In MID, what is the goal of selective caries removal?

• A. Remove all dentin until hard dentin is reached
• B. Remove only enamel lesions
• C. Remove soft carious tissue, leave firm dentin near pulp, minimize pulpal exposure
• D. Do not remove any caries tissue

Answer: (C)

Selective caries removal in minimally invasive dentistry focuses on preserving pulp vitality by removing only the soft, demineralized carious tissue while leaving dentin that is firm and near the pulp intact. Soft dentin houses most of the decay and bacteria, so removing it reduces the microbial load and halts progression, whereas firm dentin near the pulp acts as a natural barrier and provides structural support. After removing the soft tissue, sealing the cavity with an appropriate restoration helps limit microleakage and can promote remineralization of the remaining dentin. If you removed all dentin down to the hard margin, the tooth is more likely to suffer pulpal exposure and unnecessary loss of structure. If you only removed enamel lesions, any dentin caries would continue, failing to address the decay. If you removed no caries tissue at all, decay would progress. Thus, the best approach is to remove soft carious tissue, leave firm dentin near the pulp, and minimize pulpal exposure.