Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association

Rebecca L. Slayton, Olivia Urquhart, Marcelo W.B. Araujo, Margherita Fontana, Sandra Guzmán-Armstrong, Marcelle M. Nascimento, Brian B. Nový, Norman Tinanoff, Robert J. Weyant, Mark Wolff, Douglas A. Young, Domenick T. Zero, Malavika P. Tampi, Lauren Pilcher, Laura Banfield, Alonso Carrasco-Labra

Research output: Contribution to journalArticle

Abstract

Background: An expert panel convened by the American Dental Association Council on Scientific Affairs and the Center for Evidence-Based Dentistry conducted a systematic review and formulated evidence-based clinical recommendations for the arrest or reversal of noncavitated and cavitated dental caries using nonrestorative treatments in children and adults. Types of Studies Reviewed: The authors conducted a systematic search of the literature in MEDLINE and Embase via Ovid, Cochrane CENTRAL, and Cochrane database of systematic reviews to identify randomized controlled trials reporting on nonrestorative treatments for noncavitated and cavitated carious lesions. The authors used the Grading of Recommendations Assessment, Development and Evaluation approach to assess the certainty in the evidence and move from the evidence to the decisions. Results: The expert panel formulated 11 clinical recommendations, each specific to lesion type, tooth surface, and dentition. Of the most effective interventions, the panel provided recommendations for the use of 38% silver diamine fluoride, sealants, 5% sodium fluoride varnish, 1.23% acidulated phosphate fluoride gel, and 5,000 parts per million fluoride (1.1% sodium fluoride) toothpaste or gel, among others. The panel also provided a recommendation against the use of 10% casein phosphopeptide–amorphous calcium phosphate. Conclusions and Practical Implications: Although the recommended interventions are often used for caries prevention, or in conjunction with restorative treatment options, these approaches have shown to be effective in arresting or reversing carious lesions. Clinicians are encouraged to prioritize use of these interventions based on effectiveness, safety, and feasibility.

Original languageEnglish (US)
Pages (from-to)837-849.e19
JournalJournal of the American Dental Association
Volume149
Issue number10
DOIs
StatePublished - Oct 1 2018

Fingerprint

American Dental Association
Evidence-Based Practice
Practice Guidelines
Sodium Fluoride
Acidulated Phosphate Fluoride
Evidence-Based Dentistry
Gels
Topical Fluorides
Toothpastes
Dentition
Dental Caries
Caseins
Fluorides
MEDLINE
Tooth
Therapeutics
Randomized Controlled Trials
Databases
Safety

Keywords

  • American Dental Association
  • caries
  • Carious lesion
  • clinical recommendations
  • decision making
  • evidence-based dentistry
  • general practice
  • nonrestorative treatments
  • practice guidelines

ASJC Scopus subject areas

  • Dentistry(all)

Cite this

Slayton, R. L., Urquhart, O., Araujo, M. W. B., Fontana, M., Guzmán-Armstrong, S., Nascimento, M. M., ... Carrasco-Labra, A. (2018). Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association. Journal of the American Dental Association, 149(10), 837-849.e19. https://doi.org/10.1016/j.adaj.2018.07.002

Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions : A report from the American Dental Association. / Slayton, Rebecca L.; Urquhart, Olivia; Araujo, Marcelo W.B.; Fontana, Margherita; Guzmán-Armstrong, Sandra; Nascimento, Marcelle M.; Nový, Brian B.; Tinanoff, Norman; Weyant, Robert J.; Wolff, Mark; Young, Douglas A.; Zero, Domenick T.; Tampi, Malavika P.; Pilcher, Lauren; Banfield, Laura; Carrasco-Labra, Alonso.

In: Journal of the American Dental Association, Vol. 149, No. 10, 01.10.2018, p. 837-849.e19.

Research output: Contribution to journalArticle

Slayton, RL, Urquhart, O, Araujo, MWB, Fontana, M, Guzmán-Armstrong, S, Nascimento, MM, Nový, BB, Tinanoff, N, Weyant, RJ, Wolff, M, Young, DA, Zero, DT, Tampi, MP, Pilcher, L, Banfield, L & Carrasco-Labra, A 2018, 'Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions: A report from the American Dental Association', Journal of the American Dental Association, vol. 149, no. 10, pp. 837-849.e19. https://doi.org/10.1016/j.adaj.2018.07.002
Slayton, Rebecca L. ; Urquhart, Olivia ; Araujo, Marcelo W.B. ; Fontana, Margherita ; Guzmán-Armstrong, Sandra ; Nascimento, Marcelle M. ; Nový, Brian B. ; Tinanoff, Norman ; Weyant, Robert J. ; Wolff, Mark ; Young, Douglas A. ; Zero, Domenick T. ; Tampi, Malavika P. ; Pilcher, Lauren ; Banfield, Laura ; Carrasco-Labra, Alonso. / Evidence-based clinical practice guideline on nonrestorative treatments for carious lesions : A report from the American Dental Association. In: Journal of the American Dental Association. 2018 ; Vol. 149, No. 10. pp. 837-849.e19.
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