Abstract
AimThis was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistryMethodsBased on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies.ResultsThe use of fluoridated water, careful diligent daily use of fluoride toothpaste, fluoride varnishes, pit and fissure sealants and leak-proof restorative materials without excavation of caries are evidence based for caries prevention and for non-invasive treatment of pre-cavitated and cavitated caries. Other technologies are far less evidenced based and would not logically fit in guidelines for the non-invasive treatment of caries. Recent studies on cavitated lesions in the primary dentition demonstrate that thorough oral hygiene practices may arrest progression. This strategy depends heavily on the strategies in the dental surgery to change behaviour of children. An important aspect is for advice to be tailored at recall intervals to ensure compliance and to timely detect unnecessary and unwanted progression of the lesions.ConclusionNon-invasive therapies have been proven to be effective for caries prevention and the management of pre-cavitated caries lesions. Non-invasive therapies can also be effective to arrest cavitated lesions but the success depends greatly on behavioural changes of patients to brush the lesions.
Highlights
Dentistry often focuses on invasive and restorative treatments, maybe because it is most tangible and thereby rewarding
Aim This was to collect information for the 9th European Academy of Paediatric Dentistry Interim Seminar and Workshops to discuss the state of art on non-invasive caries therapy to be used if possible to formulate clinical guidelines by European experts in paediatric dentistry Methods Based on systematic reviews and additional papers were assessed for methods to prevent caries initiation and caries progression both in the state of pre-cavitation and cavitation without invasive technologies
The use of fluoridated water, careful diligent daily use of fluoride toothpaste, fluoride varnishes, pit and fissure sealants and leak-proof restorative materials without excavation of caries are evidence based for caries prevention and for non-invasive treatment of pre-cavitated and cavitated caries
Summary
Dentistry often focuses on invasive and restorative treatments, maybe because it is most tangible and thereby rewarding. Unless the balance between de- and remineralization is altered, new and recurrent caries lesions are likely to occur. Young children who are not cooperative are sedated or treated under general anaesthesia. Despite receiving this costly treatment, children all too often develop new and recurrent caries (Ng et al 2014). Recent literature suggests that for the primary dentition a successful rebalancing of risk and protective factors may completely halt or slow down the disease process, resulting in caries arrest even in cavitated lesions (Mijan et al 2014; Santamaria et al 2014). A pre-requisite is that the oral care provider guides parents and children this approach which, importantly, relies upon adequate care. When caries is a slow process, this approach is often effective. When caries is a slow process, this approach is often effective. Gruythuysen et al (2011) summarised the advantages of this approach, which is designated as non-
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