Nonrestorative Treatments for Carious Lesions
Publication Date: October 1, 2018
Last Updated: March 14, 2022
PRIMARY DENTITION Recommendations
To arrest advanced cavitated carious lesions on any coronal surface of primary teeth, the expert panel recommends clinicians prioritize the use of 38% SDF solution (biannual application) over 5% NaF varnish (application once per week for 3 weeks). (S, M)
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To arrest or reverse noncavitated carious lesions on occlusal surfaces of primary teeth, the expert panel recommends clinicians prioritize the use of sealants plus 5% NaF varnish (application every 3-6 months) or sealants alone over 5% NaF varnish alone (application every 3-6 months), 1.23% APF gel (application every 3-6 months), resin infiltration plus 5% NaF varnish (application every 3-6 months), or 0.2% NaF mouthrinse (once per week).) (S, M)
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To arrest or reverse noncavitated carious lesions on approximal surfaces of primary teeth, the expert panel suggests clinicians use 5% NaF varnish (application every 3-6 months), resin infiltration alone, resin infiltration plus 5% NaF varnish (application every 3-6 months), or sealants alone. (C, )
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To arrest or reverse noncavitated carious lesions on facial or lingual surfaces of primary teeth, the expert panel suggests clinicians use 1.23% APF gel (application every 3-6 months) or 5% NaF varnish (application every 3-6 months. (C, )
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To arrest or reverse noncavitated carious lesions on coronal surfaces of primary teeth, the expert panel suggests clinicians do not use 10% CPP-ACP paste if other fluoride interventions, sealants, or resin infiltration is accessible. (C, L)
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PERMANENT DENTITION Recommendations
To arrest advanced cavitated carious lesions on any coronal surface of permanent teeth, the expert panel suggests clinicians prioritize the use of 38% SDF solution (biannual application) over 5% NaF varnish (application once per week for 3 weeks). (C, L)
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To arrest or reverse noncavitated carious lesions on occlusal surfaces of permanent teeth, the expert panel recommends clinicians prioritize the use of sealants plus 5% NaF varnish (application every 3-6 months) or sealants alone over 5% NaF varnish (application every 3-6 months), 1.23% APF gel (application every 3-6 months), or 0.2% NaF mouthrinse (once per week). (S, M)
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To arrest or reverse noncavitated carious lesions on approximal surfaces of permanent teeth, the expert panel suggests clinicians use 5% NaF varnish (application every 3-6 months), resin infiltration alone, resin infiltration plus 5% NaF varnish (application every 3-6 months), or sealants alone. (C, )
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To arrest or reverse noncavitated carious lesions on facial or lingual surfaces of permanent teeth, the expert panel suggests clinicians use 1.23% APF gel (application every 3-6 months) or 5% NaF varnish (application every 3-6 months). (C, )
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To arrest or reverse noncavitated carious lesions on coronal surfaces of permanent teeth, the expert panel suggests clinicians do not use 10% CPP-ACP paste if other fluoride interventions, sealants, or resin infiltration is accessible. (CL)
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To arrest or reverse noncavitated and cavitated carious lesions on root surfaces of permanent teeth, the expert panel suggests clinicians prioritize the use of 5,000 parts per million fluoride (1.1% NaF) toothpaste or gel (at least once per day) over 5% NaF varnish (application every 3-6 months), 38% SDF plus potassium iodide solution (annual application), 38% SDF solution (annual application), or 1% chlorhexidine plus 1% thymol varnish (application every 3-6 months). (CL)
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Title
Nonrestorative Treatments for Carious Lesions
Publication Month/Year
October 1, 2018
Last Updated Month/Year
June 9, 2022
External Publication Status
Published
Country of Publication
US
Document Objectives
An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults.
Target Patient Population
Patients with dental caries
Inclusion Criteria
Female, Male, Adolescent, Adult, Child, Older adult
Health Care Settings
Ambulatory, Outpatient, School
Intended Users
Dentist, nurse, nurse practitioner, physician, physician assistant
Scope
Prevention, Management, Treatment
Diseases/Conditions (MeSH)
D003731 - Dental Caries, D003945 - Diagnosis, Oral, D009909 - Oral Health, D003736 - Dental Cavity Lining, D003733 - Dental Caries Susceptibility, D009910 - Oral Hygiene
Keywords
oral cavity, cavity, carious lesion, caries