Cariology in pediatric dentistry: An updated evidence-based narrative review

Abstract

Despite notable progress in understanding the pediatric dental caries area, its multifactorial etiology—including biofilm dynamics, dietary habits, host factors, and social determinants—the burden of untreated caries persists, particularly in socioeconomically disadvantaged populations. This systematic review aimed to synthesize the evidence on [intervention/exposure] in the management of early childhood caries. Advances such as the use of the International Caries Detection and Assessment System (ICDAS), risk-based management, and noninvasive or microinvasive interventions—including professional fluoride application, silver diamine fluoride, resin infiltration, sealants, and atraumatic restorative treatment—have improved early lesion identification and patient-specific care, prioritized the preservation of tooth structure and pulp vitality, and reduced the need for extensive restorative procedures. Nevertheless, significant challenges remain in translating these protocols to routine practice, including variability in provider training, healthcare infrastructure limitations, socioeconomic and cultural disparities, and inconsistent guideline implementation. The integration of digital and artificial intelligence technologies, alongside teleodontology, holds promise for improving diagnostic accuracy, reducing access barriers, and facilitating early intervention—especially for underserved populations. However, the findings from this review should be interpreted with caution due to the heterogeneity of study designs, diagnostic criteria, and outcome measures, as well as the potential risk of bias. Ongoing research is essential for understanding the cost-effectiveness, long-term outcomes, and real-world applicability of these contemporary protocols. The widespread adoption of biologically oriented, patient-centered principles and interdisciplinary collaboration is key to reducing the global burden of dental caries and achieving equitable pediatric oral health outcomes.