Remineralisation – the buzzword for early MI caries management

Key Points

  • Highlights that minimal intervention dentistry aims to preserve dental tissues first and restore only when indicated.

  • Emphasises non-operative treatment of initial caries lesions as an integral part of comprehensive caries management.

  • Discusses the strategies available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces.

  • Points out that all caries remineralisation treatment be complemented with general behaviour modification advice.


Minimal intervention (MI) dentistry aims to preserve dental tissues first and restore only when indicated, thus remineralisation of initial (non-cavitated) caries lesions, an integral part of caries management, is an essential treatment strategy in MI. With this understanding, dental practitioners are increasingly embracing the principle of non-operative treatment of initial caries lesions. The purpose of this review was to summarise the most recent literature published in non-operative management of dental caries. Three electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL) were searched, and clinical studies, systematic reviews and meta-analysis were included. This report outlines the strategies and numerous therapeutic materials available to aid in arrestment/remineralisation of initial caries lesions on root and coronal surfaces. However, the level of evidence of effect is variable, as well as the availability in different parts of the world. Options available to practitioners will vary when placing emphasis on the level of evidence supporting them. Strong clinical evidence support the effectiveness of pits/fissure sealants for therapeutic management of active initial caries on occlusal surfaces, and fluoride varnishes for remineralisation of caries lesions on root and coronal smooth surfaces, including proximal surfaces. Other materials formulated to enhance the effectiveness of any chosen remineralisation strategy were discussed. However, it is absolutely necessary that all caries remineralisation treatment be complemented with general behavioural modification in oral health through motivational interviewing directed towards change in oral hygiene to control plaque, dietary attitude modification to reduce the frequency of intake of fermentable sugars, and establishment of risk-based recall visits.

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Figure 1
Figure 2: Decision tree for management of caries lesions on proximal coronal surfaces.
Figure 3: ADA Caries Classification System 2015.
Figure 4: Decision tree for management of caries lesions on occlusal pits and fissure.
Figure 5: Decision tree for management of Caries Lesions on Non-Proximal Coronal Smooth Surfaces.
Figure 6: Decision tree for management of caries lesions on root surfaces.
Figure 7


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Amaechi, B. Remineralisation – the buzzword for early MI caries management. Br Dent J 223, 173–182 (2017).

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