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Cite as: Segura-Egea JJ. Complete excavation or removal of carious tissues to hard dentin: Overtreatment. J Oral Res 2017; 6(2): 30-31. doi:10.17126/joralres.2017.013 For many years most Schools of Dentistry have taught that all carious tissue must be removed, and this was considered the gold standard in cavity preparation. Therefore, many dentists continue this practice despite being considered incorrect by the progressive development of minimally invasive dentistry that advocates a much less invasive approach.1 The complete excavation or removal of carious dentin is currently considered over-treatment.2 At this time, the treatment of carious lesion should be based on the principles and techniques of minimally invasive dentistry.3 Thus, the correct diagnosis of the extent of carious lesion and the degree of pulp involvement is critical to determine whether an invasive endodontic treatment or a conservative operative procedure is indicated. Nevertheless the terminology used in this matter is not homogenous, which is problematic. As such, in order to avoid misunderstandings there is a need to unify the terminology used for carious lesions and tissue removal procedures, establishing well-defined criteria for the treatment of caries. The International Caries Consensus Collaboration Group (ICCC), in its convention in Leuven (Belgium) in 2015, has proposed important changes with regard to the terminology, management of caries, and operative techniques indicated for the treatment of the different types of dentin carious lesions. The results of this consensus has been published recently,1,2 representing an important frame of reference for the treatment of carious lessions. To relate the clinical signs of caries with the histopathological state of the dentin carious lesion is not easy. The visual and tactile assessment of dentin (color, degree of hardness and moisture) can inform about what is happening histopathologically. The demineralization of the dentin brought about by dental caries induces a decrease in the hardness of dentin, which is in more easily deformed, penetrated, and removed by exploratory instruments. Therefore, obtaining tactile information about the hardness of the dentin in the carious lesion, using the dental probe, is the best way to determine the degree of carious involvement.2 According to ICCC group, four different states of the dentin hardness can be stablished. Soft dentin: deforming when pressed by a hard instrument and requiring little force to be easily scooped with a sharp hand excavator. Histopathologically, it is necrotic dentin contaminated with biofilm. Leathery dentin: when explored with the dental probe it resembles touching leather. It does not deform under pressure, but can be easily excavated without much force. From the histopathological point of view, it is demineralized dentin. Firm dentin: does not deform under pressure and is resistant to hand excavation. It corresponds to sclerotic dentin. Hard dentin: resistant to hand excavation when the tip of the dental probe is scrapped Complete excavation or removal of carious tissues to hard dentin: Overtreatment.