Caries management pathways preserve dental tissues and promote oral health

作者：Amid Ibrahim Ismail, Marisol Merchan Tellez, Nigel Berry Pitts, Kim Ekstrand, David Ricketts, Christopher Longbottom, Hafsteinn Eggertsson, Chris Deery, Julian Fisher, Douglas A. Young, J.D.B. Featherstone, Robin Wendell Evans, Gregory G. Zeller, Domenick Thomas Zero, Stefanía Martignon, Margherita Fontana, Andréa G. Ferreira Zandoná · 发表于：Community Dentistry And Oral Epidemiology · 年份：2013 · DOI：10.1111/cdoe.12024 · 被引用次数：179 · 研究领域：Dental Health and Care Utilization、Oral microbiology and periodontitis research、Dental Radiography and Imaging

In May 2012, cariologists, dentists, representatives of dental organizations, manufacturers, and third party payers from several countries, met in Philadelphia, Pennsylvania, to define a common mission; goals and strategic approaches for caries management in the 21th century. The workshop started with an address by Mr. Stanley Bergman, CEO of Henry Schein Inc. which focused on the imperative for change in academia, clinical practice, and public health. For decades, new scientific evidence on caries and how it should be managed have been discussed among experts in the field. However, there has been some limited change, except in some Scandinavian countries, in the models of caries management and reimbursement which have been heavily skewed toward 'drilling and filling'. There is no overall agreement on a caries' case definition or on when to surgically intervene. The participants in the workshop defined a new mission for all caries management approaches, both conventional and new. The mission of each system should be to preserve the tooth structure, and restore only when necessary. This mission marks a pivotal line for judging when to surgically intervene and when to arrest or remineralize early noncavitated lesions. Even when restorative care is necessary, the removal of hard tissues should be lesion-focused and aim to preserve, as much as possible, sound tooth structure. Continuing management of the etiological factors of caries and the use of science-based preventive regime...