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Caries Management— Science and Clinical Practice
Univ.-Prof.
Dr. Hendrik Meyer-Lueckel, MPH
Department of Operative Dentistry,
Periodontology, and Preventive Dentistry
Rheinisch-Westfälische Technische Hochschule (RWTH) Aachen
Aachen, Germany
Priv.-Doz. Dr. Sebastian Paris, DDS
Clinic for Operative Dentistry
and Periodontology
Christian-Albrechts-Universität zu Kiel
Kiel, Germany
Assoc. Prof. Kim R. Ekstrand, DDS, PhD
Vice Dean and Chair
Section for Cariology, Endodontics,
Pediatric Dentistry, and Clinical Genetics
Department of Odontology
Faculty of Health and Medical Sciences
University of Copenhagen
Copenhagen, Denmark
Managing Editor:
Dr. Susanne Effenberger
Manager Clinical Research
DMG Dental-Material Gesellschaft mbH
Hamburg, Germany
With contributions by
Mohammad Alkilzy, Bennett T. Amaechi, Uwe Blunck, Wolfgang Buchalla, Brian H. Clarkson, Agata Czajka-Jakubowska, Christof Doerfer, Hafsteinn Eggertsson, Roland Frankenberger, Rainer Haak, Leandro Augusto Hilgert, Soraya Coelho Leal, Stefania Martignon, Vera Mendes Soviero, David Nigel James Ricketts, Ulrich Schiffner, Christian Andres Schneider, R. Peter Shellis, Christian H. Splieth, Svante Twetman, Martin J. Tyas, Cornelis van Loveren, Bart Van Meerbeek, Michael Jochen Wicht, Yasuhiro Yoshida, Domenick T. Zero
409 illustrations
Thieme
Stuttgart · New York
Library of Congress Cataloging-in-Publication Data is available from the publisher.
Illustrators: Christine Lackner, Ittlingen, Germany; Eva M. Reinwald, Copenhagen, Denmark (portraits in preface)
© 2013 Georg Thieme Verlag KG
Rüdigerstrasse 14, 70469 Stuttgart,
Germany
http://www.thieme.de Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA http://www.thieme.com
Cover design: Thieme Publishing Group
Translation: Dolphin Translations, Stuttgart, Germany
Typesetting by primustype Robert Hurler GmbH, Notzingen,
Germany
Printed in Italy by L.E.G.O., Vincenza
ISBN 978-3-13-154711-8
eISBN 978-3-13-169381-5
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Preface
Dental caries is still one of the most common diseases in human beings, causing smaller or larger problems to millions of people around the world every day. As dental professionals we have to help people to understand the disease to enable them to prevent caries by themselves (self-management). When more severe decay is diagnosed, we, together with the patient, should manage the caries disease in a minimally interventional way.
This introductory chapter will present some general thoughts about caries and where we come from in cariology. Moreover, we will explain why we think it is important to have another book about cariology and will describe the concept of the book, which is presented in two main parts: science and practice.
Caries—Important but Preventable
Dental caries is the term used for pathoanatomical changes of the dental hard tissues. These changes are caused by acids that are created in the dental plaque (biofilm) covering the affected tooth surface, when certain microorganisms ferment sugars, which in turn demineralize the dental hard tissues. Thus, the disease, which professionals perceive as changes of the dental hard tissues, in fact reflects activities within the overlying dental biofilm. If these unfavorable biofilm activities are occurring frequently, the signs of the caries process on the dental hard tissues will become more easily detectable. Nonetheless, the caries “scar” starts with signs that are only visible with high magnification in the laboratory but end up with clinically visible alterations of the tooth surface integrity. Thus, caries is a term which actually covers changes in the dental hard tissue from the time the first mineral ion leaves the tissue to when no mineral is left. This development
