Book Review

  • Falk Schwendicke
Springer; 2018 price £58.99 pp. 130 ISBN: 9783319613697 | ISBN: 978-3-3196-1369-7

Professor Falk Schwendicke has compiled a very useful and factually informative book which is extremely relevant to any dental professional with the ability to put drill to tooth. He has amassed the expertise and research of leaders in the field to shed light on the very latest in the management of deep carious lesions. As we are aware, dental caries cannot develop without the presence of dietary fermentable carbohydrates. This book focuses on limiting physical intervention, thus reducing the restorative spiral, in a bid to prolong the longevity of a tooth.

The text is divided into eight chapters and also written by as many authors. Each chapter is very logically mapped out with an abstract, main body, summary and references. Included in every chapter are numerous illustrations .

The authors, backed up by robust evidence, attempt to challenge the traditional invasive school of thought which encourages removal of almost all cariogenic bacteria from a cavity. Its main message is that of minimally invasive dentistry. A more holistic approach is required to treat an individual patient effectively: 1) identify risk category; 2) control dietary sugars; 3) utilise non-invasive strategies wherever possible; 4) attempt to shift the balance in favour of mineral gain rather than mineral loss; 5) employ invasive strategies only as a last resort, while maintaining the integrity of the pulp.

A figure in chapter 1 (Page 11, F1.7) depicts the death spiral of a tooth very well. All restorations have a lifespan, therefore early invasive intervention will inevitably lead to the premature loss of a tooth. Each chapter further emphasises these points and the fact that we should only be removing tooth tissue which is absolutely necessary.

Selective removal of carious dentine, however, may pose a threat with regards to incorrect radiographic diagnosis should this patient be treated by another dentist where records are inaccessible. Due to the litigious environment we now work in, many dentists may not choose to employ these techniques simply for that reason. Chapter 6, section 6 'radiographic diagnosis after selective caries removal' touches on this subject.

In summary, I believe this book is an excellent resource to every practising clinician. It should be on the reading list of every undergraduate in order to adopt good practice early into their career.