Selective removal of carious tissue in shallow, moderately deep and deep carious lesions in pediatric patients

The selective removal of carious tissue is a contemporary method of managing shallow, moderately deep, and deep carious lesions. The aim is to prevent pulp exposure while simultaneously restoring a tooth with no signs or symptoms of irreversible pulp pathology. The rationale behind selective removal is that the microorganisms, in the carious tissue that is left behind, are deprived of micronutrients when the carious lesion is hermetically sealed. The microorganisms thereby lose potency, slowing down the carious process. This helps the pulp–dentinal complex deposit reactionary dentin over the pulp. Depending on the depth of the carious lesion, the selective removal of carious tissue can be approached in two ways: Selective carious tissue removal to “firm” dentine and selective carious tissue removal to “soft” dentine. These conservative strategies decrease the likelihood of the need for more invasive and stress-inducing procedures in children.