Aktuelle Leitlinien zum Karies- management

A group of experts from Great Britain (UK) noticed that teaching in the field of caries management in paediatric dentistry is not uniform. While some universities take a biological approach to teaching, other institutions tend to teach rather outdated methods (more radical caries excavation). As part of a systematic literature search, current guidelines for the treatment of caries in children and adolescents were, therefore, to be recorded and analyzed. A total of eight guidelines were identified for synthesis and interpretation, which were used for quality assessment. It was found that the recommendations have shifted towards selective caries removal with the avoidance of complete caries removal. Under certain circumstances, a different decision can be made in the anterior region. For “initial lesions” (with and without cavitation), several guidelines recommend biological management. This includes specific prophylactic measures and fissure sealing. However, significant gaps were found in the literature when reviewing the current guidelines on caries management for children and adolescents. This applies in particular to the classification of initial carious lesions and the treatment of early cavitated lesions. There is a need to investigate the integration of biological caries treatment into treatment planning, selective caries removal, and whether pulpotomy is a specialist-level treatment and requires referral.