Caries management: diagnosis and treatment strategies

Traditional caries management has consisted of the detection of carious lesions followed by immediate restoration. In other words, caries was managed primarily by restorative dentistry. However, when the dentist takes the bur in hand, an irreversible process begins. Placing a restoration does nor guarantee a sound future for the tooth; on the contrary, it may be the start of a restorative cycle in which the restoration will be replaced several times. The decision to initiate invasive treatment should be preceded by a number of questions: Is caries present and if so, how far does it extend? Is a restoration required, or could the process be arrested by preventive treatment? Sometimes the decision to restore may be based on questionable diagnostic criteria. Introduction