The International Caries Classification and Management System (ICCMS™) An Example of a Caries Management Pathway

Introduction The International Caries Classification and Management System (ICCMSTM) is a comprehensive set of clinical protocols that address all diagnostic, preventive and restorative decisions necessary “to preserve tooth structure and restore only when indicated,” which is the mission adopted at the Temple University Caries Management Pathways workshop, in 2012 [1]. The foundation for ICCMSTM is based on extensive critical analyses, research, and clinical feedback on the best approaches to move away from the mechanical or restorative care that has been followed around the world, towards a system where prevention is emphasized, initial caries lesions are prevented from progressing (controlled), and moderate or extensive caries lesions are restored with the goal of preserving, as much as possible, natural tooth structure [2]. This chapter will describe the scientific, and clinical management protocols that have been developed over the last several years by over 70 cariologists, epidemiologists, and clinicians. While ICCMSTM is recommended as the most comprehensive pathway for caries management to achieve the desired aforementioned mission, it is important to emphasize that ICCMSTM is not the only system available today that promotes staging of the caries process and risk assessment and management [1]. The ICCMSTM, in contrast to other systems, has well-developed and documented protocols for the implementation of a new model of caries management. It is based on the well-established and widely used International Caries Detection and Assessment System (ICDASTM).