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Faculty Member Helps Draft New Caries Guidelines

Friday, June 28, 2013 - 3:16pm

Dr. Ana Neumann (second row, fifth from left) attended the recent Global Collaboratory for Caries Management workshop in London.

Dr. Ana Neumann (second row, fifth from left) attended the recent Global Collaboratory for Caries Management workshop in London.

A University of Texas School of Dentistry at Houston faculty member is playing a key role in an international effort to expand use of an evidence-based system for detecting and classifying caries in dental education and clinical practice.

Ana Neumann, DDS, PhD, MPH, assistant professor in the Department of General Practice and Dental Public Health, attended the recent Global Collaboratory for Caries Management workshop in London.  The workshop was directed by the International Caries Detection and Assessment System (ICDAS) Foundation, Temple University and King’s College London, with representatives invited from various dental schools around the world. UTSD was one of 18 U.S. dental schools participating. 

Dentistry is gradually shifting from an indiscriminate “drill-and-fill” approach toward a more nuanced and less invasive prevention and management strategy, Neumann said. The goal of the ICDAS group is to devise a new set of protocols and best practices dental professionals can employ in everyday practice.

“We believe preserving teeth whenever possible and restoring only when necessary is best for our patients,” Neumann said. “We need to plan our treatment taking into account an individual’s risk and not solely the presence or absence of disease. This is a very exciting time where personalized dentistry is expanding and modernizing.”

A draft of the group’s report – which will include practical recommendations on risk assessment, detection and treatment of caries – will be ready by fall or early 2014, Neumann said.  The report will be published in a peer-reviewed journal and then it will be up to schools like UTSD to lead the way in implementation and encouraging dentists to embrace the new protocols, she added.

The workshop participants were assigned to committees, and Neumann is part of the group working to devise a form for initial patient assessment. A risk assessment – which includes patient history, extent of the tooth decay and other factors – helps dentists determine a treatment plan.

The key is simplicity, Neumann added – just a few quick questions that can be filled out in any dental office. UTSD’s dental clinic already incorporates a caries risk assessment questionnaire into electronic health records. A risk assessment is assigned depending on several questions,  such as whether there is heavy plaque on the teeth or inadequate saliva flow, whether the patient has required recent tooth restorations or shows new lesions since the last visit.

“UTSD is at the cutting edge of this movement toward managing caries through risk assessment,” Neumann said.

This new paradigm for caries management and avoiding unnecessary procedures will ultimately require more from the patient as well as the dentist, she said, so that minor lesions do not become major cavities, or to prevent caries from forming at all.

“We educate our patients about established preventive measures like brushing with fluoride, proper diet, acid attacks on the teeth and to not sip colas all day,” Neumann said. “But patients have to do their part; it has to be a partnership.”