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Choosing Wisely®

American Dental Association

High quality evidence shows sealants are safe and effective in arresting caries progression in initial stage (incipient) non-cavitated, occlusal caries. Sealants offer a tooth-preserving treatment when compared to restorations, which may require removal of some healthy tooth structure, thereby weakening the tooth and increasing the risk that the tooth will eventually require more extensive treatment. Applying sealants as soon as initial stage caries is detected can improve outcomes by ...

Choosing Wisely®

American Dental Association

The benefit of fluoride-containing toothpaste arises from its topical effect on dental enamel by interrupting enamel demineralization caused by bacterial acids and enhancing remineralization of the enamel surface. Anti-caries (anti-cavities) benefit begins with eruption of the first primary tooth. Brushing with non-fluoridated toothpaste provides no anti-caries benefit. Use of recommended amounts of fluoride toothpaste minimize risks of fluorosis, a whitish discoloration of enamel.

Choosing Wisely®

American Society of Breast Surgeons

After a new diagnosis of breast cancer in a single breast, many patients desire removal of both breasts, believing their cancer risk in the other breast is high and their cancer cure rate will be improved with double mastectomy. Double mastectomy should not be routinely performed in these patients until they have been provided with adequate understandable information about the generally low risk they will develop cancer in the other breast and the minimal effectiveness, if any, of double ...

Choosing Wisely®

American Society of Breast Surgeons

Patients undergoing partial breast removal (lumpectomy) of the breast for invasive cancer benefit from re-operation to excise more breast tissue if microscopic review of the lumpectomy breast tissue indicates cancer cells at the tissue edge. However, if cancer cells are close to the edge, but not at the actual edge, then re-operation is not mandatory but can be considered on a case-by-case basis.

Choosing Wisely®

American Society of Breast Surgeons

There are multiple new tumor multi-gene signature tests that provide selected patients with information about their risk of distant cancer recurrence, dying of cancer or the likelihood they will benefit from chemotherapy. These tests are helpful in selected patients, including those with early stage hormone receptor positive cancers with low scores on 21 gene recurrence testing, who can safely omit chemotherapy. There is no evidence these tests should be used routinely in every patient. These ...