Table 1 Caries OUT pandemic-adapted CCI-4D interventions at the tooth-surface level with non-AGP for primary dentition

ICDAS-merged Epi score

Caries OUT modified-CCI—care options

Initial caries

 Inactive

AM

 Active

NOC

Fossae and fissure:

Smooth surfaces:

Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3–6 m)

SDF 30–38% (every 6 m)/5% NaF (every 3 m)

Option 2: 30–38% SDF (every 6 m)/5% NaF (every 3 m)

In teeth close to exfoliation: option 2 (1 time)

Moderate caries microcavity/shadow

 Inactive

AM

After clinical judgement and in teeth close to exfoliation

NOC

Fossae and fissure:

Smooth surfaces:

Option 1: High-viscosity Glass Ionomer ART sealant

Option 1: 30–38% SDF (1 time)/5% NaF (1 time)

Option 2: 30–38% SDF (1 time)/5% NaF (1 time)

Option 2: High-viscosity Glass Ionomer ART sealant

 Active

NOC

Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3–6 m)

Option 2: 30–38% SDF (every 6 m)/5% NaF (every 3 m)

In teeth close to exfoliation option 2 (1 time)

TPOC

If there is a more advanced Moderate lesion and in a High-risk patient: ART/Hall Technique

When considered it necessary have a bitewing radiograph taken to assess the depth of the radiolucency and correlate it with the likelihood of dentine infection (in the middle dentine third). Register radiographic score in 2D, and combine it with the clinical score and the individual caries risk to decide in 3D the specific tooth-surface care plan (NOC/TPOC)

Extensive caries

 Inactive

AM

After clinical judgement and in teeth close to exfoliation

NOC

High-viscosity Glass Ionomer ART sealant/30–38% SDF (1 time)/5% NaF (1 time)

 Active

NOC

Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3–6 m)

Option 2: 30–38% SDF (every 6 m)/5% NaF (every 3 m)

TPOC

Molar teeth

Anterior teeth:

Option 1: Hall Technique

Option 1: ART

Option 2: ART

Option 2: 30–38% SDF (every 6 m)

Option 3: 30–38% SDF (every 6 m)

In teeth close to exfoliation: High-viscosity Glass Ionomer ART sealant + 5% NaF (1 time)/30–38% SDF (1 time)

In deep cavities or reversible pulpitis (without other pulp symptomatology): One-Step Excavation + ART