OBJECTIVE: The aim of the present consensus paper was to provide recommendations for clinical practice considering the use of visual examination, dental radiography and adjunct methods for primary caries detection.
METHODS: The executive councils of the European Organisation for Caries Research (ORCA) and the European Federation of Conservative Dentistry (EFCD) nominated ten experts each to join the expert panel. The steering committee formed three work groups that were asked to provide recommendations on (1) caries detection and diagnostic methods, (2) caries activity assessment and (3) forming individualised caries diagnoses. The experts responsible for \"caries detection and diagnostic methods\" searched and evaluated the relevant literature, drafted this manuscript and made provisional consensus recommendations. These recommendations were discussed and refined during the structured process in the whole work group. Finally, the agreement for each recommendation was determined using an anonymous Delphi survey.
RESULTS: Recommendations (N = 8) were approved and agreed upon by the whole expert panel: visual examination (N = 3), dental radiography (N = 3) and additional diagnostic methods (N = 2). While the quality of evidence was found to be heterogeneous, all recommendations were agreed upon by the expert panel.
CONCLUSIONS: Visual examination is recommended as the first-choice method for the detection and assessment of caries lesions on accessible surfaces. Intraoral radiography, preferably bitewing, is recommended as an additional method. Adjunct, non-ionising radiation methods might also be useful in certain clinical situations.
CONCLUSIONS: The expert panel merged evidence from the scientific literature with practical considerations and provided recommendations for their use in daily dental practice.

BACKGROUND: Early childhood caries (ECC) is characterized by \"the presence of one or more decayed (non-cavitated or cavitated lesions), missing (due to caries), or filled surfaces, in any primary tooth in a child 71 months of age or younger\". There have been reports of increased incidence of caries in developing countries.A systematic analysis of the global burden of diseases, injuries and risk factors for 195 countries from 1990 to 2015 reported that almost 8% of children globally were affected by untreated ECC. As such, ECC was classified as one of the diseases of public health concern because it affects millions of infants and preschool children worldwide. This study aimed to review the prevalence and associated factors of early childhood caries in Nigeria and also provides current overview alongside globally recommended treatment guidelines.
METHODS: PubMed database, the Cochrane Central Register of Controlled Trials, and the Cochrane Database of Systematic Reviews (to February 2022) was used for articles search on the guidelines and recommendations for the treatment of ECC. Guidelines and recommendations published by the American Academy of Paediatric Dentistry, International Association of Paediatric Dentistry and European Academy of Paediatric Dentistry from 2017-2020 were retrieved. The following keys used in the MeSH were \'early childhood caries among Nigerian children, \'caries in preschool Nigerian children\' \'treatment guidelines\', \'treatment policies\'and \'treatment recommendations.
METHODS: A total of 105 (24 plus 81) articles were retrieved but 21(15 plus 6 articles) were selected after the removal of non-specific and duplicated articles.
RESULTS: The prevalence of early childhood caries ranged from 4.3-23.5% in Nigeria while the treatment guidelines and recommendations were case-specific.
CONCLUSIONS: The prevalence of early childhood caries varies within the country\'s geo-political zones.
BACKGROUND: Les caries de la petite enfance (CPE) se caractérisent par \"la présence d\'une ou de plusieurs surfaces cariées (lésions non cavités ou cavités), manquantes (en raison de caries) ou obturées, sur une ou plusieurs dents primaires chez un enfant de 71 mois ou moins\". Des rapports ont fait état d\'une incidence accrue de caries dans les pays en développement. Une analyse systématique de la charge mondiale des maladies, des blessures et des facteurs de risque pour 195 pays de 1990 à 2015 a indiqué qu\'environ 8 % des enfants dans le monde étaient touchés par des CPE non traitées. En tant que tel, les CPE ont été classées comme l\'une des maladies préoccupantes pour la santé publique car elles touchent des millions de nourrissons et de jeunes enfants dans le monde. Cette étude visait à examiner la prévalence et les facteurs associés des caries de la petite enfance au Nigeria et à fournir une vue d\'ensemble actuelle ainsi que des lignes directrices de traitement recommandées au niveau mondial.
UNASSIGNED: La base de données PubMed, le Registre Cochrane central des essais contrôlés et la base de données Cochrane des revues systématiques (jusqu\'à février 2022) ont été utilisés pour la recherche d\'articles sur les lignes directrices et recommandations pour le traitement des CPE. Les lignes directrices et recommandations publiées par l\'American Academy of Paediatric Dentistry, l\'International Association of Paediatric Dentistry et l\'European Academy of Paediatric Dentistry de 2017 à 2020 ont été récupérées. Les termes suivants ont été utilisés dans le MeSH : \'caries de la petite enfance chez les enfants nigérians\', \'caries chez les enfants préscolaires nigérians\', \'lignes directrices de traitement\', \'politiques de traitement\' et \'recommandations de traitement\'.
UNASSIGNED: Un total de 105 (24 plus 81) articles ont été récupérés, mais 21 (15 plus 6 articles) ont été sélectionnés après la suppression des articles non spécifiques et en double.
UNASSIGNED: La prévalence des caries de la petite enfance variait de 4,3 % à 23,5 % au Nigeria, tandis que les lignes directrices et recommandations de traitement étaient spécifiques à chaque cas.
CONCLUSIONS: La prévalence des caries de la petite enfance variait au sein des zones géopolitiques du pays.
UNASSIGNED: Caries de la petite enfance, CPE, Lignes directrices de traitement.

An expert panel convened by the American Dental Association (ADA) Council on Scientific Affairs together with the ADA Science and Research Institute\'s program for Clinical and Translational Research conducted a systematic review and developed recommendations for the treatment of moderate and advanced cavitated caries lesions in patients with vital, nonendodontically treated primary and permanent teeth.
The authors searched for systematic reviews comparing carious tissue removal (CTR) approaches in Ovid MEDLINE, Embase, Cochrane Database of Systematic Reviews, and Trip Medical Database. The authors also conducted a systematic search for randomized controlled trials comparing direct restorative materials in Ovid MEDLINE, Embase, Cochrane Central Register of Controlled Trials, ClinicalTrials.gov, and the World Health Organization International Clinical Trials Registry Platform. The authors used the Grading of Recommendations Assessment, Development, and Evaluation approach to assess the certainty of the evidence and formulate recommendations.
The panel formulated 16 recommendations and good practice statements: 4 on CTR approaches specific to lesion depth and 12 on direct restorative materials specific to tooth location and surfaces involved. The panel conditionally recommended for the use of conservative CTR approaches, especially for advanced lesions. Although the panel conditionally recommended for the use of all direct restorative materials, they prioritized some materials over the use of others for certain clinical scenarios.
The evidence suggests that more conservative CTR approaches may decrease the risk of adverse effects. All included direct restorative materials may be effective in treating moderate and advanced caries lesions on vital, nonendodontically treated primary and permanent teeth.

To adapt an evidence-based clinical practice guideline (CPG) for risk-based management of caries in 18-55 year-old Iranian adults.
A multidisciplinary adaptation team reviewed evidence-based guidelines such as the NICE, SIGN, and ADA according to the defined clinical questions. In addition, databases such as the PubMed and Google Scholar were searched and CPGs were screened and appraised using the AGREE II (Appraisal of Guidelines for Research and Evaluation II) tool. Clinical scenarios were developed and their level of evidence, clinical advantage and adaptability were assessed. Following a two-round ranking by experts, the final recommendations were selected using the RAND-UCLA appropriateness method.
Of 17 CPGs, 5 were selected as the source guidelines for adaptation. To assess the risk of caries in the adult population, reduced Cariogram (without saliva tests) and CAMBRA were suggested as diagnostic tools. In addition, 53 risk-based recommendations on the preventive care (including the use of fluoride toothpaste, fluoride, and chlorhexidine mouthwash, at home and in-office fluoride gel, fluoride varnish, mouth buffering, and sealant), operative intervention threshold, and follow-up interval were adapted for Iranian adults.
A guideline was adapted for risk-based management of dental caries in Iranian adults. This helps local dentists in decision making and promoting oral health of adults. Further research is needed to assess the external validity and feasibility of the adapted guideline in the Iranian population.

Early childhood caries (ECC) is a significant chronic disease of childhood and a rising public health burden worldwide. ECC may cause a higher risk of new caries lesions in both primary and permanent dentition, affecting lifelong oral health. The occurrence of ECC has been closely related to the core microbiome change in the oral cavity, which may be influenced by diet habits, oral health management, fluoride use, and dental manipulations. So, it is essential to improve parental oral health and awareness of health care, to establish a dental home at the early stage of childhood, and make an individualized caries management plan. Dental interventions according to the minimally invasive concept should be carried out to treat dental caries. This expert consensus mainly discusses the etiology of ECC, caries-risk assessment of children, prevention and treatment plan of ECC, aiming to achieve lifelong oral health.

A guideline called FRAMM, which is an acronym in Swedish for the most important parts of this guideline, namely \"fluoride\", \"advice\", \"arena\", \"motivation\" and \"diet\", was implemented in 2008 in the Västra Götaland Region in Sweden. This guideline included fluoride varnish applications performed at school twice a year at six-monthly intervals for all 12- to 15-year-olds, together with lessons on oral health. The aim of this analysis was to estimate the long-term cost-effectiveness, using prognostic calculations, of the FRAMM Guideline for 12- to 15-year-olds, compared with routine care, until the participants were 23 years old. A cost-effectiveness analysis was performed from a health care perspective, based on four years of verified data and seven years of prognosis. Data from FRAMM were combined with cost data from price lists in Sweden. The cost-effectiveness was analyzed by relating the difference in costs to the difference in the number of approximal surfaces with fillings and/or dentin lesions (DFSa). The analysis shows that FRAMM was considered dominant compared to the controls in all alternative scenarios, hence costs were prognosed to be lowered and outcomes were prognosed to be improved. A dental health program like the FRAMM Guideline with fluoride varnish during the caries risk period from 12 to 15 years is predicted to be cost-effective in the longer perspective. To further study the actual long-term caries increment after a preventive dental health program would be of great interest to verify these results.

This paper charts the 20-year collaborative journey made by international teams of dental researchers, educators and practitioners. Following the initial development of the International Caries Detection and Assessment System (ICDAS) in 2002, the International Caries Classification and Management System (ICCMS) was collaboratively developed between 2010-2017 with several dental research and practice organisations, and influenced by best evidence judged via SIGN methodology, the UNEP Minamata Treaty (and linked phasing down of dental amalgam), three Dental Policy Labs and an international movement in operative dentistry to move towards minimally invasive dentistry. The FDI World Dental Federation publicised and advocated the ICCMS in 2019, when the \'CariesCare International\' Consensus Guide and 4D caries management system was published to aid the delivery of ICCMS into practice. This system, which is designed to help practitioners deliver optimal caries care for patients, is now being adapted internationally for post-pandemic use in the \'Caries OUT\' study. It is also being used as a vehicle for implementing the updated Delivering better oral health guidance on caries, as part of the minimum intervention oral healthcare delivery framework in the UK.

暂无摘要。

Caries of children under 3 years old has such characteristics as early onset, multiple tooth involvement and rapid development. It may affect the mastication and digestive functions of the children, as well as oral and systemic development, and may become a risk factor for systemic diseases. In order to standardize the prevention and treatment of the caries of the infants and toddlers, to fully utilize the existing medical resources to prevent caries, to reduce the incidence rate and to increase the treatment rate, and to improve the oral health statuses of the infants and toddlers in China, the Society of Pediatric Dentistry and the Society of Preventive Dentistry of the Chinese Stomatological Association convened experts of pediatric dentistry and preventive dentistry from 19 universities and hospitals to conduct profound discussions on this topic, and finally developed the present guideline on diagnosis, prevention, clinical practice and effect evaluation for caries of children under 3 years old suitable to China\'s conditions.
婴幼儿龋具有发病时间早、龋蚀波及牙数多、龋损发展快及龋坏范围广等特点，影响婴幼儿咀嚼和消化功能，对口腔健康及全身生长发育可产生严重影响，亦可能成为某些全身疾病的危险因素。为统一和规范婴幼儿龋的防治标准，充分利用现有医疗资源防治婴幼儿龋，降低我国婴幼儿龋的患病率，提高治疗率，改善我国婴幼儿口腔健康状况，由中华口腔医学会儿童口腔医学专业委员会和口腔预防医学专业委员会牵头，组织19所医学院校及附属医院的18名儿童口腔医学专家和13名口腔预防医学专家制订适合我国婴幼儿龋的防治指南，包括婴幼儿龋的诊断方法、预防措施、治疗方法和防治效果评价体系。.

Objectives To define an expert Delphi consensus on when to intervene in the caries process and existing carious lesions.Methods Non-systematic literature synthesis, expert Delphi consensus process and expert panel conference.Results Lesion activity, cavitation and cleansability determine intervention thresholds. Inactive lesions do not require treatment (in some cases, restorations may be placed for form, function, aesthetics); active lesions do. Non-cavitated carious lesions should be managed non- or micro-invasively, as should most cavitated lesions which are cleansable. Cavitated lesions which are not cleansable usually require minimally invasive management. In specific circumstances, mixed interventions may be applicable. Occlusally, cavitated lesions confined to enamel/non-cavitated lesions extending radiographically into deep dentine may be exceptions. Proximally, cavitation is hard to assess tactile-visually. Most lesions extending radiographically into the middle/inner third of dentine are assumed to be cavitated. Those restricted to the enamel are not cavitated. For lesions extending radiographically into the outer third of dentine, cavitation is unlikely. These lesions should be managed as if they were non-cavitated unless otherwise indicated. Individual decisions should consider factors modifying these thresholds.Conclusions Comprehensive diagnosis is the basis for systematic decision-making on when to intervene in the caries process and existing lesions.