Cariologia Clinica
Clinical Cariology: Giovanni Sammarco’s Book on the Diagnosis, Prevention, and Treatment of Dental Caries
Within the field of cariology, dental caries, and oral hygiene books, Clinical Cariology by Giovanni Sammarco is a comprehensive work devoted to understanding and managing caries disease.
The volume proposes a substantial change in the way dental caries is approached: not simply as a cavity to be restored, but as a chronic, multifactorial disease requiring diagnosis, assessment of caries susceptibility, biofilm control, analysis of dietary habits, management of salivary factors, fluoride prophylaxis, and modification of patient behaviour.
The book is not intended simply to teach readers how to identify and treat a carious lesion. Its objective is to provide dentists and dental hygienists with a method for understanding why the patient develops the disease, which factors sustain it, and which interventions can genuinely modify its progression.
Published in 2025, Clinical Cariology contains 600 pages and 1,158 images. The title and author are confirmed in the official extract from the volume.
Through cariological assessment forms, diagnostic protocols, behavioural interviews, tables, and operative recommendations, the book serves as a clinical guide to the rational management of patients affected by dental caries.
A New Way of Interpreting Dental Caries
One of the central messages of Giovanni Sammarco’s book is the need to distinguish caries disease from its consequences.
A cavity, a non-cavitated lesion, pulpitis, or loss of dental tissue are consequences of the pathological process. A restoration may be necessary to repair one of these outcomes, but it does not automatically eliminate the factors that caused the disease.
The text explains that caries can and must be treated, whereas actions such as excavation, removal, or restoration concern the lesions produced by the disease. Equating caries treatment with the placement of a restoration would mean neglecting a fundamental part of therapy.
The volume therefore encourages readers to move beyond an exclusively restorative approach in which patients are treated only once a cavity appears.
True treatment includes:
- identification of causative factors;
- assessment of lesion activity;
- control of cariogenic biofilm;
- modification of dietary habits;
- management of saliva;
- rational use of fluoride and remineralising agents;
- patient education;
- risk monitoring;
- restorative intervention when necessary.
Restoration remains an important part of therapy, but it must be included within a broader disease-control plan.
Dental Caries as a Chronic Biofilm-Mediated Disease
The book presents dental caries as an acquired chronic disease influenced by the oral environment, lifestyle, and behaviours developed within the family setting.
Dental caries and periodontal disease share the involvement of pathogenic bacterial biofilms, although their mechanisms, clinical manifestations, and treatment strategies differ.
The text highlights that an intervention aimed at the causes has a different medical value from a procedure limited to correcting symptoms or outcomes. Preventing tooth loss should therefore be an essential part of the dentist’s mission.
This approach places cariology firmly within medicine.
The professional does not merely examine a tooth surface, but evaluates a system in which the following interact:
- biofilm;
- sugars;
- pH;
- saliva;
- fluoride;
- dental anatomy;
- systemic conditions;
- oral-hygiene habits;
- behaviours;
- the patient’s willingness to change their lifestyle.
Dental caries is therefore interpreted as the result of a balance that may shift towards demineralisation or towards stability and remineralisation.
Restoration Alone Is Not Enough to Treat the Disease
In the preface, Giovanni Sammarco explains how he came to understand that highly precise restorations did not necessarily correspond to treating dental caries. Repairing the damage without modifying what caused it meant treating the consequence while leaving the pathological mechanisms active.
This distinction has important clinical consequences.
A patient may receive technically and aesthetically successful restorations while continuing to present:
- frequent sugar intake;
- abundant and mature biofilm;
- limited fluoride exposure;
- reduced salivary flow;
- an unfavourable oral pH;
- inadequate interproximal hygiene;
- poor attendance at follow-up appointments;
- new carious lesions;
- secondary caries around restorations.
Without treatment of the disease itself, the patient may enter the restorative cycle: new lesions, replacement of restorations, progressive loss of healthy tissue, and the need for increasingly extensive rehabilitation.
Clinical Cariology instead proposes a model in which restorative treatment is integrated with preventive, behavioural, and non-surgical interventions.
A Reference for Modern Clinical Cariology
The book examines dental caries systematically, beginning with biological and microbiological foundations, continuing through diagnostic methods, and concluding with preventive and therapeutic strategies.
In Lorenzo Breschi’s foreword, the text is described as a guide that integrates scientific evidence with clinical experience, providing step-by-step procedures, cases, and guidelines that can be transferred into everyday practice.
The reader is guided through a pathway that includes:
- understanding the disease;
- diagnosing lesions;
- assessing caries susceptibility;
- analysing risk factors;
- completing cariological assessment forms;
- defining the treatment plan;
- prescribing products and behavioural changes;
- monitoring the therapeutic response.
The result is a method that allows treatment to be personalised and avoids applying the same recommendations indiscriminately to every patient.
Giovanni Sammarco’s Experience Applied to Clinical Practice
Giovanni Sammarco is a dentist and lecturer in cariology whose professional and educational work focuses on caries prevention and minimally invasive methods.
The curriculum included in the volume presents him as a lecturer in Cariology on the Level II Master’s programme in Aesthetic Restorative Dentistry at the University of Bologna, an active member of the Italian Academy of Conservative and Restorative Dentistry, and the founder of the TRAP group, an acronym for Tooth Respect and Prevention. He is also the creator of the educational programme Vincere la Carie—“Defeating Caries”.
Clinical Cariology brings together more than fifteen years of the author’s experience and an editorial project that began several years before publication.
Sammarco uses a direct and often conversational style, with the aim of guiding even readers without an initial specialist background. In the preface, he recommends reading the book completely and progressively, emphasising that the clinical sensitivity required to manage caries develops through knowledge and prolonged practice.
The Central Role of the Dental Hygienist
One of the distinctive features of the volume is the attention devoted to dental hygiene and to the role of the dental hygienist in caring for patients with high caries susceptibility.
The hygienist is not regarded merely as the professional who removes plaque and calculus or assists the periodontist. In caries management, the hygienist plays a central role in:
- biofilm analysis;
- oral-hygiene education;
- patient motivation;
- assessment of home-care products;
- application of fluorides and remineralising agents;
- dietary counselling;
- periodic monitoring;
- recording risk factors;
- monitoring behavioural change.
The first chapter emphasises that dentists and dental hygienists share the objective of preserving the tooth, with hygienists focusing particularly on non-surgical methods of prevention and treatment. The text is expressly intended for both professional groups.
This approach supports a working model in which dentist and hygienist participate together in cariological diagnosis and treatment planning.
The Foundations of Cariology
The first chapter introduces the fundamental concepts required to understand the disease.
Topics include:
- level of treatment of a disease;
- relationship between dental caries and periodontal disease;
- reversible and irreversible lesions;
- prevalence of caries;
- cariological terminology;
- outcomes of the disease;
- treatment of biofilm-mediated oral diseases;
- presence of disease;
- cariological balance;
- concept of defence;
- essential history of cariology.
The objective is to establish precise terminology.
The term “caries” is reserved for the disease, while its manifestations at tooth level are defined as carious lesions, which may be classified as:
- cavitated or non-cavitated;
- active or inactive;
- reversible or irreversible;
- initial, moderate, or advanced.
This terminological precision also changes therapeutic reasoning. A non-cavitated lesion should not automatically be ignored, just as a radiographically visible lesion should not necessarily be restored without further assessment.
Immunity and Genetics
The second chapter analyses the relationships between caries disease, the immune system, and genetics.
The volume discusses:
- innate or non-specific immunity;
- specific or acquired immunity;
- individual response;
- genetic influence;
- different levels of susceptibility.
These topics help explain why patients exposed to apparently similar conditions may have very different caries experiences.
Genetics is not used to support a deterministic view of the disease. The clinical picture results from the interaction between predisposition, oral environment, behaviour, diet, biofilm, saliva, and preventive interventions.
Treatment therefore remains focused on modifiable factors.
Demineralisation and Remineralisation
The third chapter explores cariological dynamics, analysing the chemical processes through which dental tissues lose or regain minerals.
The development of a carious lesion is described as the result of the interaction between biofilm and the chemical laws governing the demineralisation and remineralisation of mineralised tissues.
Every dental surface undergoes continuous cycles of mineral loss and recovery.
When conditions favouring demineralisation prevail, progressive and localised tissue loss occurs. When the oral environment is restored to more favourable conditions, initial lesions may be stabilised and, under certain circumstances, remineralised.
The chapter covers:
- principles of solubility;
- dental apatites;
- oral fluids;
- action of acids;
- chelating substances;
- enamel maturation;
- dentine response;
- dental erosion;
- initial carious demineralisation.
This knowledge provides the rationale for understanding the actions of fluoride, saliva, and remineralising products.
Cariogenic Biofilm
Biofilm is one of the most important keywords in the volume.
It is not simply an undifferentiated mass of bacteria deposited on the teeth. It is an organised ecosystem influenced by where it develops, nutrient availability, pH, saliva, and patient habits.
The book examines:
- biofilm formation;
- maturation;
- stratification;
- permeability;
- relationship between saliva and biofilm;
- cariogenic biofilm;
- Stephan curves;
- disease transmission.
The oral environment selects the microbial species best able to adapt to the existing conditions. Even limited changes in pH and sugar availability may favour more acidogenic and aciduric bacterial communities.
Treatment therefore does not consist in the unrealistic attempt to eliminate every bacterium, but in modifying the ecosystem so that it becomes less favourable to disease progression.
Caries Susceptibility, DMF, and Disease Severity
An entire chapter is devoted to caries susceptibility, the DMF index, and disease severity.
Caries susceptibility expresses the patient’s tendency to develop new lesions or experience progression of existing ones.
The volume analyses:
- objective caries susceptibility;
- caries experience;
- dmf-t and DMF-T indices;
- comparison with population epidemiological averages;
- disease severity;
- reversible lesions;
- conservative or interventionist attitudes.
Dental diagnosis makes it possible to quantify the outcomes already produced by the disease. Only after identifying and recording these outcomes can clinicians properly assess case severity and objective caries susceptibility.
The DMF value alone, however, does not represent the entire future risk. It must be integrated with lesion activity and current biological and behavioural factors.
The Two Diagnoses in Cariology
One of the book’s most interesting concepts is the distinction between:
- dental diagnosis;
- cariological diagnosis.
Dental diagnosis identifies and classifies outcomes affecting individual teeth: lesions, restorations, missing teeth, involved surfaces, and disease activity.
Cariological diagnosis instead considers the person and seeks to answer different questions:
- Why did the patient develop the disease?
- Which factors are maintaining it?
- What level of risk is present?
- Which behaviours need to be modified?
- Which non-surgical interventions are indicated?
- How frequently should the patient be monitored?
The contents introduce this distinction together with classes of factors, the treatment plan, and the 43-point CRA and RCG assessment forms.
The two diagnoses complement each other. Understanding the lesions without understanding the patient produces incomplete care; assessing risk without correctly identifying dental outcomes prevents appropriate treatment planning.
Cariological Assessment Forms
The cariological assessment forms are among the most practical tools proposed in the book.
Two principal models are presented:
- the 43-point CRA cariological assessment form;
- the RCG cariological assessment form.
The forms systematically organise information concerning:
- caries experience;
- existing lesions;
- risk level;
- biofilm;
- oral hygiene;
- diet;
- saliva;
- fluoride;
- products used;
- systemic conditions;
- medications;
- motivation;
- ability to modify behaviour.
Their purpose is not to turn the appointment into a bureaucratic exercise. They teach a method for collecting and interpreting information.
With experience, professionals may use selected sections of the forms, but the ability to simplify comes from first acquiring complete knowledge of the process.
Dental Diagnosis and Lesion Classification
The chapter on dental diagnosis examines the assessment of tooth surfaces in detail.
Topics include:
- medical history and interview;
- clinical examination;
- ICDAS II criteria;
- lesion activity;
- brown lesions;
- lesions adjacent to restorations and sealants;
- occlusal surfaces;
- pits and fissures;
- buccal and lingual surfaces;
- non-cavitated lesions;
- interproximal surfaces.
Distinguishing between cavitated and non-cavitated lesions is fundamental because restorative intervention is irreversible and may involve sacrificing healthy dental structure.
The text warns against deciding on surgical treatment on the basis of a single examination, particularly on interproximal surfaces, where no diagnostic technique can always establish cavitation and activity with certainty.
ICDAS and Lesion Activity
The ICDAS II system allows lesions to be described according to their visible characteristics and extent.
The book does not stop at recording the code, but also covers:
- clinical interpretation;
- conditions required for examination;
- difference between colour and activity;
- presence of opacities;
- “dark” and “white” lesions;
- relationship with fissures and restorations;
- identification of initial lesions.
Establishing whether a lesion is active or inactive is essential for treatment planning.
An active initial lesion may require intensified preventive measures and monitoring, whereas an inactive lesion may be maintained under observation without invasive treatment.
Bite-Wing Radiographs and Caries Diagnosis
Radiology is an important support tool, particularly for analysing interproximal surfaces.
The volume examines:
- principles of radiation protection;
- bite-wing projections;
- radiographic classifications;
- limitations of the examination;
- timing of follow-up radiographs;
- Mach-band effect;
- cervical burnout;
- interpretation of radiographs.
Radiographs must be integrated with clinical examination, medical history, and risk assessment.
A radiolucency does not automatically indicate whether a lesion is cavitated, active, or progressing. The book therefore warns against making an automatic connection between a radiographic image and the need for restoration.
Transillumination and Laser Fluorescence
Alongside conventional methods, the text analyses supplementary diagnostic examinations.
These include:
- FOTI;
- DIFOTI;
- NIR-DIFOTI;
- laser fluorescence;
- other complementary methods.
The contents cover methods of use, classifications, and the advantages and limitations of laser fluorescence, as well as the integration of radiography and transillumination.
These tools may increase the amount of information available, but they do not replace clinical reasoning.
The ideal diagnosis derives from combining multiple sources:
- observation;
- drying;
- non-traumatic tactile assessment;
- radiography;
- transillumination;
- activity assessment;
- the patient’s overall risk.
Cariological Diagnosis and Treatment Planning
After identifying dental outcomes, the professional must formulate the cariological diagnosis.
The chapter devoted to treatment planning examines:
- cariological strategy;
- risk categories;
- completion of assessment forms;
- interpretation of data;
- behavioural interview;
- definition of priorities.
The plan should not be limited to a list of restorations.
It may include:
- oral-hygiene instructions;
- modification of sugar frequency;
- prescription of fluoride toothpaste;
- use of mouth rinses or gels;
- professional applications;
- salivary stimulation;
- fissure sealing;
- lesion monitoring;
- restorative therapy;
- personalised recall intervals.
Prescriptions should be proportionate to risk and sustainable for the patient.
Behavioural Interview
Dental caries is strongly influenced by daily behaviour.
For this reason, the volume devotes considerable space to the behavioural interview.
The professional assesses:
- when the patient brushes;
- for how long;
- which technique is used;
- which tools are used;
- how interproximal spaces are cleaned;
- which toothpastes and mouth rinses are used;
- how frequently sugars are consumed;
- what is eaten or drunk after evening oral hygiene;
- which products have been recommended by professionals;
- level of awareness;
- willingness to change.
The proposed form also records toothbrushes, toothpastes, floss, interdental brushes, mouth rinses, and gels, distinguishing frequency, method of use, and whether they were professionally recommended.
This information makes it possible to move from generic advice to specific recommendations.
Simply telling a patient to “brush better” is very different from showing them which surfaces are not being reached, which device to use, and when the result should be reassessed.
Bacterial Factors and Dental Plaque
The chapter devoted to bacterial factors analyses biofilm through different parameters:
- quantity;
- maturity;
- pH;
- distribution;
- accumulation sites;
- local risk;
- oral-hygiene habits.
The book includes procedures for measuring and staging biofilm quantity, together with guidance on recording the data in the cariological forms.
It also addresses:
- Streptococcus mutans;
- lactobacilli;
- plaque-disclosing agents;
- chlorhexidine;
- other antibacterial agents;
- professional and home-care products;
- bioactive materials;
- prebiotics, probiotics, and postbiotics.
The quantity of Streptococcus mutans and lactobacilli in saliva is included within the broader assessment of caries risk, without reducing the disease to the presence of a single bacterial species.
Treatment focuses primarily on modifying the environment and the conditions that favour cariogenic biofilm.
Oral Hygiene and Biofilm Removal
Mechanical biofilm removal remains a fundamental component of therapy.
The volume examines:
- manual and electric toothbrushes;
- brushing technique and duration;
- dental floss;
- interdental brushes;
- plaque-disclosing agents;
- cleaning of brushable surfaces;
- interproximal hygiene;
- professional devices;
- practical verification in the dental office.
Plaque quantity can be staged and associated with different actions by the dental team.
When substantial deposits are present, the book recommends instruction, motivation, professional cleaning, and close follow-up. In patients with good plaque control, the behaviour should be reinforced and maintained.
Monitoring is not intended to judge the patient, but to verify whether the recommendations provided are genuinely applicable and effective.
Diet, Sugars, and Lifestyle
The chapter devoted to dietary factors connects cariology, nutrition, and healthy lifestyle.
Topics include:
- role of sugars;
- free sugars;
- obvious and hidden sources;
- daily quantity;
- frequency of intake;
- functional foods;
- milk;
- polyphenols;
- isothiocyanates;
- between-meal habits.
In dental caries, the total quantity of sugar is not the only relevant factor. The number of exposures may also influence the duration and frequency of acidic conditions within the biofilm.
Assessment should therefore reconstruct the patient’s real daily routine:
- breakfast;
- meals;
- snacks;
- drinks;
- sweets or lozenges;
- supplements;
- sugar-containing medicines;
- evening herbal teas;
- night-time intake.
Dietary counselling does not necessarily involve a rigid diet. It may focus on a small number of high-impact changes agreed with the patient and compatible with their lifestyle.
Saliva and Caries Risk
Saliva performs essential functions in maintaining oral balance.
It helps to:
- dilute and remove substances;
- buffer acids;
- transport minerals;
- support remineralisation;
- lubricate tissues;
- modulate biofilm;
- protect dental surfaces.
The chapter on salivary factors proposes assessment of:
- function of the minor salivary glands;
- pH of unstimulated saliva;
- volume of stimulated saliva;
- buffering capacity;
- hydration;
- mouth breathing;
- medications;
- caffeine;
- smoking;
- alcohol;
- other substances;
- diet.
The volume also examines salivary stimulants and substitutes, buffering agents, and dedicated counselling.
Reduced salivary flow can profoundly alter risk and may require more intensive preventive measures.
Fluoride and Fluoride Prophylaxis
Fluoride is one of the principal keywords in the book.
The chapter on fluoride prophylaxis examines:
- functions of fluorides;
- penetration into biofilm;
- fluoride prophylaxis in children;
- recommended levels;
- common fluoride sources;
- dosages;
- types of fluoride;
- risks of insufficient intake;
- toxicity;
- home and professional use.
Fluoride is not presented as an identical prescription for every patient.
Product type, concentration, frequency, and method of use should be defined according to:
- age;
- caries risk;
- ability to perform oral hygiene;
- existing fluoride exposure;
- lesion activity;
- salivary conditions;
- patient compliance.
The text connects fluoride use with demineralisation and remineralisation processes, placing it within an individualised plan.
Remineralisation and Remineralising Products
The chapter on fluoride also includes an examination of remineralising and regenerative materials.
The active principles discussed include:
- self-assembling peptides;
- amorphous calcium phosphate;
- hydroxyapatite;
- substituted hydroxyapatite;
- calcium silicates;
- calcium and phosphate;
- bioactive glasses;
- calcium phosphosilicates;
- arginine.
The book distinguishes between concepts such as regeneration, remineralisation, and repair, avoiding the use of these terms as interchangeable synonyms.
Product selection should depend on the clinical indication and the patient’s condition rather than on marketing claims alone.
The contents also include summary tables and procedures for evaluating the patient’s relationship with fluorides and remineralising products.
Toothpastes for Patients with High Caries Susceptibility
Toothpastes are an essential everyday tool, but they must be selected carefully.
The book examines:
- composition;
- fluoride concentration;
- function;
- timing of brushing;
- quantity;
- supplementary toothpastes;
- remineralising products;
- indications for high-risk patients.
It is not enough to know that a patient uses toothpaste. It is also necessary to understand:
- which product is used;
- how many times per day;
- how long the patient brushes;
- how much toothpaste is applied;
- whether the mouth is rinsed extensively afterwards;
- whether the patient eats or drinks immediately afterwards;
- whether several products are alternated;
- why the products were selected.
The prescription thus becomes part of the treatment plan rather than a generic recommendation.
Mouth Rinses, Gels, Varnishes, and Mousses
The text contains specific sections on mouth rinses, comparing them with toothpaste and analysing when they may be prescribed for patients with high caries susceptibility.
It also covers:
- fluoride gels;
- varnishes;
- foams;
- remineralising mousses;
- other fluoride-containing products;
- 38% silver diamine fluoride.
The contents distinguish indications, methods of use, and selection criteria for the different products.
A mouth rinse does not automatically replace brushing with fluoride toothpaste. It may be an additional aid when there is a genuine indication and when it is used with an appropriate frequency, method, and duration.
Other Risk Factors
Dental caries does not depend exclusively on biofilm, sugars, saliva, and fluoride.
The chapter devoted to other factors considers:
- previous caries experience;
- diseases;
- systemic conditions;
- medications;
- smoking;
- other substances;
- compliance;
- willingness and ability to follow the plan.
Patient cooperation is itself a clinical factor.
A theoretically perfect protocol may fail if it is too complicated, poorly understood, or incompatible with the patient’s habits.
The treatment plan must therefore take into account not only what would be ideal in theory, but also what the patient can realistically do.
Completing the Assessment Forms and Establishing the Initial Treatment Plan
After collecting the information, the professional must transform it into a practical strategy.
The chapter devoted to completing the forms includes:
- caries-risk level;
- disease severity;
- categories of factors most involved;
- behavioural recommendations;
- product prescriptions;
- basic hygiene steps;
- patient reports.
This phase makes it possible to establish priorities.
One patient may have sugar frequency as the main factor; another may have medication-induced xerostomia; another may present abundant biofilm combined with limited fluoride exposure.
Prescriptions should therefore differ.
The First Cariology Appointment
The volume provides an operative description of the first appointment.
The stages include:
- initial approach;
- preliminary assessments;
- introduction to the pathway;
- behavioural interview;
- extraoral and intraoral examination;
- instrumental examinations;
- clinical dental examination;
- evaluation of severity.
Initial communication is particularly important.
The patient must understand that the pathway is not simply about identifying cavities, but about evaluating the disease and constructing a control strategy.
The interview should not become an interrogation. Its objective is to reconstruct real behaviours and conditions in order to identify sustainable changes.
The Second Appointment
The second appointment is used to complete and integrate the information collected.
The chapter includes:
- review of documentation;
- completion of the interview;
- preparation of materials;
- assignment of the oral-hygiene level;
- measurement of biofilm pH;
- identification of ICDAS 1 and 2 lesions;
- practical testing of oral-hygiene devices;
- hygiene session;
- application of substances;
- behavioural and hygiene prescriptions;
- scheduling of the next review.
This structure provides sufficient time for diagnosis and communication, avoiding the attempt to concentrate everything into an excessively short appointment.
Pit and Fissure Sealing
Pit and fissure sealing is addressed in a dedicated chapter.
The procedure is analysed through fundamental clinical questions:
- What is fissure sealing used for?
- Is it effective?
- Which material should be used?
- Which teeth should be sealed?
- How should risk be evaluated?
- How important is fissure morphology?
- Can the operative field be adequately isolated?
The book considers different materials:
- glass-ionomer cements;
- resin-modified glass ionomers;
- compomers;
- resin-based sealants;
- bioactive resin-based sealants.
Selection is related to risk, fissure anatomy, and the possibility of isolation.
The chapter also includes operative procedures, the RSI approach, and a question-and-answer section on sealing.
Fissure sealing is therefore not presented as an automatic procedure to be applied indiscriminately, but as a preventive or therapeutic intervention to be included within the cariological treatment plan.
Downloadable Forms and Resources
The book includes a download area linked to its operative resources.
The final chapter contains:
- a glossary;
- download area;
- supporting materials;
- forms for clinical management.
The downloadable forms allow professionals to transfer the method described in the volume more easily into clinical practice.
They may be used for:
- data collection;
- patient interviews;
- diagnosis;
- risk classification;
- recording prescriptions;
- communication with the patient;
- monitoring over time.
A Visual and Practical Work
With 1,158 images, Clinical Cariology is strongly focused on visual understanding.
Photographs, diagrams, and tables help readers interpret:
- carious lesions;
- dental surfaces;
- biofilm;
- plaque-disclosing agents;
- radiographic images;
- transillumination;
- risk indices;
- cariological assessment forms;
- products;
- clinical procedures.
The book’s presentation highlights the use of photographs, diagrams, cases, and guidelines to make the knowledge immediately applicable.
The documentation therefore does not serve a purely illustrative function, but supports clinical decision-making.
Who Is Clinical Cariology Intended For?
Clinical Cariology is primarily intended for:
- general dentists;
- restorative dentists;
- dental hygienists;
- professionals interested in prevention;
- clinicians practising minimally invasive dentistry;
- dental students;
- dental-hygiene students;
- professionals managing patients at high risk of caries;
- dental teams interested in shared protocols.
The text may be used both by experienced professionals and by readers who wish to build structured knowledge beginning with the fundamentals.
Why Read Clinical Cariology?
Clinical Cariology is not simply a book about diagnosing cavities.
It is a work that integrates:
- dental caries;
- dental hygiene;
- biofilm;
- fluoride prophylaxis;
- pit and fissure sealing;
- remineralisation;
- caries susceptibility;
- mouth rinses;
- demineralisation;
- toothpastes;
- bacterial plaque;
- saliva;
- cariological assessment forms;
- Streptococcus mutans;
- diet;
- behaviour;
- minimally invasive diagnosis.
The principal value of the volume lies in its ability to transform a complex discipline into an organised clinical pathway.
The professional is guided in moving from treating the individual lesion to treating the person affected by a chronic disease.
For readers seeking a book on clinical cariology and caries prevention that integrates diagnosis, oral hygiene, biofilm, diet, saliva, fluoride, and practical assessment forms, Giovanni Sammarco’s volume represents a comprehensive guide for everyday clinical practice.
Frequently Asked Questions About Clinical Cariology
1. What is Giovanni Sammarco’s Clinical Cariology about?
The book examines the diagnosis, prevention, and treatment of caries disease. It analyses biofilm, caries susceptibility, diet, saliva, fluoride, remineralisation, oral hygiene, sealants, home-care products, and treatment planning.
2. What is the book’s main message?
Its central message is that a restoration treats an outcome of dental caries, but does not by itself represent treatment of the disease. Controlling the pathology requires identifying and modifying the biological and behavioural factors that sustain it.
3. Who is the volume intended for?
The book is intended for dentists, dental hygienists, dental and dental-hygiene students, and professionals interested in prevention and minimally invasive methods.
4. What does caries susceptibility mean?
Caries susceptibility expresses the patient’s clinical tendency to develop carious lesions or experience progression of existing lesions. Its assessment considers caries experience, lesion activity, and current risk factors.
5. What is the difference between dental diagnosis and cariological diagnosis?
Dental diagnosis identifies the outcomes present on the teeth, such as lesions, restorations, and missing teeth. Cariological diagnosis instead evaluates the causes and factors maintaining the disease in the individual patient.
6. Does the book discuss biofilm and bacterial plaque?
Yes. The volume examines biofilm formation, maturity, quantity, and pH, as well as home and professional procedures for modifying it.
7. Is Streptococcus mutans discussed?
Yes. The book considers the quantity of Streptococcus mutans and lactobacilli in saliva as part of bacterial-risk assessment, integrating this information with other clinical and behavioural factors.
8. Does the book cover fluoride and fluoride prophylaxis?
Yes. A complete chapter is devoted to the functions of fluoride, fluoride prophylaxis in children and adults, concentrations, fluoride sources, and home and professional products.
9. Which oral-hygiene products are analysed?
The text covers toothpastes, mouth rinses, gels, varnishes, remineralising mousses, plaque-disclosing agents, dental floss, interdental brushes, and other products used for patients with high caries susceptibility.
10. Does the book examine saliva?
Yes. It analyses salivary flow, pH, buffering capacity, salivary glands, mouth breathing, hydration, medications, and salivary stimulants and substitutes.
11. Are cariological assessment forms included?
Yes. The book presents the 43-point CRA form and the RCG form, together with downloadable materials for data collection and patient management.
12. Does the text discuss pit and fissure sealing?
Yes. An entire chapter is devoted to indications, materials, isolation, and operative procedures for pit and fissure sealing.
13. Does the book also consider diet and sugars?
Yes. It examines the quantity and frequency of free-sugar intake, hidden sources, between-meal habits, and dietary-counselling strategies.
14. Why purchase Clinical Cariology?
Because it provides a comprehensive method for moving from simple lesion treatment to the management of caries disease, integrating diagnosis, prevention, behaviour, oral hygiene, fluoride prophylaxis, and follow-up.
Chapters and Topics
- Fundamentals
- Level of treatment of a disease
- Dental caries and periodontal disease
- Reversible and irreversible lesions
- Prevalence and terminology of caries
- Biofilm-mediated oral diseases
- Cariological balance
- Immunity and Genetics
- Innate immunity
- Acquired immunity
- Genetic influence
- Cariological Dynamics
- Demineralisation and remineralisation
- Dental apatites
- Acids and chelating agents
- Dental erosion
- Cariogenic biofilm
- Stephan curves
- Saliva and biofilm
- Caries Susceptibility, DMF, and Disease Severity
- dmf/DMF
- Caries experience
- Reversible lesions
- Severity
- The Two Diagnoses in Cariology and Introduction to the Assessment Forms
- Dental diagnosis
- Cariological diagnosis
- 43-point CRA form
- RCG form
- Dental Diagnosis
- Clinical examination
- ICDAS II
- Lesion activity
- Bite-wing radiographs
- Transillumination
- Laser fluorescence
- Cariological Diagnosis and Treatment Planning
- Risk categories
- Cariological assessment forms
- Behavioural interview
- Therapeutic strategy
- Bacterial Factors
- Biofilm quantity and maturity
- pH
- Streptococcus mutans and lactobacilli
- Oral hygiene
- Chlorhexidine and antibacterial agents
- Probiotics and bioactive materials
- Dietary Factors
- Free sugars
- Frequency of intake
- Functional foods
- Dietary-risk assessment
- Salivary Factors
- Salivary flow and pH
- Buffering capacity
- Stimulants and substitutes
- Medications and lifestyle
- Salivary counselling
- Fluoride and Remineralising Agents
- Fluoride prophylaxis
- Toothpastes
- Mouth rinses
- Gels and varnishes
- Remineralising mousses
- Hydroxyapatite, ACP, and bioactive glasses
- Silver diamine fluoride
- Other Factors
- Caries experience
- Diseases and systemic conditions
- Medications
- Smoking and other substances
- Compliance
- Completing the Forms and Establishing the Initial Treatment Plan
- Caries risk
- Severity
- Prescriptions
- Hygiene steps
- Patient report
- First and Second Appointments
- Behavioural interview
- Clinical and instrumental examinations
- Hygiene session
- Application of agents
- Prescriptions and follow-up
- Pit and Fissure Sealing
- Indications
- Materials
- Isolation
- RSI approach
- Operative procedures
- Glossary and Download Area
- Cariology glossary
- Downloadable forms and materials
