TY - JOUR

T1 - How to Intervene in the Caries Process in Children

T2 - A Joint ORCA and EFCD Expert Delphi Consensus Statement

AU - Splieth, Christian H.

AU - Banerjee, Avijit

AU - Bottenberg, Peter

AU - Breschi, Lorenzo

AU - Campus, Guglielmo

AU - Ekstrand, Kim Rud

AU - Giacaman, Rodrigo A.

AU - Haak, Rainer

AU - Hannig, Matthias

AU - Hickel, Reinhard

AU - Juric, Hrvoje

AU - Lussi, Adrian

AU - Machiulskiene, Vita

AU - Manton, David J.

AU - Jablonski-Momeni, Anahita

AU - Opdam, Niek J. M.

AU - Paris, Sebastian

AU - Santamaría, Ruth M.

AU - Schwendicke, Falk

AU - Tassery, Herve

AU - Ferreira Zandona, Andrea

AU - Zero, Domenick T.

AU - Zimmer, Stefan

AU - Doméjean, Sophie

N1 - © 2020 S. Karger AG, Basel.

PY - 2020

Y1 - 2020

N2 - This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.

AB - This paper provides recommendations for dentists for the treatment of dental caries in children, with an emphasis on early childhood caries (ECC), primary teeth, and occlusal surfaces in permanent teeth. A consensus workshop followed by an e-Delphi consensus process was conducted with an expert panel nominated by the European Organization for Caries Research (ORCA) and European Federation of Conservative Dentistry (EFCD)/German Association of Conservative Dentistry (DGZ) boards. Based on 3 systematic reviews and a nonsystematic literature search, recommendations were developed. The caries decline has led to a more polarized disease distribution in children and adolescents along social gradients which should be taken into account when managing the caries process at all levels, such as the individual, the group, or a population. The control or reduction of caries activity is the basis for successful caries management. In children, caries management requires adequate daily oral hygiene and fluoride application via toothpaste, ensured by caregivers, and especially for ECC prevention an emphasis on sugar intake reduction is needed. These noninvasive interventions are also suitable to arrest or control initial or even cavitated dentine caries lesions in the absence of irreversible pulpitis. Fluoride varnish or silver diammine fluoride can be added as supplementary agents. In pits and fissures, composite resin materials can be used as preventive sealants and for defect-oriented minimally invasive restorations. In primary molars, preformed metal crowns are more successful than multisurface fillings, especially in caries-active patients. With persisting high caries activity, multiple lesions, and limited cooperation, caries control should consist of robust measures with high success rates, even including extraction in selected cases. This applies especially to treatments performed under general anesthesia.

U2 - 10.1159/000507692

DO - 10.1159/000507692

M3 - Journal article

C2 - 32610317

VL - 54

SP - 297

EP - 305

JO - Caries Research

JF - Caries Research

SN - 0008-6568

IS - 4

ER -