PARADIGM SHIFT IN MANAGEMENT OF DENTAL CARIES

This book discusses the paradigm shift in dental caries management from the traditional surgical "drill and fill" approach to a modern biological, preventive, and minimally invasive philosophy. Dental caries is now recognized as a multifactorial, biofilm-mediated, sugar-driven, dynamic disease resulting from an imbalance between demineralization and remineralization rather than simply a structural defect requiring restoration. The review describes the evolution of caries etiology from early theories to contemporary concepts such as the Ecological Plaque Hypothesis and Caries Balance Concept, highlights the limitations of conventional caries removal, and emphasizes the principles of Minimal Intervention Dentistry (MID), including early diagnosis, risk assessment, remineralization, selective caries removal, and preservation of tooth structure. It further outlines modern caries detection and risk assessment systems such as CAMBRA, Cariogram, ICDAS, ICCMS, digital radiography, fluorescence-based technologies, transillumination methods, and other advanced diagnostic tools.