Caries Preventive Treatment

Dental Caries and Periodontal

Disease
The most common chronic diseases in the
world.
 Factors that may have an impact
on the prevention of Caries
Host Resistance
Diet
Pits and Fissure Sealant
Restoration
Tooth Alignment
 Host Resistance
General Health
Declining health signals the need for increased
preventive measures including frequent recalls.
Early signs of increased risk include:
Increased plaque
Puffy bleeding gingivae
Dry mouth with red glossy mucosa
Demineralization of teeth
Decreased salivary flow is very common during acute
and chronic systemic illnesses.
 Host Resistance
Fluoride Treatment
Produces spectacular decrease in dental caries
Optimum level -1ppm
Excessive fluoride fluorosis or mottled enamel
Topical application of fluoride semi-annually
Acidulated phosphate fluoride-most effective and
least objectionable topical agent
Stannous fluoride (8%F) has bitter, metallic taste,
may burn the oral mucosa and short shelf life
 Diet
Dietary sucrose has two detrimental
effects on plaque, there are:
Frequent ingestion of foods containing
sucrose provides a stronger potential for
colonization by mutans streptococci,
enhancing caries potential of the plaque.
Mature plaque exposed frequently to sucrose
rapidly metabolizes it into organic acids,
resulting in profound and prolonged drop in
plaque pH.
 Pits and Fissure Sealant
Three important preventive effects of
sealant:
1. sealant mechanically fill pits and fissure
with acid resistant resin
2. sealant deny mutan streptococci and other
cariogenic organism their preferred habitat
because the pits and fissure are filled.
3. sealants render the pits and fissures easier
to clean by physical procedures including
brushing and mastication.
 Pits and Fissure Sealant
Effective Preventive measure of sealant
for caries
Prevent caries in newly erupted teeth
Arrest incipient caries
Prevent odontopathogenic growth in sealed
fissures
Prevent infection of the sites.
 Restoration
The status of the patients existing
restoration may have important bearing on
the outcome of the preventive measures
and caries treatment.
Restoration defects such as:
Overhangs
Open proximal contacts
Defective contours can contribute to the
formation and retention of plaque
 Tooth Alignment
Tooth mal alignment can contribute to
caries problems providing sheltered areas
for plaque retention.
 Methods of Caries Treatment
Methods/ Rationale Techniques or
Indication Material
A. Limit Reduce number, Eliminate
Substrate duration and sucrose from
intensity of acid
Indication: between meals
attacks.
Frequent snack.
Reduce selection
Sucrose pressure for Substantially
exposure streptococcus reduce or
mutans eliminate
Poor quality diet
sucrose from
meals
 Methods of Caries Treatment
B. Modify Microflora Intensive Bactericidal
Indication: mouthrinse-
antimicrobial Chlorhexidine
High MS counts
High Lactobacillus
treatment to Topical fluoride
counts eliminate MS treatment
Antibiotics treatment-
from mouth vancomycin,
tetracycline
C. Plaque Disruption Prevent plaque Brushing
Indication: succession
High Plaque scores Decreases plaque Flossing
Puffy red gingiva mass
High bleeding point Promotes buffering
score
 Methods of Caries Treatment
D. Modify Tooth Increase Systemic
Structure resistance to
Indication:
fluoride, topical
demineralization;
Incipient lesion fluoride; smooth
decrease plaque
Surface roughening retention surface

E. Stimulate Salivary Increase Eat non-cariogenic

Flow foods that require lots
Indication:
clearance of chewing
Dry mouth, little saliva, substrate and Sugarless chewing
red mucosa, acids, promotes gum
medication that Medication to
reduces flow
buffering stimulate saliva
 Methods of Caries Treatment
F. Restore Deny habitat for Restore all
Tooth Structure MS cavitated lesions
Seal pits and
Indication:
fissures at caries
Cavitated risk
lesions Correct all defects-
Pits and marginal crevices,
proximal
fissures at
overhangs
caries risk
Defective
restoration