A Practical Guide to Modern Caries Management - MIOC and MID Part 1 - PDP268

If you showed the same bitewing to 10 dentists, would they all agree on whether to pick up the drill? Why does the word monitoring mean nothing to a patient — and how does swapping it for active surveillance change everything from your notes to your indemnity to your government policy meetings? Is it overtreatment to act on an E2 lesion — or is “watch and wait” actually the lazy answer dressed up as minimally invasive? And what should you actually do with AI caries detection that flags shadows your eye doesn’t see? In this episode, Professor Avijit Banerjee (https://uk.linkedin.com/in/avijit-banerjee-0b17518) — Professor of Cariology & Operative Dentistry at King’s College London, Honorary Consultant at Guy’s & St Thomas’, and First Dean of the Faculty of Dentistry at the College of General Dentistry — sits down with Jaz for what is genuinely one of the most important caries conversations on the podcast. Part one of two. Protrusive Dental Pearl: Delete the Word “Monitor” from Your Vocabulary Stop saying monitor. Start saying active surveillance. ⚠️ Active surveillance must not mean passive delay — document your reasoning, risk assessment, and what would trigger intervention. ✅ Explain it to patients as structured, proactive care: clinical checks, radiographs, risk review, behaviour support, and timely action if things change. Key Takeaways -Minimum intervention oral care is bigger than minimally invasive dentistry. -MIOC is prevention-based, person-focused, susceptibility-related, and delivered by the whole oral healthcare team. -MID is only one part of MIOC: operative dentistry when a tooth actually needs intervention. -The four MIOC domains are: identify the problem, prevent lesions and control disease, provide minimally invasive operative care, then reassess. -A care plan is more useful than a treatment plan because it includes justification, prevention, behaviour change, and review. -Cavitation, cleansability, and lesion activity should guide whether to intervene operatively. -A cavitated lesion that cannot be cleaned is much more likely to remain active. -Restorations are not just about filling holes; they help recreate a cleansable tooth surface. -If using NIRI, fluorescence, scanners, or AI, understand how the technology works and where it fails. Highlights 00:00 Teaser 02:17 Protrusive Dental Pearl: Active Surveillance, Not Monitoring 09:14 Minimum Intervention Oral Care vs Minimally Invasive Dentistry 11:28 Core Principles of MIOC 11:48 Domain 1: Identify the Problem 12:46 Domain 2: Prevention of Lesions and Control of Disease 13:18 Microinvasive Care Options 14:41 Domain 3: Minimally Invasive Operative Dentistry 16:38 Why “Active Surveillance” Matters 18:24 MIOC as a Practical Framework 19:43 Applying MIOC in Patient Communication 22:38 Sustainability & Salutogenesis 29:05 When to Pick Up a Drill 30:23 Biofilm as the Engine of Caries 31:33 Purpose of a Restoration in Caries Management 36:13 Caries Detection Technologies 42:44 Watch and Wait vs Detect and Manage 01:02:52 Outro Professor Avijit Banerjee’s recommended reading and ongoing work: New textbook: A Clinical Guide to Advanced Minimum Intervention Restorative Dentistry (Banerjee A., Elsevier, 2024) — the most comprehensive single reference for modern MIOC and MID. ISBN 978-0-443-10971-3 (https://www.uk.elsevierhealth.com/a-clinical-guide-to-advanced-minimum-intervention-restorative-dentistry-9780443109713.html) 🦷 Interested in Proximal Resin Infiltration? Explore The Iconic Method with Cat Edney: a free 1-hour webinar on 24 June 2026 (https://www.eventbrite.co.uk/e/webinar-the-iconic-method-tickets-1989311147192), followed by a hands-on 1-day Birmingham course on 4 July 2026 (https://www.eventbrite.co.uk/e/1-day-course-the-iconic-method-tickets-1989315193294), with CPD available. DMG Icon Proximal discount for dental professionals at https://protrusive.co.uk/dmg Loved This Episode? Try this next: Is Caries Detector Dye BS? – PDP138 (https://youtu.be/L8fScyRTet0) #PDPMainEpisodes #BreadandButterDentistry ----------------------------------- Apply for FREE access to the Nicest and Geekiest Dental Community in the World 🌍 https://protrusive.app - it’s absolutely Free We also have paid plans so you can Claim Verifiable CPD/CE + EXCLUSIVE content: https://protrusive.app 🔊 Subscribe on Apple: https://protrusive.co.uk/apple 🔊 Subscribe on Spotify: https://protrusive.co.uk/spotify 📷 Instagram: https://www.instagram.com/protrusivedental/ Online Courses: 😬 Learn Occlusion Online: https://occlusion.online/ 📚 Learn TMD and Occlusal Appliances: https://www.splintcourse.com 🦷 Gain Confidence with Resin Bonded Bridges: https://rbbmasterclass.com 🎒 Learn Vertipreps, Rubber Dam and More: https://protrusive.co.uk/ultimate Life by KV /kvmusicprod Creative Commons — Attribution 4.0 International — CC BY 4.0 Free Download / Stream: https://www.audiolibrary.com.co/kv/life Music promoted by Audio Library Life – KV (No Copyright Music)