caries diagnosis and management.
• Clearer communication facilitates the implementation of evidence-based, less invasive treatment strategies.
• Consistent terminology across all stakeholders, including patients, is crucial for effective caries management.