What is the correct approach for managing deep caries in a vital tooth?

Correct answer: A. Remove infected dentin; leave affected dentin

• A. The current evidence-based approach to deep caries management is SELECTIVE CARIES REMOVAL: Remove INFECTED dentin (soft, disorganized, heavily bacterially contaminated, cannot remineralize) while LEAVING AFFECTED dentin (harder, partially demineralized but can remineralize, less bacterially contaminated) to preserve pulp vitality. This is supported by the IADT and AAPD guidelines for deep caries management.
• B. Removing ALL caries including affected dentin near the pulp risks unnecessary pulp exposure in vital teeth.
• C. Removing only affected dentin is incorrect — infected dentin must be removed to eliminate the cariogenic bacteria.
• D. Removing affected dentin while leaving infected dentin would leave bacteria and compromise restoration.