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Adv Dent Res. 2016 May;28(2):49-57. doi: 10.1177/0022034516639276.

Managing Carious Lesions: Consensus Recommendations on Terminology.

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Paediatric Dentistry, Dundee Dental Hospital and School, University of Dundee, Dundee, UK
Department of Oral Function and Prosthetic Dentistry, College of Dental Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
Department of Cariology and Endodontics, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
Department of Preventive and Social Dentistry, Faculty of Odontology, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Melbourne Dental School, University of Melbourne, Melbourne, Australia.
Operative Dentistry, Fixed Prosthodontics and Endodontology, Dundee Dental Hospital and School, University of Dundee, Dundee, UK.
KULeuven BIOMAT, Department of Oral Health Sciences, University of Leuven and Dentistry University Hospitals Leuven, Leuven, Belgium.
Conservative and MI Dentistry, King's College London Dental Institute, London, UK.
Department of Surgery, Microsurgery and Medicine Sciences, School of Dentistry, University of Sassari, Sassari, Italy; WHO Collaborating Centre for Epidemiology and Community Dentistry, University of Milan, Milan, Italy.
CHU Clermont-Ferrand, Service d'Odontologie, Hôtel-Dieu, Clermont-Ferrand, France; Univ Clermont1, UFR d'Odontologie, Clermont-Ferrand, France; Centre de Recherche en Odontologie Clinique EA 4847, Clermont-Ferrand, France.
Department of Cariology, Restorative Sciences and Endodontics, School of Dentistry, University of Michigan; Ann Arbor, MI, USA.
Department of Dentistry, Faculty of Health Sciences, University of Brasília, Brasília, Brazil.
Faculty of Dentistry, University of Hong Kong, Hong Kong, China.
Department of Dental and Oral Pathology, Faculty of Odontology, Lithuanian University of Health Sciences, Kaunas, Lithuania.
Department of Special Care Dentistry, Faculty of Health, University of Witten/Herdecke, Witten, Germany.
Preventive and Pediatric Dentistry, University of Greifswald, Greifswald, Germany.
Department of Operative Dentistry, University of North Carolina at Chapel Hill School of Dentistry, Chapel Hill, NC, USA.
Department of Operative and Preventive Dentistry, Charité-Universitätsmedizin Berlin, Berlin, Germany.


Variation in the terminology used to describe clinical management of carious lesions has contributed to a lack of clarity in the scientific literature and beyond. In this article, the International Caries Consensus Collaboration presents 1) issues around terminology, a scoping review of current words used in the literature for caries removal techniques, and 2) agreed terms and definitions, explaining how these were decided.Dental cariesis the name of the disease, and thecarious lesionis the consequence and manifestation of the disease-the signs or symptoms of the disease. The termdental caries managementshould be limited to situations involving control of the disease through preventive and noninvasive means at a patient level, whereascarious lesion managementcontrols the disease symptoms at the tooth level. While it is not possible to directly relate the visual appearance of carious lesions' clinical manifestations to the histopathology, we have based the terminology around the clinical consequences of disease (soft, leathery, firm, and hard dentine). Approaches to carious tissue removal are defined: 1)selective removal of carious tissue-includingselective removal to soft dentineandselective removal to firm dentine; 2)stepwise removal-including stage 1,selective removal to soft dentine, and stage 2,selective removal to firm dentine6 to 12 mo later; and 3)nonselective removal to hard dentine-formerly known ascomplete caries removal(technique no longer recommended). Adoption of these terms, around managing dental caries and its sequelae, will facilitate improved understanding and communication among researchers and within dental educators and the wider clinical dentistry community.


caries management; dental caries; excavation; minimally invasive dentistry; nomenclature; stepwise caries removal

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