Abstract
The current mode of dental caries management mainly operates through irreversible and symptomatic treatment by means of drilling and filling, while caries prevention is largely overlooked or omitted. Focus should be redirected through a medical model towards elimination of the disease through tackling its causes and risk factors to address current and future caries initiation. Caries is the demineralisation of dental hard tissues by bacterial acids when periodically exposed to fermentable carbohydrates. The medical model of caries management is a philosophy that steers sustainable caries management through controlling bacterial infection, a reduction of risk levels, remineralisation of teeth and long-term follow-up. Its goal is to prevent new and recurrent caries, arrest ongoing caries processes by alteration of the cariogenic environment, and support the healing of remineralisable enamel and dentine. The mechanism involves dietary counselling and plaque control, placement of dental sealants, administration of fluoride agents and chemotherapeutic medications and use of chewing gum. This paradigm shift from a surgical to a medical model aims to pursue the ultimate intention of maintaining a caries-free dentition and is anticipated to promote true oral health-related quality of life. The objective of this paper is to discuss the medical model of caries management.
Highlights
Caries remains a prevalent disease worldwide, affecting every region, regardless of age and socioeconomic status
Treating cavities, which are signs, is not quite the same as treating caries, the disease. It is quite certain within the dental scientific community that the removal of so-called “gangrenous tissue”, as it was referred to in the past, or “diseased structures” of the tooth, is no longer the contemporary approach given the ability of dental hard tissues to heal following appropriate interventions, such as remineralisation therapy [6]
In the context of caries management, the aim of the medical model is to improve and maintain a person’s dental health by preventing caries from occurring, stopping caries from progressing and reversing damages caused by caries
Summary
Caries remains a prevalent disease worldwide, affecting every region, regardless of age and socioeconomic status. The medical model for caries management is a philosophy where optimising dental health by eliminating caries is the primary aim. The surgical model involves the cutting and drilling of teeth with cavities and replacing them with artificial materials to restore the tooth to form and function. Both models have their strengths and value; when the focus is on elimination of the caries disease, it is apparent that the medical approach to the caries disease should prevail
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