Current Concepts on Caries Removal

Abstract

This chapter offers a comprehensive introduction of dental caries management, with a central emphasis on selective caries removal as a cornerstone of minimally invasive dentistry. Rooted in evidence-based dentistry and a grasp of carious dentin progression, the shift from conventional dental paradigms is explored. Various challenges and debates surrounding selective caries removal techniques are discussed, encompassing non-selective, selective, and stepwise methods. Histological and clinical identification methods for carious dentin are explored till the date, including color, hardness, and texture variations. It is important to pay attention to the connection between tactile examinations and the International Caries Detection and Assessment System (ICDAS) index. The relationship between clinical staging and histological aspects of carious dentin is established. Diverse techniques like hand excavation, polymer-based burs, chemomechanical agents, air abrasion, lasers, and tungsten carbide burs are evaluated, highlighting benefits, limitations, and comparisons. The chapter underscores selective caries removal’s role in minimally invasive dentistry, focusing on tissue preservation and its impact on pulp vitality, restoration durability, and patient well-being. This comprehensive presentation covers clinical, histological, and technological facets of caries management in a minimally invasive context.