In the early 20th century, GV Black's caries classification system, based on tooth type and involved tooth surface, played a pivotal role in shaping dental practice. However, this era viewed caries as irreversible, leading to a surgical focus on removing carious lesions and repairing resulting cavities.
Although effective for over a century, this philosophy faces challenges in the context of modern cariology, advanced technology, and adhesive restorative materials.
Black's system, designed for non-adhesive restorations like silver amalgam, struggles with detecting initial lesions and accommodating the complexity of restoring exposed tooth surfaces as lesions progress. It adheres to the "extension for prevention" principle, requiring extensive cavity preparation.
Despite evolving classifications and caries management systems globally, Black's approach remains prevalent in Pakistan. However, dental professionals acknowledge its focus on cavity treatment rather than carious processes. Recognizing its misalignment with minimal intervention approaches, there's a pressing need for comprehensive education on contemporary systems.
GJ Mount's 1997 caries classification system, discussed internationally and subsequently refined, considers lesion location, size, and activity status. It emphasizes early detection, prompt intervention, and disease prevention. Widely adopted globally, this system aligns with minimal intervention dentistry.
In Pakistan, there's a critical need for transitioning to modern approaches through dental education. All dental team members should be familiar with new classifications, fostering interprofessional communication, disease comprehension, and improved patient outcomes. Embracing contemporary systems can minimise the sacrifice of healthy tooth structure advocated by Black's recommendations, marking a positive shift in dental practices.
By Prof. Dr Asaad Javaid
Dean, Faculty of Dentistry, Baqai Medical University
