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Minimum intervention dentistry in the US: an update from a cariology perspective


Despite evidence strongly supporting use of non-invasive or minimally invasive procedures in caries management, there is still a large gap between evidence-based recommendations and application of these concepts in practice, with the practice of dentistry still largely dominated by invasive procedures in the US. This paper describes efforts in education and clinical practice in the US in the last decade to promote evidence-based cariology strategies, which support a minimum intervention dentistry (MID) philosophy. These include, for example: a competency-based core cariology curriculum framework which has been developed and disseminated. National education accreditation standards supporting caries management are likely to soon be changed to support assessment of best evidence in cariology. There are several ongoing efforts by organised dentistry and other groups involving dental educators, researchers and clinical practitioners to promote cariology concepts in practice, such as the development of evidence-based clinical practice guidelines for caries management by the American Dental Association. Within each of these strategies there are challenges, but also opportunities to expand the implementation of MID in the US, which create optimism for future improvements over time.

Key points

  • Even though multiple challenges exist to changing the paradigm of care as it relates to caries management in the US, there are also multiple opportunities to promote MID strategies within cariology education and practice

  • Collaborative efforts have led to the development and implementation of a core cariology curriculum framework in the US that promotes principles of MID.

  • Several organisations have developed or updated evidence-based guidelines for caries interventions, including the development of guidelines for non-restorative management of cavitated and non-cavitated lesions by the American Dental Association, which promotes principles of MID.

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Correspondence to Margherita Fontana.

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CEF is coordinator of the cariology unit, at the University of Talca, Chile, and declares to have no commercial or financial relationships that could be construed as a potential conflict of interest. MF is past chair and councillor of the ADEA cariology section, current co-chair of the Canada-US section of ACFF, current chair of AAC, and clinical co-director of cariology at the University of Michigan School of Dentistry. CG is co-director of cariology at the University of Michigan School of Dentistry.

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Fernández, C., González-Cabezas, C. & Fontana, M. Minimum intervention dentistry in the US: an update from a cariology perspective. Br Dent J 229, 483–486 (2020).

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