Expert panel advises conservative approaches may decrease risk of adverse effects

The American Dental Association has released a new clinical practice guideline on restorative treatments for caries lesions that suggests more conservative approaches to removing carious tissue may decrease the risk of adverse effects.

The guideline, published as the cover story of the July issue of The Journal of the American Dental Association, includes 16 recommendations for the treatment of moderate or advanced caries lesions in primary and permanent teeth that have not received endodontic treatment.

The recommendations identify selective carious tissue removal as an effective treatment option in most cases of moderate or advanced caries in primary and permanent teeth. The guideline also affirms the efficacy of the most common restorative materials for treating moderate or advanced caries and suggests specific materials for primary and permanent teeth depending on the extent of the decay.

This is the second guideline in a series of clinical practice guidelines on caries treatment developed by the ADA Council on Scientific Affairs and ADA Science & Research Institute, which convened a panel of experts to review the best-available scientific evidence on treatments and materials. The group previously published a systematic review in the February issue of JADA that found general equivalence among restorative materials and helped to inform this guideline.

The recommendations are meant to assist clinicians in making restorative choices with their patients, but the guideline notes dentists should use clinical judgment to determine when the recommended course of action may not be appropriate, warranting deviation from these recommendations.

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