A systematic review of selected caries prevention and management methods

Abstract

A systematic review of the periodic scientific literature was undertaken to determine the strength of the evidence for the efficacy of professional caries preventive methods applied to high risk individuals, and the efficacy of professionally applied methods to arrest or reverse non-cavitated carious lesions. An initial search identified 1435 articles, of which 27 were eventually included in the review. Among the 22 studies addressing the prevention of carious lesions in caries-active or high risk individuals, the strength of the evidence was judged to be fair for fluoride varnishes and insufficient for all other methods. Among the seven studies addressing the management of non-cavitated carious lesions, the strength of the evidence for efficacy was judged to be insufficient for all methods. The results do not indicate that the preventive and management methods reviewed are not efficacious; rather, they demonstrate that not enough is known to determine the efficacy of the methods. Suggestions for strengthening the limited evidence base involve the following: i) increasing the number of studies that examine prevention among high risk individuals and non-surgical management of non-cavitated lesions, ii) including a wider variety of subject ages, iii) targeting aspects of the efficacy questions not yet addressed, iv) strengthening research methods employed in the studies, and v) reporting methods and outcomes more completely.

Effectiveness of near-infrared transillumination in early caries diagnosis

“…Our results showed that the visual-tactile method failed to determine the presence of occlusal caries lesion in 3.4% of the cases, so the condition of the patient was underestimated. Concerning the application of the visual-tactile method for proximal lesions, it is generally accepted that it could lead to false negative results, especially when the process involves only the enamel [19,20]. In the diagnosis of non-cavitated proximal lesions, our results correspond to other reports: the radiographic method is accurate when the dentin is involved, but often leads to underestimation when only the enamel is affected, although it gives better results than the visual-tactile method [21,22].…”

“…False positive results were measured. Other authors obtained similar results, too [16,17,19,20]. Based on these and our study, we could recommend the device to be used as an adjunct method.…”

Evaluation of Diagnostic Tests Using Information Theory for Multi-Class Diagnostic Problems and its Application for the Detection of Occlusal Caries Lesions

“…According to some of the results, the radiographic method was found to have worse performance than the visual examination and LF device methods when compared using sensitivity, specificity, accuracy, and AUC values (20)(21)(22)(23). This could be due to the depth of the caries lesion on the radiograph, difficulty in noticing hidden caries because of the fissure system and not removing all of the colorization on the occlusal region (21,24,25). Therefore, new methods are being researched for early caries lesions.…”

The Efficacy of Screening for Common Dental Diseases by Hygiene-Therapists

“…This could be due to the difficulties in diagnosing borderline cases (i.e., H-Ts may have less experience in screening for caries). This would appear reasonable given the difficulties in caries diagnosis at all levels of the profession (Bader et al 2001) and the proliferation of adjunctive aids to inform this decision. The forest plots ( Figs.…”