Minimal intervention
Prioritise prevention, remineralisation, selective tissue removal and repair where appropriate. Preserve tooth structure while achieving a durable seal.
Understand
Minimal intervention combines risk control, early lesion management, selective tissue removal and repair where feasible. Pulp protection and a durable seal are more useful goals than a colour-based endpoint.
Assess
Assess lesion depth, pulpal status, restorability and isolation. Consider sealing or monitoring a non-cavitated lesion and selective removal in a deep cavitated lesion where appropriate.
Apply
Explain the trade-off between residual affected tissue and pulp exposure. Review symptoms and radiographs when indicated; avoid making a large restoration without addressing the patient's risk.
Key distinctions
Selective caries removal is a biological strategy to lower pulp exposure risk while achieving peripheral tissue suitable for a seal. It is not permission to leave an open, contaminated cavity. Explain what will be monitored and what signs suggest failure. Repairing a local defective margin may conserve more tissue than replacing an entire restoration.
Think through a case
A deep carious molar has no spontaneous pain and a plausible vital pulp. A selective removal strategy may reduce exposure risk if an effective seal can be achieved.
The distinction to remember
Do not excavate to a uniform colour or firmness at the expense of exposing the pulp without considering the biological objective.
Test your recall
Why avoid removing all stained dentine indiscriminately?
Show answer
Colour alone does not reliably identify infected tissue.