4D at the surface level: permanent dentition | |||
---|---|---|---|
ICDAS-merged epi score | Caries OUT modified CCI—Care option | ||
Initial caries | |||
Inactive | AM | ||
Active | NOC | Fossae and fissure: | Smooth surfaces: |
Option 1: High-viscosity Glass Ionomer ART sealant + 5% NaF (every 3 m) | 5% NaF (every 3 m) | ||
Option 2: 30–38% SDF (every 6 m)/5% NaF (every 3 m) | |||
Moderate caries microcavity/shadow | |||
Inactive | AM | ||
NOC | Fossae and fissure: | Smooth surfaces: | |
Option 1: High-viscosity Glass Ionomer ART sealant | Option 1: 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) (only in molar teeth)/5% NaF (every 3 m) | |||
TPOC | If there is a more advanced Moderate lesion and in a High-risk patient: ART | ||
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 | ||
NOC | High-viscosity Glass Ionomer ART sealant/30–38% SDF (1 time)/5% NaF (1 time) | ||
Active | NOC | 30–38% SDF (every 6 m) | |
TPOC | ART | ||
In deep cavities or reversible pulpitis (without other pulp symptomatology): One-Step Excavation + careful ART |