Nonsurgical treatment of incipient and hidden caries

The treatment of noncavitated caries requires that one consider the lesion, its depth, and its activity, as well as the caries risk classification of the patient [27]. Traditionally, dentists have been trained in the surgical model for caries management in which detection is akin to diagnosis, and this model has unfortunately been translated to patient expectations. A growing body of clinical evidence suggests that noncavitated lesions, even those extending into dentin, can be managed by nonsurgical means with an expectation for remineralization. The question that remains to be answered for most dentists is whether a clinically or radiographically detectable lesion will progress. If patients can collaborate with the dentist and his or her staff to acquire and maintain a low-caries risk behavior, a growing body of evidence suggests that the bacteria responsible for caries will be at such a low level, even in pits and fissures, that the caries will not progress. The remineralization process will predominate in all of these ecologic niche areas for caries-forming bacteria, which are present in every dentate individual.