Minimal intervention dentistry is a modern dental practice designed around a principal aim of preservation of as much of the natural tooth structure as possible. The concept recognises that all caries lesions do not need operative treatment. In many cases, lesions should rather be handled by preventive methods.   nl-5-2016-1

In 2009 an electronic questionnaire study was performed by one of the researchers currently working at NIOM. The aim was to explore dentists’ thresholds for instigating operative treatment of carious lesions. The survey was distributed to all dentists in the member register of the Norwegian Dental Association (NTF). Replies were obtained from 61.3%. The respondents were shown images of approximal and occlusal caries lesions of increasing severity (Figures 1 and 2), and were asked which lesions should be operatively treated. The responses were compared with results from identical surveys performed in 1983 and 1995. As shown in Figures 1 and 2, there has been a significant decrease in the number of dentists who would operatively treat enamel lesions in the period 1983–2009. nl-5-2016-2

In 2009 only 7.0% of the dentists would initiate operative treatment of approximal carious lesions confined to the enamel, compared with 18.3% in 1995 and 65.6% in 1983. The number of dentists who would operatively treat occlusal caries lesions decreased from 17.8% in 1995 to 12.4% in 2009. There was a tendency that dentists treating early stages of approximal lesions also treated early stages of occlusal lesions.

Clinical implications
The concept of minimal intervention dentistry seems to have been adopted by most Norwegian dentists. This indicates that most dentists have taken into account that caries is a slowly progressing disease and that lesions can be arrested.

Read more
Vidnes-Kopperud S, Tveit AB, Espelid I. Changes in the treatment concept for approximal caries from 1983 to 2009 in Norway. Caries Research 2011;45:113–120.
Kopperud SE, Tveit AB, Opdam NJM, Espelid I. Occlusal caries management – preferences among dentists in Norway. Caries Research 2016;50:40–47.

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