Id |
Subject |
Object |
Predicate |
Lexical cue |
T31 |
0-60 |
Sentence |
denotes |
Caries management strategies with reduced aerosol generation |
T32 |
61-236 |
Sentence |
denotes |
Although they are changing frequently, in response to evidence, we have set this paper against a background of local, national and international standards and recommendations. |
T33 |
237-449 |
Sentence |
denotes |
These include use of patient flow and environment cleaning processes, and standard and enhanced PPE use, as well as other measures put in place to practice safely practice while COVID-19 is still a health threat. |
T34 |
450-649 |
Sentence |
denotes |
Dental professionals are familiar with infection control strategies, but after an outbreak of a highly infective, potentially airborne-transmitted virus, extra protective measures have to be adopted. |
T35 |
650-864 |
Sentence |
denotes |
In this time of emerging evidence resulting in constant change, these measures should continue to be in line with national and local regulations, with vigilance to changes and by reference to Public Health England. |
T36 |
865-997 |
Sentence |
denotes |
The paper will consider the alignment of traditional AGPs for caries management with 'non-AGPs' and 'low AGPs' (see Tables 1 and 2). |
T37 |
998-1326 |
Sentence |
denotes |
Non-AGPs are those that generally do not include steps that generate aerosols, such as the use of rotary instruments and air-water syringes where air and water are used together in a spray, or procedures that can be modified to be carried out in a way that does not generate aerosols and compromise the quality of the procedure. |
T38 |
1327-1509 |
Sentence |
denotes |
Low AGPs are those that also contain steps that might generate a lower amount of aerosol, such as the air-water syringe where the air and water are used independently of one another. |
T39 |
1510-1629 |
Sentence |
denotes |
Non-AGPs still have potential for salivary contamination and low AGPs may need the air-water syringe in some instances. |
T40 |
1630-1847 |
Sentence |
denotes |
However, there is less aerosol produced if the water is used to wash without combining it with air to give a spray.16,26 Use of rubber dam with sealing around tooth holes and high-volume evacuation help minimise risk. |
T41 |
1848-1976 |
Sentence |
denotes |
Because of the possibility of viral load in the blood of COVID-19-positive patients, it is preferable to avoid pulpal exposures. |
T42 |
1977-2205 |
Sentence |
denotes |
The non-invasive and minimally invasive procedures, such as selectively removing carious tissues during atraumatic restorative treatment (ART) and the Hall Technique (HT), are discussed below and make pulp exposures less likely. |
T43 |
2206-2315 |
Sentence |
denotes |
However, if a pulp exposure did look likely during caries removal, an indirect pulp cap should be considered. |
T44 |
2316-2518 |
Sentence |
denotes |
Table 1 Direct restorative procedures (ie not involving a laboratory stage) for managing coronal and root surface carious lesions for permanent and primary teeth with high, low and non-AGP alternatives |
T45 |
2519-2561 |
Sentence |
denotes |
Lesion location High AGP* Low AGP* Non-AGP |
T46 |
2562-2595 |
Sentence |
denotes |
Carious lesions limited to enamel |
T47 |
2596-2673 |
Sentence |
denotes |
Smooth surface N/A Resin infiltration Maximise fluoride during tooth brushing |
T48 |
2674-2698 |
Sentence |
denotes |
Topical fluoride therapy |
T49 |
2699-2732 |
Sentence |
denotes |
(Other remineralisation agents**) |
T50 |
2733-2793 |
Sentence |
denotes |
Occlusal surface N/A Resin fissure sealant ART/HVGIC sealant |
T51 |
2794-2805 |
Sentence |
denotes |
GIC sealant |
T52 |
2806-2856 |
Sentence |
denotes |
Approximal surface N/A Resin infiltration Fluoride |
T53 |
2857-2890 |
Sentence |
denotes |
(Other remineralisation agents**) |
T54 |
2891-2947 |
Sentence |
denotes |
Carious lesion extending into dentine or on root surface |
T55 |
2948-3068 |
Sentence |
denotes |
Smooth or root surface Carious tissue removal (high-speed air rotor) and composite resin restoration N/A ART restoration |
T56 |
3069-3073 |
Sentence |
denotes |
NRCC |
T57 |
3074-3077 |
Sentence |
denotes |
SDF |
T58 |
3078-3237 |
Sentence |
denotes |
Occlusal surface Carious tissue removal (high-speed air rotor) and composite resin restoration Resin fissure sealant (minimal enamel breakdown) ART restoration |
T59 |
3238-3243 |
Sentence |
denotes |
NRCC† |
T60 |
3244-3247 |
Sentence |
denotes |
SDF |
T61 |
3248-3350 |
Sentence |
denotes |
Approximal/multi-surface Carious tissue removal (high-speed air rotor) and composite resin restoration |
T62 |
3351-3397 |
Sentence |
denotes |
Stainless steel crown (conventional placement) |
T63 |
3398-3468 |
Sentence |
denotes |
Zirconia crown Resin infiltration (outer 1/3 dentine) ART restoration† |
T64 |
3469-3483 |
Sentence |
denotes |
Hall Technique |
T65 |
3484-3489 |
Sentence |
denotes |
NRCC† |
T66 |
3490-3494 |
Sentence |
denotes |
SDF† |
T67 |
3495-3499 |
Sentence |
denotes |
Key: |
T68 |
3500-3585 |
Sentence |
denotes |
* = use rubber dam with sealant around tooth/dam interface and high-volume aspiration |
T69 |
3586-3670 |
Sentence |
denotes |
** = CPP-ACP could be used as an additional measure but should not replace fluoride. |
T70 |
3671-3748 |
Sentence |
denotes |
Peptides may be considered, though there is limited evidence to support them. |
T71 |
3749-3790 |
Sentence |
denotes |
SDF is not recommended for anterior teeth |
T72 |
3791-3817 |
Sentence |
denotes |
† = only for primary teeth |
T73 |
3818-3856 |
Sentence |
denotes |
ART = atraumatic restorative treatment |
T74 |
3857-3895 |
Sentence |
denotes |
CMCR = chemo-mechanical caries removal |
T75 |
3896-3922 |
Sentence |
denotes |
GIC = glass-ionomer cement |
T76 |
3923-3966 |
Sentence |
denotes |
HVGIC = high-viscosity glass-ionomer cement |
T77 |
3967-4004 |
Sentence |
denotes |
NRCC = non-restorative cavity control |
T78 |
4005-4034 |
Sentence |
denotes |
SDF = silver diamine fluoride |
T79 |
4035-4081 |
Sentence |
denotes |
Table 2 Non-aerosol caries management options |
T80 |
4082-4128 |
Sentence |
denotes |
Depth of carious lesion Occlusal Multi-surface |
T81 |
4129-4188 |
Sentence |
denotes |
Primary teeth Permanent teeth Primary teeth Permanent teeth |
T82 |
4189-4210 |
Sentence |
denotes |
Limited to enamel APP |
T83 |
4211-4213 |
Sentence |
denotes |
TF |
T84 |
4214-4221 |
Sentence |
denotes |
SDF APP |
T85 |
4222-4224 |
Sentence |
denotes |
TF |
T86 |
4225-4241 |
Sentence |
denotes |
ART/HVGIC FS APP |
T87 |
4242-4244 |
Sentence |
denotes |
TF |
T88 |
4245-4252 |
Sentence |
denotes |
SDF APP |
T89 |
4253-4255 |
Sentence |
denotes |
TF |
T90 |
4256-4315 |
Sentence |
denotes |
Extending no more than the outer 1/3 to 1/2 of dentine NRCC |
T91 |
4316-4319 |
Sentence |
denotes |
SDF |
T92 |
4320-4323 |
Sentence |
denotes |
ART |
T93 |
4324-4337 |
Sentence |
denotes |
+/- CMCR ART* |
T94 |
4338-4351 |
Sentence |
denotes |
+/- CMCR NRCC |
T95 |
4352-4355 |
Sentence |
denotes |
SDF |
T96 |
4356-4359 |
Sentence |
denotes |
ART |
T97 |
4360-4368 |
Sentence |
denotes |
+/- CMCR |
T98 |
4369-4376 |
Sentence |
denotes |
HT ART* |
T99 |
4377-4385 |
Sentence |
denotes |
+/- CMCR |
T100 |
4386-4420 |
Sentence |
denotes |
Over halfway through dentine ART** |
T101 |
4421-4429 |
Sentence |
denotes |
+/- CMCR |
T102 |
4430-4443 |
Sentence |
denotes |
+/- SDF ART** |
T103 |
4444-4452 |
Sentence |
denotes |
+/- CMCR |
T104 |
4453-4466 |
Sentence |
denotes |
+/- SDF ART** |
T105 |
4467-4475 |
Sentence |
denotes |
+/- CMCR |
T106 |
4476-4478 |
Sentence |
denotes |
HT |
T107 |
4479-4492 |
Sentence |
denotes |
+/- SDF ART** |
T108 |
4493-4501 |
Sentence |
denotes |
+/- CMCR |
T109 |
4502-4509 |
Sentence |
denotes |
+/- SDF |
T110 |
4510-4514 |
Sentence |
denotes |
Key: |
T111 |
4515-4668 |
Sentence |
denotes |
* = because the lesion is shallow, it is likely that complete carious tissue removal will be necessary to give adequate depth to the restorative material |
T112 |
4669-4755 |
Sentence |
denotes |
** = because the lesion is deeper, selective carious tissue removal can be carried out |
T113 |
4756-4787 |
Sentence |
denotes |
APP = active primary prevention |
T114 |
4788-4826 |
Sentence |
denotes |
ART = atraumatic restorative treatment |
T115 |
4827-4932 |
Sentence |
denotes |
ART/HVGIC FS = atraumatic restorative treatment fissure sealant using high-viscosity glass-ionomer cement |
T116 |
4933-4971 |
Sentence |
denotes |
CMCR = chemo-mechanical caries removal |
T117 |
4972-4991 |
Sentence |
denotes |
HT = Hall Technique |
T118 |
4992-5029 |
Sentence |
denotes |
NRCC = non-restorative cavity control |
T119 |
5030-5059 |
Sentence |
denotes |
SDF = silver diamine fluoride |
T120 |
5060-5081 |
Sentence |
denotes |
TF = topical fluoride |
T121 |
5082-5103 |
Sentence |
denotes |
+/- = with or without |
T122 |
5104-5390 |
Sentence |
denotes |
The procedures discussed here are based around minimal intervention dentistry approaches, aiming to maintain the dentition throughout the course of life by handling the disease, dental caries, in a biological manner; treating the cause and not just its symptoms (the carious lesions).27 |
T123 |
5391-5852 |
Sentence |
denotes |
The non-AGPs and low AGPs for managing carious lesions can be grouped into:Control the disease - prevention, early detection and managing the carious lesion (whether confined to enamel or cavitated) through controlling the biofilm, by making the lesion cleansable with non-restorative cavity control (NRCC) or by removing the plaque and using chemicals to stop its progress and promote remineralisation (commonly silver diamine fluoride [SDF]; topical fluoride) |
T124 |
5853-6125 |
Sentence |
denotes |
Cover and seal the biofilm and carious lesion - involves no caries removal and creates a seal to deprive the carious biofilm of nutrients, oxygen etc, causing the carious lesion to arrest, such as fissure sealing and resin infiltration for non-cavitated lesions and the HT |
T125 |
6126-6330 |
Sentence |
denotes |
Carious tissue removal - only decomposed, infected dentine and unsupported demineralised enamel should be removed selectively using hand instruments (eg ART and/or chemo-mechanical caries removal [CMCR]). |
T126 |
6331-6442 |
Sentence |
denotes |
The online supplementary information file details further sources and some video tutorials of these techniques. |