Secondary caries: what is it, and how it can be controlled, detected, and managed?

Askar, Haitham; Krois, Joachim; Göstemeyer, Gerd; Bottenberg, Peter; Zero, Domenick T.; Banerjee, Avijit; Schwendicke, Falk

doi:10.1007/s00784-020-03268-7

Cited by 125 publications

(106 citation statements)

References 56 publications

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“…Regarding the risk of secondary carious lesions next to restorations placed using different adhesive strategies and restorative materials, the review yielded only a few robust findings [23]. Overall, amalgams appear to be associated with a lower risk of secondary caries [24], which is in agreement with amalgams showing an overall lower risk of failure in most cavities (see above).…”

Section: Dietary Advicementioning

confidence: 86%

How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement

et al. 2020

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Objectives To provide consensus recommendations on how to intervene in the caries process in adults, specifically proximal and secondary carious lesions. Methods Based on two systematic reviews, a consensus conference and followed by an e-Delphi consensus process were held with EFCD/ORCA/DGZ delegates. Results Managing an individual's caries risk using non-invasive means (oral hygiene measures including flossing/interdental brushes, fluoride application) is recommended, as both proximal and secondary carious lesions may be prevented or their activity reduced. For proximal lesions, only cavitated lesions (confirmed by visual-tactile, or radiographically extending into the middle/ inner dentine third) should be treated invasively/restoratively. Non-cavitated lesions may be successfully arrested using noninvasive measures in low-risk individuals or if radiographically confined to the enamel. In high-risk individuals or if radiographically extended into dentine, for these lesions, additional micro-invasive (lesion sealing and infiltration) treatment should be considered. For restoring proximal lesions, adhesive direct restorations allow minimally invasive, tooth-preserving preparations. Amalgams come with a lower risk of secondary lesions and may be preferable in more clinically complex scenarios, dependent on specific national guidelines. In structurally compromised (especially endodontically treated) teeth, indirect cuspal coverage restorations may be indicated. Detection methods for secondary lesions should be tailored according to the individual's caries risk. Avoiding false positive detection and over-treatment is a priority. Bitewing radiographs should be combined with visualtactile assessment to confirm secondary caries detections. Review/refurbishing/resealing/repairing instead of replacing partially defective restorations should be considered for managing secondary caries, if possible. Conclusions An individualized and lesion-specific approach is recommended for intervening in the caries process in adults. Clinical significance Dental clinicians have an increasing number of interventions available for the management of dental caries. Many of them are grounded in the growing understanding of the disease. The best evidence, patients' expectations, clinicians' expertise, and the individual clinical scenario all need to be considered during the decision-making process.

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Section: Dietary Advicementioning

confidence: 86%

How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement

et al. 2020

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“…Clinical studies compared materials for their risk of secondary caries, but only limited data from randomized controlled trials provide evidence for the comparison between composites and amalgam. Glass ionomers show similar effectiveness regarding to secondary caries in comparison with composites but may be connected with higher risk of fracture in extended cavities [29].…”

Section: Introductionmentioning

confidence: 99%

“…What we know for sure is that the factors that cause demineralization, which are related to an individual behavior misbalance on sugar consumption associated with local biofilm accumulation, are exactly the same for primary and secondary caries [29,33].…”

Section: Introductionmentioning

confidence: 99%

Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm–On Children Caries-Associated Streptococcus Mutans Isolates

Staszczyk

Jurczak

Magacz

et al. 2020

IJERPH

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Secondary caries is a disease associated with the formation of biofilm on the border of the tooth and dental filling. Its development is strongly influenced by the dietary sweet foods and the type of dental material. The aim of the study was to assess the effect of sweeteners on the ability of clinical Streptococcus mutans strains to form biofilm on dental materials. Strains were isolated from plaque samples from 40 pediatric patients from the 3–6 ICADS II group. The ability to form biofilm was tested on composite and glass ionomer dental materials used for milk teeth filling in the presence of sucrose, xylitol, sorbitol, and erythritol. The bacterial film mass after 12, 24, 48, and 72 h and the number of bacterial colonies significantly decreased (p < 0.01) compared to the initial value for 5% erythritol and sorbitol on examined materials. A greater inhibitory effect was noted for glass ionomers compared to composites. Sucrose and xylitol supported biofilm formation, while erythritol had the best inhibitory effect. The use of fluoride-releasing glass ionomers exerted an effect synergistic to erythritol, i.e., inhibited plaque formation and the amount of cariogenic S. mutans. Selection of proper type of dental material together with replacing sucrose with polyols can significantly decrease risk of secondary caries development. Erithritol in combination with glass ionomer seems to be the most effective in secondary caries prevention.

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“…To summarize the current scientific knowledge, selected members of the three associations were asked prior to the meeting to prepare systematic literature reviews regarding the treatment of most prevalent caries forms in the three age groups. The reviews were published in Caries Research and Clinical Oral Investigations [Meyer-Lueckel et al, 2019;Askar et al, 2020;Santamaria et al, 2020, in press;Schmoeckel et al, 2020;Splieth et al, 2020]. In preparation of the current consensus, a systematic review on the management of root caries was performed [Meyer-Lueckel et al, 2019].…”

Section: Methodsmentioning

confidence: 99%

How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

et al. 2020

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Aim: To provide recommendations for dental clinicians for the management of dental caries in older adults with special emphasis on root caries lesions. Methods: A consensus workshop followed by a Delphi consensus process were conducted with an expert panel nominated by ORCA, EFCD, and DGZ boards. Based on a systematic review of the literature, as well as non-systematic literature search, recommendations for clinicians were developed and consented in a two-stage Delphi process. Results: Demographic and epidemiologic changes will significantly increase the need of management of older adults and root caries in the future. Ageing is associated with a decline of intrinsic capacities and an increased risk of general diseases. As oral and systemic health are linked, bidirectional consequences of diseases and interventions need to be considered. Caries prevention and treatment in older adults must respond to the patient’s individual abilities for self-care and cooperation and often involves the support of caregivers. Systemic interventions may involve dietary counselling, oral hygiene instruction, the use of fluoridated toothpastes, and the stimulation of salivary flow. Local interventions to manage root lesions may comprise local biofilm control, application of highly fluoridated toothpastes or varnishes as well as antimicrobial agents. Restorative treatment is often compromised by the accessibility of such root caries lesions as well as the ability of the senior patient to cooperate. If optimum restorative treatment is impossible or inappropriate, long-term stabilization, e.g., by using glass-ionomer cements, and palliative treatments that aim to maintain oral function as long and as well as possible may be the treatment of choice for the individual.

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Secondary caries: what is it, and how it can be controlled, detected, and managed?

Cited by 125 publications

References 56 publications

How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement

How to intervene in the caries process in adults: proximal and secondary caries? An EFCD-ORCA-DGZ expert Delphi consensus statement

Effect of Polyols and Selected Dental Materials on the Ability to Create a Cariogenic Biofilm–On Children Caries-Associated Streptococcus Mutans Isolates

How to Intervene in the Caries Process in Older Adults: A Joint ORCA and EFCD Expert Delphi Consensus Statement

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