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International Dental Journal 2013; 63: 4–5    ORIGINAL ARTICLE                                                            ...
Classification of caries lesions    population, to identify needs and priorities in den-            governments about carie...
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FDI policy statement on classification of caries lesions of tooth surfaces and caries management systems adopted by the fdi general assembly 17 september 2011, mexico city, mexicoidj 12014


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FDI policy statement on classification of caries lesions of tooth surfaces and caries management systems adopted by the fdi general assembly 17 september 2011, mexico city, mexicoidj 12014

  1. 1. International Dental Journal 2013; 63: 4–5 ORIGINAL ARTICLE doi: 10.1111/idj.12014FDI policy statement on Classification of caries lesionsof tooth surfaces and caries management systemsAdopted by the FDI General Assembly: 17 September 2011,Mexico City, MexicoFDI World Dental FederationFDI World Dental Federation, Geneva, Switzerland.INTRODUCTION CURRENT SITUATIONCaries is a major global oral disease and its manage- • Caries is a multifactorial disease, which is largelyment should be based on our current knowledge of preventablethe disease process; its aetiology, prevention and • The disease process results in loss of mineral ionscontrol. Health promotion and wellbeing across all from the tooth surface and subsurface, which maycommunities are linked to caries control. lead to surface cavitation • The disease becomes established before cavitation of the tooth surfaceBACKGROUND • The disease process can be treated and reversed inThe original classification of carious cavities in its earliest stages; early recognition and arrest orexposed tooth surfaces was proposed by G. V. Black reversal is therefore highly desirable and possible inin the early 1900s for use in operative procedures1. A most cases, without restoration (‘surgical treat-century later, this system is still in widespread use by ment’) of the tooththe majority of dentists. • Failure to intervene early may result in lesion pro- Over the last 30 years there have been marked gression, leading to irreversible damage to the toothimprovements in the understanding of the aetio- structure (i.e. cavitation) and an increasing burdenpathology and the nature of caries and the caries to the patient throughout lifeprocess. Dental caries is the localized destruction of • Modifiable and non-modifiable risk factors aresusceptible dental hard tissue by acidic byproducts important contributory factorsfrom bacterial fermentation of carbohydrates. The • Social determinants of health play an importantcaries process is the dynamic sequence of biofilm– role in the risk assessment, prevention, surgicaltooth interactions which can occur over time on and treatment and continuing management of a carieswithin a tooth surface. Improvements in understand- also extend to the role of bacterial transmission • The Black caries classification, as commonly imple-in young children, the importance of common risk mented, is based on five standardized cavityfactors and the potential impact of caries on general designs, regardless of the stage or size of the lesionhealth. • Any revised classification should recognize the site, Scientists and clinicians now also recognize the need the stage, activity and size of lesions, for both pri-for a minimal intervention approach to surgical caries mary caries and recurrent caries, associated withmanagement, including the potential for arrest and both restorations and sealantsremineralisation of early lesions. • Any new classification would ideally be relevant for At the other end of the disease spectrum there is a deciduous and permanent teeth and take intoneed to recognize the consequences of untreated car- account the systemic consequences of untreatedies, both to the individual and society, as the evidence cariesfor the close interrelation between oral health, general • Any new classification should enable decisionhealth and quality of life is growing. makers to understand the oral health status of the4 © 2013 FDI World Dental Federation
  2. 2. Classification of caries lesions population, to identify needs and priorities in den- governments about caries, its prevention, control tal care and reflect the care that has been provided and management• Any new classification should be designed to give rel- • That the caries classification and caries manage- evant and high-quality information to clinical prac- ment system should provide a framework for design tice, for educational purposes and for researchers of appropriate health policy and planning decisions,• Any new classification should relate to the need for and relevant and cost-effective implementation of early arrest of lesions and their reversal to the ability caries management planning to monitor preventive treatment, and to the complex- • That adequate and appropriate surveillance, record ity of a restoration, if a restoration is required keeping and information technology support• Caries management and monitoring of the disease systems be developed progress should take into account local oral factors, • That implementation of existing, continuing and and the general health status and environment of future research activities to improve the systems the individual patient. and their delivery be a priority.THE FDI WORLD DENTAL FEDERATION REFERENCERECOMMENDS 1. Black GV. A work on operative dentistry, vol 2. Chicago: The• The continued development and adoption of a car- Medico-Dental Publ Co, 1908. ies lesion classification and a separate caries man- agement system, including risk assessment and Correspondence to: prevention, that are able to describe and document FDI World Dental Federation, the total caries (clinical) experience at both a popu- Avenue Louis Casai 84, lation and an individual level Case Postale 3,• That this caries classification and caries manage- CH–1216 Geneva, ment system be used as the basis for communicat- Switzerland. ing and educating patients, health professions and Email:© 2013 FDI World Dental Federation 5