Nélio Veiga

Non-treated dental caries is the most prevalent disease and constitutes a major public health issue worldwide in both children and adults. To treat and prevent dental caries, it is essential to know the oral health indicators and the methods for the assessment of associated risk factors. This knowledge allows a more accurate clinical approach focused on the risk factors that increase the probability of disease development, as well as the definition of strategies for the prevention of dental caries. The modern concept of dental caries is characterized as a biofilm-mediated, diet-modulated, multifactorial, non-communicable, dynamic disease and totally preventable, resulting from a dysbiosis caused by the imbalance of multiple cariogenic species triggered by the consumption of sugars. The significant advance in bioactive restorative materials that allow a remineralization and clinical operative techniques/technologies, behaviour management and motivational interviewing, are all enabling oral healthcare teams to deliver successfully this contemporary approach to achieve and maintain oral health and long-term wellbeing. And finally, an increase in the life expectancy of the population makes necessary a change in the concept of caries management, in both the child and adult patient. The main objective of Minimal Intervention Dentistry is tissue preservation, including early caries detection and non-operative treatment, combined with minimally invasive restorative procedures (remineralization, fissure sealants, selective caries removal). The International Caries Classification and Management System has proposed a system following the 4D scheme (Determine, Detect, Decision and Do). In this sense, determining a patient’s caries risk consists of estimating the possibility that a new caries lesion may occur in the future or that pre-existing lesions progress. It is important to “detect” and assess lesions, assessing the activity of caries, “decide” a personalized plan and finally “do” a preventive and tooth preserving intervention with Minimal Intervention Dentistry. Minimum intervention oral healthcare is the approach to patient management where the oral health professionals act as one, providing individualized patient-centered care and advice to encour­age the patient to take responsibility for and maintain their own oral health.

Therefore, this presentation will focus on the existing methods for assessing the risk of oral pathology, more specifically dental caries, in order to allow a more effective and preventive clinical performance. During the conference, clinical cases will be presented following a minimal intervention dentistry philosophy.