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J Am Dent Assoc, Vol 135, No 6, 760-764. © 2004 American Dental Association

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A new paradigm for dentistry

Background. A shift is occurring in dentistry that involves a change from reliance on gross mechanical instrumentation of dental caries to early diagnosis and treatment of the bacterial infection that causes caries.

Types of Studies Reviewed. The author explores the topic of minimally invasive dentistry, and cites several studies that offer scientific evidence of the effectiveness of this approach. The author also examines the role of third-party payers, who are reluctant to provide reimbursement for sealants or treatment of incipient caries.

Conclusions. As dentists embrace a new paradigm in the treatment of the Class I lesion, they are beginning to acknowledge their role as clinical cariologists with the means to accurately assess the extent and threat of existing disease, determine the appropriate clinical response, provide minimally invasive treatment and unambiguously describe services rendered.

Clinical Implications. As evidence-based protocols become more widely accepted, dentistry will have the necessary tools to interact with third parties, which also are struggling to cope with and adapt to an emerging standard of care.

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