Guideline tracker
The guidelines that changed what you do.
Not every guideline. The ones a general dentist actually acts on: antibiotics, pain, radiographs, caries, infection control. Each row says what it tells you to do, what changed, and links to the document itself. When one is revised, this page and The Dental Grind say so.
21 guidelines · sources last checked 2026-09-12
Antibiotics, pain and prescribing
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2024 | Evidence-Based Clinical Practice Guideline for the Pharmacologic Management of Acute Dental Pain in Adolescents, Adults, and Older Adults American Dental Association Carrasco-Labra A, et al. J Am Dent Assoc. 2024;155(2):102-117.e9. | For pain after extractions or from pulpal/periapical disease, use an NSAID (ibuprofen or naproxen sodium) alone or combined with acetaminophen as first-line therapy. Opioids are not the first choice and are reserved for when NSAIDs and acetaminophen are contraindicated or insufficient. | Formalizes, as a graded ADA guideline based on 82 RCTs, what many dentists already did informally: ranking NSAID-plus-acetaminophen combinations above opioids for postoperative and pulpal pain.Checked 2026-09-12 |
| 2023 | Evidence-Based Clinical Practice Guideline for the Pharmacologic Management of Acute Dental Pain in Children American Dental Association Carrasco-Labra A, et al. J Am Dent Assoc. 2023;154(9):814-825.e2. | For children under 12 with pain from extractions or pulpal/periapical disease, use acetaminophen or ibuprofen (alone, alternating, or combined) as first-line therapy; the guideline recommends against opioids in this age group. | The ADA's first guideline focused specifically on pediatric acute dental pain, extending the adult NSAID/acetaminophen-first approach to children and explicitly discouraging opioid prescribing for them.Checked 2026-09-12 |
| 2021 | Prevention of Viridans Group Streptococcal Infective Endocarditis: A Scientific Statement From the American Heart Association American Heart Association Wilson WR, et al. Circulation. 2021;143(20):e963-e978. | Confirms that the 2007 list of high-risk cardiac conditions and covered dental procedures still stands: no conditions were added or removed. | After reviewing 14 years of subsequent evidence, the writing group made no changes to the 2007 recommendations, while noting that prophylaxis is still being over-prescribed to lower-risk patients in practice.Checked 2026-09-12 |
| 2019 | Evidence-Based Clinical Practice Guideline on Antibiotic Use for the Urgent Management of Pulpal- and Periapical-Related Dental Pain and Intraoral Swelling American Dental Association Lockhart PB, et al. J Am Dent Assoc. 2019;150(11):906-921.e12. | For an immunocompetent adult with symptomatic irreversible pulpitis, symptomatic apical periodontitis, or a localized acute apical abscess, definitive dental treatment (pulpotomy, pulpectomy, nonsurgical root canal treatment, or incision and drainage) plus an OTC analgesic is recommended over antibiotics. Antibiotics are for cases with signs of systemic involvement (fever, malaise, lymphadenopathy, trismus, or spreading swelling) or when definitive treatment truly can't be done right away. | Moved practice away from routinely prescribing antibiotics for pain and swelling that dental treatment alone resolves, as part of a broader push to cut unnecessary dental antibiotic use.Checked 2026-09-12 |
| 2016 | Appropriate Use Criteria: Management of Patients With Orthopaedic Implants Undergoing Dental Procedures American Academy of Orthopaedic Surgeons and American Dental Association J Am Dent Assoc. 2017;148(2):57-59. | Gives a case-by-case tool for the small group of implant patients the 2015 guideline doesn't fully settle (e.g. immunocompromised patients, poorly controlled diabetes, or a prior prosthetic joint infection), where prophylaxis may occasionally be "appropriate" or "may be appropriate." For the great majority of scenarios it rates prophylaxis "rarely appropriate." | Approved by the AAOS Board on September 28, 2016 as a companion decision aid to the 2015 ADA guideline, with the ADA's own explanatory guidance published in JADA the following year.Checked 2026-09-12 |
| 2015 | The Use of Prophylactic Antibiotics Prior to Dental Procedures in Patients With Prosthetic Joints: Evidence-Based Clinical Practice Guideline for Dental Practitioners American Dental Association Sollecito TP, et al. J Am Dent Assoc. 2015;146(1):11-16.e8. | For most patients with a prosthetic joint, do not give prophylactic antibiotics before dental procedures to prevent prosthetic joint infection. The panel found no credible evidence linking dental treatment to these infections. | Reversed the routine premedication that earlier ADA/AAOS advisories had recommended for joint-replacement patients, after a systematic review turned up no association between dental procedures and prosthetic joint infection.Checked 2026-09-12 |
| 2007 | Prevention of Infective Endocarditis: Guidelines From the American Heart Association American Heart Association Wilson W, et al. Circulation. 2007;116(15):1736-1754. | Antibiotic prophylaxis before dental procedures is reasonable only for patients with the highest-risk cardiac conditions: prosthetic heart valves or prosthetic material used in valve repair, a prior episode of infective endocarditis, certain unrepaired or recently repaired congenital heart disease, and cardiac transplant recipients who develop valve disease. Patients with mitral valve prolapse or most other murmurs no longer qualify. | Sharply narrowed prophylaxis from the much broader 1997 AHA recommendations, reasoning that endocarditis is far more likely to follow the random bacteremia of daily chewing and brushing than a single dental appointment.Checked 2026-09-12 |
Radiography and imaging
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2026 | American Dental Association and American Academy of Oral and Maxillofacial Radiology Patient Selection for Dental Radiography and Cone-Beam Computed Tomography: Clinical Recommendations American Dental Association and American Academy of Oral and Maxillofacial Radiology Benavides E, et al. J Am Dent Assoc. 2026;157(1):20-35.e5. | Order radiographs and CBCT based on a patient's history, exam findings, and individual caries/periodontal risk, not on a fixed time-based recall schedule. The guideline sets updated, condition-specific selection criteria and adds CBCT-specific indications that didn't exist before. | Replaces the 2012 ADA/FDA "Dental Radiographic Examinations" selection criteria (the ADA's first update to patient-selection guidance in more than a decade), and for the first time gives explicit criteria for when CBCT is and isn't indicated.Checked 2026-09-12 |
| 2024 | Optimizing Radiation Safety in Dentistry: Clinical Recommendations and Regulatory Considerations American Dental Association Benavides E, Krecioch JR, Connolly RT, et al. J Am Dent Assoc. 2024;155(4):280-293.e4. | Lead aprons and thyroid collars are no longer recommended for any dental radiographic exam, including panoramic and CBCT. Radiation protection now relies on rectangular collimation, digital receptors, and the ALARA principle rather than draping the patient. | Reverses the decades-old default of shielding patients with lead aprons/thyroid collars, since modern beam-limited digital equipment already keeps scatter dose to other body areas negligible, and collars can obscure anatomy or clip the beam.Checked 2026-09-12 |
Caries and prevention
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2023 | Evidence-Based Clinical Practice Guideline on Restorative Treatments for Caries Lesions American Dental Association Dhar V, et al. J Am Dent Assoc. 2023;154(7):551-566.e51. On the site: Should You Leave Caries Behind? (The End of Complete Excavation) | For moderate-to-advanced caries in vital, non-endodontically-treated teeth, the guideline favors selective (rather than complete) carious tissue removal in most cases, and gives conditional preferences among direct restorative materials. | The first ADA guideline to formally endorse selective/partial caries removal over complete excavation as the default for moderate and advanced lesions, based on evidence it lowers pulp-exposure risk without hurting restoration survival.Checked 2026-09-12 |
| 2018 | Evidence-Based Clinical Practice Guideline on Nonrestorative Treatments for Carious Lesions American Dental Association Slayton RL, et al. J Am Dent Assoc. 2018;149(10):837-849.e19. On the site: Does Silver Diamine Fluoride Really Arrest Caries Long-Term? | For arresting or reversing noncavitated lesions (and some cavitated ones), the guideline ranks 38% silver diamine fluoride highest, followed by sealants/resin infiltration and fluoride varnish, all ahead of no treatment, before jumping straight to a restoration. | The first ADA guideline to formally rank nonsurgical caries-arrest options against each other and against watchful waiting, giving general dentists an evidence-graded alternative to immediate restoration for early lesions.Checked 2026-09-12 |
| 2016 | Evidence-Based Clinical Practice Guideline for the Use of Pit-and-Fissure Sealants American Dental Association and American Academy of Pediatric Dentistry Wright JT, et al. J Am Dent Assoc. 2016;147(8):631-645.e18. | Place a sealant (resin-based, resin-modified glass ionomer, or glass ionomer) on sound and noncavitated occlusal surfaces of primary and permanent molars in children and adolescents to prevent and arrest early caries; sealants are favored over fluoride varnish alone for occlusal surfaces. | Updated the ADA's 2008 sealant recommendations with a larger evidence base and, for the first time, directly compared sealants against fluoride varnish.Checked 2026-09-12 |
| 2013 | Topical Fluoride for Caries Prevention: Executive Summary of the Updated Clinical Recommendations and Supporting Systematic Review American Dental Association Weyant RJ, et al. J Am Dent Assoc. 2013;144(11):1279-1291. | Recommends professionally applied fluoride varnish (or gel) for patients at elevated caries risk, at intervals set by that risk rather than a fixed recall schedule, and does not recommend routine professional fluoride application for low-risk patients. | Updated the 2006 ADA recommendations, shifting toward a risk-based rather than blanket application policy and reaffirming varnish as the preferred professionally applied agent for most patients.Checked 2026-09-12 |
Infection control and safety
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2016 | Summary of Infection Prevention Practices in Dental Settings: Basic Expectations for Safe Care Centers for Disease Control and Prevention | A condensed, checklist-style companion to the 2003 guidelines (the practical minimum every dental setting, including portable and mobile care, should already be doing), with a self-assessment tool built in. | Distilled the 2003 guidelines plus newer CDC guidance issued since into one practical summary with a compliance checklist; it supplements rather than replaces the 2003 document, which CDC still cites as the standard of practice.Checked 2026-09-12 |
| 2003 | Guidelines for Infection Control in Dental Health-Care Settings: 2003 Centers for Disease Control and Prevention MMWR Recomm Rep. 2003;52(RR-17):1-61. | Sets the baseline standard-precautions framework U.S. dental practices are still built on: hand hygiene, personal protective equipment, instrument sterilization and monitoring, surface disinfection, dental unit waterline quality, and safe injection and sharps handling. | Consolidated and substantially expanded CDC's 1993 dental infection-control recommendations into one document, with added rigor around bloodborne-pathogen transmission and sterilizer monitoring.Checked 2026-09-12 |
Endodontics
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2025 | AAE and AAOMR Joint Position Statement: Use of Cone-Beam Computed Tomography in Endodontics (2025 Update) American Association of Endodontists and American Academy of Oral and Maxillofacial Radiology J Endod. 2026;52(1):4-13. | Use CBCT selectively, not routinely, in endodontic diagnosis and treatment planning (for example when a conventional radiograph doesn't explain the clinical picture, or to check for extra canals, resorption, or a suspected vertical root fracture) rather than as a default imaging step. | Replaces the 2015 joint statement, condensing 14 recommendations to 12 and aligning with the newer ADA/AAOMR position that lead aprons and thyroid collars are no longer needed for CBCT.Checked 2026-09-12 |
| 2021 | AAE Position Statement on Vital Pulp Therapy American Association of Endodontists | Supports vital pulp therapy (direct or indirect pulp capping, or partial/full pulpotomy) as a legitimate treatment for permanent teeth with mature roots and an exposed or inflamed pulp, not automatically root canal treatment or extraction, when the pulp is judged to have healing potential. | Formally broadened AAE-endorsed options for adult teeth with pulp exposure or injury beyond root canal therapy, reflecting newer bioceramic capping materials and better outcome data.Checked 2026-09-12 |
Surgery and medically complex patients
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2022 | American Association of Oral and Maxillofacial Surgeons' Position Paper on Medication-Related Osteonecrosis of the Jaws: 2022 Update American Association of Oral and Maxillofacial Surgeons Ruggiero SL, et al. J Oral Maxillofac Surg. 2022;80(5):920-943. | Frames risk around drug class and duration (antiresorptive and antiangiogenic agents) rather than a fixed rule. Extractions and routine dentoalveolar surgery should not be automatically withheld from most at-risk patients, and getting patients dentally healthy before they start these drugs is emphasized. | Dropped the earlier recommendation for a preoperative bisphosphonate "drug holiday" as a blanket rule, replacing it with individualized risk stratification since the evidence didn't show a fixed holiday reduced MRONJ risk.Checked 2026-09-12 |
| 2022 | Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs (2nd edition) Scottish Dental Clinical Effectiveness Programme (United Kingdom) | For most patients on a single anticoagulant or antiplatelet drug, including DOACs and warfarin within its therapeutic range, routine extractions and minor oral surgery can go ahead without stopping or adjusting the medication, using local hemostatic measures instead. | The 2nd edition updated dosing-timing advice for direct oral anticoagulants and clarified when to involve the prescriber, based on bleeding-outcome data gathered since the 1st edition.Checked 2026-09-12 |
Periodontics
| Year | Guideline | What it tells you to do | What changed |
|---|---|---|---|
| 2020 | Treatment of Stage I-III Periodontitis: The EFP S3 Level Clinical Practice Guideline European Federation of Periodontology Sanz M, et al. J Clin Periodontol. 2020;47(Suppl 22):4-60. | Lays out a stepwise treatment path for periodontitis: patient education and risk-factor control first, then subgingival instrumentation, then adjunctive or surgical therapy only for sites that don't respond, followed by ongoing supportive periodontal care. | The first formal, systematic-review-based (S3-level) European guideline for periodontitis treatment, standardizing a stepped-care pathway that previously varied more by individual clinician and country.Checked 2026-09-12 |
| 2018 | A New Classification Scheme for Periodontal and Peri-Implant Diseases and Conditions American Academy of Periodontology and European Federation of Periodontology Caton JG, et al. J Periodontol. 2018;89(Suppl 1):S1-S8. | Replaced the 1999 classification with a staging (I-IV, extent and severity) and grading (A-C, rate of progression and risk) system for periodontitis, and introduced the first formal categories for peri-implant health, peri-implant mucositis, and peri-implantitis. | Retired the 1999 categories, including the "chronic" versus "aggressive" periodontitis split, in favor of stage and grade, and added peri-implant disease categories that hadn't existed before.Checked 2026-09-12 |
A guideline is the issuing body’s reading of the evidence at the time, and it is not a substitute for the document itself or your judgment about the patient in the chair. Every link goes to the issuer or the journal record.
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