Title : Beyond the drill: The paradigm shift to non restorative caries management
Abstract:
Dental caries has traditionally been managed through a surgical "drill and fill" approach. However, modern cariology defines caries not merely as a localized lesion, but as a dynamic, behavioral, and biofilm-mediated disease. This understanding mandates a critical shift from surgical intervention to a "Medical Model" of care, focusing on managing the disease process rather than just the resultant symptom. This presentation evaluates the efficacy and clinical protocols of Non-Restorative Cavity Control (NRCC) techniques, aiming to preserve natural tooth structure and arrest lesion progression without surgical excavation. Key methods analyzed include Silver Diamine Fluoride (SDF), Resin Infiltration, and advanced remineralization therapies. The discussion will cover the critical diagnostic criteria for differentiating active versus arrested lesions (using ICDAS), the dual mechanism of action of SDF in antimicrobial activity and remineralization, and the application of Resin Infiltration for micro-invasive management of esthetically challenging initial enamel lesions (white spots). Furthermore, the biochemical foundations of repair, focusing on Fluorapatite formation and new peptide-based therapies, will be explored. In conclusion, NRCC techniques offer a proven, minimally invasive, and highly effective alternative to traditional restoration, improving patient outcomes, reducing dental anxiety, and fostering a truly preventative approach to long-term oral health.
