Indian Association of Conservative Dentistry and Endodontics consensus statement on deep caries management

Dental caries remains one of the most ubiquitous chronic diseases worldwide, affecting people across geographic, socioeconomic, and demographic boundaries. In response to this pervasive burden, the consensus statement; developed by a panel of experts in cariology, restorative dentistry and endodontics during the Symposium on Deep Caries Management Symposium at the 39^th Indian Association of Conservative Dentistry and Endodontics National Conference, Jio Convention Centre, Mumbai, November 29, to December 3, 2024, synthesises contemporary understanding of carious pathogenesis with evidence-based clinical strategies. It is intended for dental practitioners managing deep caries in vital permanent teeth of all age groups, from adolescents to older adults. Recommendations are grounded in systematic reviews, high-quality clinical trials, and structured expert consensus, charting the paradigmatic evolution from traditional, invasive endodontic approaches toward biologically informed, minimally invasive care that prioritises tissue preservation and harnesses natural reparative processes. The guideline outlines diagnostic thresholds, risk-assessment tools, and operative protocols - such as selective caries excavation and vital pulp therapy - that optimise long-term outcomes while reducing adverse events. This consensus statement has been formulated according to the AGREE guidelines for reporting consensus-based recommendations, ensuring methodological rigour and transparency in development. It elucidates the complex interplay between microbiological, biochemical, and structural factors governing caries initiation and progression, while establishing evidence-based protocols for conservative management that optimize long-term therapeutic outcomes.