Managing carious lesions:consensus recommendations on terminology

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Feline Caries in Two Cats from a 13th Century Archeological Excavation

Mandibles of two cats containing carious lesions were discovered among the previously published findings of feline dental resorptive lesions from materials examined at an archaeological museum. These lesions were too small to be noted on radiographs, and consisted of two inconspicuous enamel lesions in a mandibular left first molar tooth (309), a clinically visible white spot area containing an enamel lesion in a mandibular left fourth premolar tooth (308), and a root surface caries in the 308 of a different specimen. Histologic examination using special stains and polarized light revealed both initial and early initial stage enamel caries, as well as root surface caries. Knoop hardness measurements confirmed these findings, considered the first documented cases of feline caries

The Hall Technique

The contemporary view of caries management focuses on treating carious lesions using less invasive treatment options. The Hall Technique is an innovative, less invasive, operative management option, in which preformed metal crowns (PMCs) are used to seal carious lesions with dentin involvement in primary molars using a glass ionomer luting cement. Thus, removal of carious tissue, tooth preparation, or the use of local anesthesia are not required for the Hall Technique. The PMCs are simply pushed over the tooth, to isolate and seal the carious lesions from the oral cavity, resulting in reduction of the nutrient supply and consequently carious lesion arrest. This makes the Hall Technique a technically simple procedure to perform, in terms of clinical skills, and is well accepted by dentists, children, and their parents. However, it should not be considered as a quick solution to the problem of treating all carious primary molars in children who are unable to cooperate with more invasive treatment. For success, the Hall Technique requires careful case selection, precise carious lesion and pulpal diagnosis, good patient management, and parental cooperation. The Hall Technique is an effective treatment option for management of asymptomatic dentin carious lesions in primary molars with long-term high success rates and is, with a strong evidence base, recommended as part of our armamentarium for everyday use in pediatric dentistry