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A Century of Change towards Prevention and Minimal Intervention in Cariology

2019/05/20 by N.P.T. Innes, Nicola Innes, Chun Hung Chu +15 · 174 citations
Dentistry · Medicine · Nursing · #Dental Health and Care Utilization #Dental Research and COVID-19 #Dentistry #Disease #Environmental health #Family medicine #Health care #Intensive care medicine #Intervention (counseling) #Medicine #Nursing #Oral microbiology and periodontitis research #Pathology #Political science #Population #Public health #Reimbursement #Specialty

paper · open access · doi:10.1177/0022034519837252

published in Journal of Dental Research 98(6), 611-617 (SAGE Publishing)

openalex publication_date 2019/05/20 · openalex created_date 2025/10/10 · openalex updated_date 2026/07/30

Abstract

Better understanding of dental caries and other oral conditions has guided new strategies to prevent disease and manage its consequences at individual and public health levels. This article discusses advances in prevention and minimal intervention dentistry over the last century by focusing on some milestones within scientific, clinical, and public health arenas, mainly in cariology but also beyond, highlighting current understanding and evidence with future prospects. Dentistry was initially established as a surgical specialty. Dental caries (similar to periodontitis) was considered to be an infectious disease 100 years ago. Its ubiquitous presence and rampant nature-coupled with limited diagnostic tools and therapeutic treatment options-meant that these dental diseases were managed mainly by excising affected tissue. The understanding of the diseases and a change in their prevalence, extent, and severity, with evolutions in operative techniques, technologies, and materials, have enabled a shift from surgical to preventive and minimal intervention dentistry approaches. Future challenges to embrace include continuing the dental profession's move toward a more patient-centered, evidence-based, less invasive management of these diseases, focused on promoting and maintaining oral health in partnership with patients. In parallel, public health needs to continue to, for example, tackle social inequalities in dental health, develop better preventive and management options for existing disease risk groups (e.g., the growing aging population), and the development of reimbursement and health outcome models that facilitate implementation of these evolving strategies. A century ago, almost every treatment involved injections, a drill or scalpel, or a pair of forceps. Today, dentists have more options than ever before available to them. These are supported by evidence, have a minimal intervention focus, and result in better outcomes for patients. The profession's greatest challenge is moving this evidence into practice.

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