When to intervene in the caries process? A Delphi consensus statement.

Area of Science:

• Dentistry
• Dental Public Health
• Cariology

Background:

• Dental caries management requires clear criteria for intervention.
• Existing guidelines for caries intervention lack definitive thresholds.
• Expert consensus is needed to standardize decision-making for caries treatment.

Purpose of the Study:

• To establish an expert Delphi consensus on intervention thresholds for the dental caries process and existing carious lesions.
• To provide evidence-based guidance for clinicians on when to treat dental caries.

Main Methods:

• Non-systematic literature synthesis.
• Expert Delphi consensus process.
• Expert panel conference.

Main Results:

• Lesion activity, cavitation, and cleansability are key determinants for intervention.
• Inactive lesions generally do not require treatment, while active lesions do.
• Non-cavitated and most cleansable cavitated lesions are managed non- or micro-invasively; non-cleansable cavitated lesions typically require minimally invasive treatment.

Conclusions:

• Comprehensive diagnosis is fundamental for systematic decision-making in caries management.
• Intervention thresholds should consider lesion activity, cavitation status, and cleansability.
• Individual patient factors and lesion-specific characteristics (e.g., radiographic depth, location) necessitate tailored treatment approaches.