More for less: Improving oral health through risk assessment, patient education and mimimal intervention

The focus in the treatment of dental caries has moved away from surgical intervention toward viewing caries as an infectious disease model with treatment centered on diagnosis and prevention. Changes to the curriculum at the University of Maryland Dental School have been made to address these issues.

Teaching the management of dental caries in dental school has traditionally been discipline-specific. The management of the disease is focused on the manner in which the affected tooth is treated. In Operative Dentistry this has emphasized the surgical treatment of tooth decay.

The FDI World Dental Federation in 2002 made a policy statement designed to promote minimal intervention in the management of caries. This policy of caries management by risk assessment (CAMBRA) was based on five principles. These are: modification of oral flora to promote health, patient education and informed participation, remineralization of non-cavitated lesions, minimal operative intervention, and the repair of defective restorations.

To promote caries management through minimal intervention, a series of lectures and projects have been introduced to the preclinical curricula of Operative Dentistry. Risk assessment and treatment planning reinforce the selection of conservative restorative treatment and materials. These materials, more suitable for a conservative preparation, help to slow down the cycle of aggressive treatments which begins with the placement of an initial dental silver amalgam restoration.

The division of Operative Dentistry at the University of Maryland is working toward promoting the policy statements of the World Dental Federation and their efforts in the management of dental caries.