Preservative dentistry is therefore based on a refined model of care

consisting of :

Accurate caries diagnosis.

Classification of the caries severity using radiographs ;
Assessment of individual caries risk (high, moderate or low);
Arresting active lesions
Remineralising and monitoring of cavitated arrested lesions
Placement of restorations in teeth with cavitated lesions, using minimal
cavity designs;

Assessing disease management outcomes (that is, change in various

decayed/ missing/filled indices) at predetermined time intervals.
MINIMAL INTERVENTION RESTORATIVE DENTISTRY :
It is time to consider and discuss modifications to the control,
elimination, and restoration of caries. The surgical approach has been
proven to be inefficient and destructive, so it

is obviously maximally

interventionist.
A recent policy document produced for the World Dental Federation
suggested that there are 4 basic principles that must be applied to fulfill the
description of minimal intervention dentistry :
1 Control the disease through reduction of cariogenic flora.
2 Remineralize early lesions.
3 Perform minimal intervention surgical procedures as required.
4 Repair, rather than replace, defective restorations.

It is suggested that these principles be followed in the modern

approach to dealing with the disease of caries.
Minimal Intervention

Evaluate

Control Disease

Prevent

1 Quantity and quality of

saliva
2 Microflora
3 Diet
4 Tooth morphology
5 General health

Assess need for

Invasive treatment

Remineralize

Maximize remineralizing
potential of oral
environment.
Disrupt demineralization
cycles.
Remineralize white spot
lesions
Educate and motivate
patient.

Repair damage

Minimal
Invasion

1
2
3

Only when integrity

of tooth is
compromised.
After adequate
control of the
disease
In consultation with
patient

2
3
4
5

Biomimetic
material

Maintain integrity
of tooth, both
biologic and
physical.
Use biomimetic
material
Remineralize
affected dentin
Eliminate
cavitation
Maintain seal

Essential aspects of diagnosis and treatment planning in a minimal intervention

approach to operative dentistry