Prevention of Dental Caries. Prevention of Caries. Trends in caries prevalence:. Caries prevalence has decreased significantly among industrialized countries during the last two decades as a result of the wide spread use of preventive programs. . Trends in caries prevalence:.
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Prevention of Dental Caries
Prevention of Caries
1. Primary prevention:
2. Secondary prevention:
3. Tertiary prevention:
1. Micro flora (etiologic factors): acidogenic bacteria that colonize the tooth surfaces.
2. Host (internal modifying factors): Quantity and quality of saliva, the quality of the tooth, macro and macro-anatomy of the teeth that favor plaque retention. Etc...
3. Diet (external modifying risk factor):
Intake of fermentable carbohydrates
especially sucrose , but also starch.
Total exposure time to inorganic acids produced by the bacteria of the dental plaque.
The objectives of oral hygiene measures:
such as dextranase, chlorohexidine and fluorides.
The only recommended antibacterial agent for caries other than fluoride is the chlorohexidine(CHX).
It is most widely form of oral hygiene measure.
Type of brush
Manual Tooth Brush
Manual vs. Powered
Relative Indications for Powered brush
Light stimulates titanium dioxide rod to generate negatively charged electrons
Positively charged hydrogen ions in plaque’s acid are attracted by the electrons
The acid is neutralized ad plaque breaks down
1. Scrub technique
2. Fones technique
3. Roll technique
- 450 apically towards A.G.
4. Charters technique
- 450 occlusally lateral, downward
Tips of bristles: on the gingival margin
Direction of bristles: pointing apically, about 45 degree to the long axis of teeth
Movement: vibrate the brush, not changing the position of the bristles
Tooth brushing alone cannot effectively control interproximal plaque
Unwaxed is recommended for individuals with normal tooth contacts
Waxed is recommended for individuals with tight contact, moderate to heavy calculus deposits, crowded teeth, and overhanging restorations
Recommended for teens and adults with good neuromuscular coordination and mental maturity
Interdental oral hygiene aids
Exposed root furcation
Orthodontic and fixed appliances
Application of fluoride or desensitizing agents
Interdental oral hygiene aids
Wooden or plastic oral hygiene devices designed for individual cleaning and stimulation, some are treated with xylitol
They are recommended for use only from the facial aspect, where the proximal surfaces are exposed to avoid traumatizing gingiva
Inserted interproximally with the base of the triangle resting on the gingival side
dental irrigation device
to decrease halitosis
Eliminate plaque and soft debris by the use of a jet stream of water
May be also used with antimicrobial agent
( dextranase, CHX, Fl)
Sewak chewing sticks
The miswak, a traditional chewing stick for cleaning teeth, is made from the plant Salvadorapersica
It was concluded that miswak use was at least as effective as tooth brushing for reducing plaque and gingivitis, and that the antimicrobial effect of S. persica is beneficial for prevention/treatment of periodontal disease.
Transports the drug substance to the tooth surface.
Effective to decrease incidence of caries, gingivitis, calculus formation or tooth sensitivity
Cleans, removes materia alba, plaque ,biofilm and food debris
Binding agent 1-2%
Foaming agent 1-3%
Flavoring agent 1-2%
Calcium carbonate and calcium phosphate react adversely with fluoride ions
Most dentifrices now use silicon oxides and insoluble sodium monophosphate abrasives
They give the foaming action of a dentifrice
They clean tooth surface
Sodium lauryl sulfate is the most common and has antibacterial effect
Diet history assessment
Points: [0 ⇔ 1 Low Risk] [2 ⇔7 Moderate Risk] [8 ⇔ 9 High Risk]
Diet Analysis for caries risk assessment
Tufts School of Dental Medicine
Dr. Ghada Mahmoud
Remarks & Recommendations
Non-cariogenic sweeteners are increasingly used to replace sugar in foods, drinks and medicines.
They cannot be fermented by microorganisms to any great extent and so are considered non cariogenic.
Fluoride- containing dentifrice
3-Fluorides which include:
b) School water fluoridation.