Dentistry
University of Bern
Freiburgstrasse 7
CH–3010 Bern (Switzerland)
E-Mail [email protected]
Klaus W. Neuhaus
Department of Preventive
Restorative and Pediatric Dentistry
Freiburgstrasse 7
CH–3010 Bern (Switzerland)
E-Mail [email protected]
Daniela Raggio
Department of Orthodontics and Pediatric Dentistry
School of Dentistry, University of São Paulo
São Paulo (Brazil)
E-Mail [email protected]
David Ricketts
School of Dentistry, University of Dundee
2 Park Place
Dundee DD1 4HR (UK)
E-Mail [email protected]
Mark Robertson
School of Dentistry, University of Dundee
2 Park Place
Dundee DD1 4HR (UK)
E-Mail [email protected]
Ruth M. Santamaría
Department of Preventive and Pediatric Dentistry
Ernst-Moritz-Arndt University of Greifswald
Rotgerbergstrasse 8
DE–17487 Greifswald (Germany)
E-Mail [email protected]
Falk Schwendicke
Operative and Preventive Dentistry
Charité – Universitätsmedizin Berlin
Corporate Member of Freie Universität Berlin
Humboldt-Universität zu Berlin, and Berlin Institute of Health
Assmannshauser Strasse 4-6
DE–14197 Berlin (Germany)
E-Mail [email protected]
Guus van Strijp
Department of Cariology Endodontology
Pedodontology
Academic Centre for Dentistry (ACTA)
University of Amsterdam and VU University Amsterdam
Gustav Mahlerlaan 3004
NL–1081 LA Amsterdam (The Netherlands)
E-Mail [email protected]
Cor van Loveren
Department of Cariology Endodontology
Pedodontology
Academic Centre for Dentistry (ACTA)
University of Amsterdam and VU University Amsterdam
Gustav Mahlerlaan 3004
NL–1081 LA Amsterdam (The Netherlands)
E-Mail [email protected]
A monograph addresses a single subject and this book is about caries excavation – everyday dentistry for many. How should soft, infected dentine be managed? The authors have studied, discussed, and researched this question and distilled contemporary knowledge for you. Intriguingly, with one notable exception, it may not matter what you do. Brush, seal, or selectively remove, all have their place but with each you must understand what is being attempted and why.
So what is the exception? What must you not do? You must never pick up a sharp excavator or burr and remove soft tissue vigorously because this could damage the tooth and even prejudice its survival. Perversely, this might be precisely what you were taught to do in dental school! This just goes to show how research changes clinical practice and how important it is to keep up to date.
So read and enjoy the book!
Edwina Kidd, London
Em. Professor in Cariology
There is a reason why medical researchers do their work. They wish to contribute to improving people’s health and well-being through eradicating diseases, to improve existing treatments and change disease-causing behaviour, and much more, through the study of these areas.
An astronomically high number of medical publications appear in the literature monthly. The number of oral health-related publications is very high, too high for a dental practitioner to read them all. Some of these have a quality that leaves one wondering how the manuscript passed the review process. Others are of extremely good quality and provide new worthwhile information.
The scientific world is assisting medical professionals by producing systematic reviews and/ or meta-analyses on an ever-growing number of topics. A systematic review merely appraises the available evidence on a topic in the literature on the basis of research quality criteria and then draws conclusions. They are not designed to make recommendations on treatment. Therefore, these reviews and/or meta-analyses cannot be left on their own as the impacts of the individual results need to be merged to facilitate change, for example in improving (oral) health or aspects of it. It is like bricks that need cement to build a solid structure. A way of combining newly acquired knowledge into contemporary disease management concepts is to write a book, or in this par-ticular case a monograph. Another way is to develop guidelines.
The current monograph was written by dedicated researchers who are experts in the various subfields of cariology and restorative dentistry. The chapters are built on evidence-based results and take the reader through the development of dental caries, assess the devices for diagnosing it in clinical practice and in an epidemiological setting, and provide new insights in the way a dentine carious cavity can be managed both from a tissue removal and a restoration point of view. Examples of dental tissue-preserving methods are presented and the necessity for sealing a dentine carious cavity with a quality restorative material is highlighted with ample evidence. Also, an update on how to conduct a randomised clinical trial is presented, and a chapter is included on terminology to support better verbal communication and interactions between members of the oral health profession from all corners of the world. The monograph concludes with recommendations and suggestions of areas in dentine carious cavity treatment that are not fully understood yet.
In essence, dental caries is a preventable, behaviour/life-style disease. It implies that members of the public do not need to go through the ordeal of drilling and filling teeth regularly as the generation following the Second World War had to undergo. At that time, oral health research was in its infancy. Over the past decades, oral science has yielded information that benefits the public. It is the duty of the oral health profession to embrace philosophies of managing dental caries, such as the minimal intervention dentistry concept, which aims to keep healthy teeth healthy throughout life by preserving sound and remineralisable tooth tissue.