Best clinical practice guidance for management of early caries lesions in children and young adults: an EAPD policy document
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The European Academy of Paediatric Dentistry (EAPD) encourages prevention and arrest of active dental caries. Therefore, the present guidance provides evidence- and clinically-based recommendations for detecting and diagnosing early/non-cavitated caries lesions, risk assessment and disease management.
A search of different databases was conducted using all terms related to the subject. Relevant papers were identified after a review of their titles, abstracts or full texts. Three workshops were held during the corresponding EAPD interim seminar in Brussels in 2015. Several statements were agreed upon and, furthermore, gaps in our knowledge were identified.
Following the systematic reviews and outcomes of the seminars, it was concluded that visual and radiographic caries detection should be utilised as a basic diagnostic approach to locate, assess and monitor non-cavitated caries lesions in primary and permanent teeth. As another important evaluation step, a caries risk assessment should be performed at a child’s first dental visit, and reassessments should be performed on a regular basis. It is widely accepted that non-cavitated caries lesions can be managed non-invasively in the majority of cases. The spectrum of measures includes a low cariogenicity tooth-friendly diet, daily and appropriate management of the biofilm, home and within the dental office/surgery usage of fluorides as well as sealing techniques.
The detection and management of non-cavitated caries is an essential aspect of preventive dentistry. Therefore, the EAPD encourages oral health care providers and caregivers to implement preventive practices that can arrest early caries and improve individual and public dental health.
KeywordsCaries Detection Diagnosis Diagnostic methods Prevention Caries risk Risk assessment Caries treatment Caries management
The European Academy of Paediatric Dentistry thanks the Belgian Organization of Paediatric Dentistry for organising the 9th Interim Seminar and Workshop in Brussels on 08–09 May 2015, on ‘Management of early caries lesions in primary and young permanent dentition’. Special thanks are attributed to both heads of the organising committee, Prof. Dominique Declerck (Catholic University of Leuven) and Prof. Luc Marks (University of Gent), who made this meeting successful. Furthermore, the Academy wishes to thank all participants of the workshops from the European EAPD member countries for their valuable contributions.
Workshop 1/Caries diagnostics Griet van Steenkiste, Stephanie Theys (Belgium), Domagoj Glavina (Croatia), Charalambos Sakkas (Cyprus), Vuokko Anttonen (Finland), Patrizia De Fabianis (Italy), Marlies Elfrink (the Netherlands), Anne Skaare (Norway), Ewa Nadolska-Gazda (Poland), Carmen Savin (Romania), Vesna Zivojinovic-Toumba (Serbia), Alenka Pavlič (Slovenia), Miguel Hernandez (Spain), Thayalan Kandiah (United Kingdom), Maria Spyridonos (Cyprus, Moderator).
Workshop 2/Caries risk assessment Luc Martens, Stephanie Theys (Belgium), Vlasta Merglova (Czech), Androniki Grigoriou-Kokkinos (Cyprus), Ulrich Schiffner (Germany), Nikos Kotsanos (Greece), David Finucane (Ireland) Livia Ottolenghi (Italy), Marit Slåttelid Skeie (Norway), Eleonora Schiller (Romania), Rok Kosem (Slovenia), Mónica Miegimolle (Spain), Juliane Leonhardt Amar(Switzerland), Hani Nazzal (United Kingdom), Sotiria Gizani (Greece, Moderator).
Workshop 3/Caries management Thierry Boulanger, Rita Cauwels (Belgium), Koberova Ivancakova (Czech), Costakis Onisiforou (Cyprus), Dorte Haubek (Denmark), Nick Lygidakis, Elias Berdouses, Kostantinos Oulis (Greece), Aifric Ni Chaollai (Ireland), Silvia Pizzi (Italy), Clarissa Bonifacio (the Netherlands), Ivar Espelid (Norway), Michał Sobczak (Poland), Rodica Luca (Romania), Mirjana Ivanovic (Serbia), Tanja Tomaževič (Slovenia), Eva Martínez (Spain), Anika Anzedei (Switzerland), Figen Seymen (Turkey), Jo Montario (United Kingdom), Jan Kühnisch (Germany, Moderator).
Please note that a slightly different wording in relation to the evidence and recommendation level was used in the sequence of papers from this workshop.
- American Academy of Pediatric Dentistry (AAPD). Policy on Early Childhood Caries (ECC): Classifications, Consequences, and Preventive Strategies. Reference Manual. 2015–2016;37/6. http://www.aapd.org/media/Policies_Guidelines/P_ECCClassifications.pdf. Accessed in Nov 2015.
- Forebyggelse and Borgernære Sundhedstilbud. Tandsundhed 18-årige. http://sundhedsstyrelsen.dk/da/sundhed/tandpleje/tandsundhed/boern-0-18-aar. Accessed in Nov 2015.
- Mijan M, de Amorim Guedes, Leal SC, et al. The 3.5-year survival rates of primary molars treated according to three treatment protocols: a controlled clinical trial. Clin Oral Invest. 2014;18:1061–9.Google Scholar
- Pitts NB. Detection, assessment, diagnosis and monitoring of caries. Monogr Oral Sci. 2009;21. Basel: S. Karger AG.Google Scholar
- Pretty IA, Ekstrand KR. Detection and monitoring of early caries lesions: a review. Eur Arch Paediatr Dent. 2015. doi: 10.1007/s40368-015-0208-6.
- Twetman S. Caries risk assessment in children: how accurate are we? Eur Arch Paediatr Dent. 2015. doi: 10.1007/s40368-015-0195-7.
- van Loveren C, van Palenstein Helderman WH. Non-invasive caries treatment. Eur Arch Paediatr Dent. 2016. doi: 10.1007/s40368-015-0219-3.