Various methods for preventions of dental caries 4
Presentation by: Ritam Chakraborty 3rd year BDS studentHALDIA INSTITUTE OF DENTAL SCIENCES AND RESEARCH Guided by: Dr. Rajarshi Banerjee(MDS,MOMS RCPS) Professor, Dept. of Oral and Maxillofacial Surgery, HIDSAR Dr. Rupam Sinha(MDS) Professor & HOD, Dept. of Oral Medicine & Radiology, HIDSAR
In spite of widespread awareness, dental caries is still the second most common disease of human civilization after common cold -According to WHODental caries is a preventable disease of the mineralized tissues of the teeth witha multi-functional etiology related to the interactions over time between toothsubstance & certain micro-organisms & dietary carbohydrates producing plaqueacids. This paper aims to throw light on various modalities of caries prevention
PRIMARY PREVENTIONPrimary prevention protects individuals against disease,often by placing barriers between the aetiological agent and the host. Primary prevention is about keeping children’s teeth free from dental caries.
Risk factors of Dental caries Clinical Dietary Social history Use of Plaque control Saliva Medical evidence habits fluoride history New lesions Frequent Social Drinking water Infrequent, Low flow rate Medically No fissure sugar deprivation not fluoridated ineffective compromised sealants intake Low knowledge cleaning Low bufferingHigh risk Fixed Ready No fluoride capacity Physical appliance availability of toothpaste Poor manual disability orthodontics snacks control High S. Partial High caries in mutans & Long term dentures siblings lactobacilli cariogenic Anterior caries count medicine or restorations No new Infrequent Social Drinking Frequent, Normal flow No medical lesions sugar intake advantage water effective rate problems Fissure Dentally fluoridated cleaningLow risk sealed aware High No physical No appliance Limited Fluoride Good manual buffering problems Sound intake of toothpaste & control capacity anterior snacks supplements No long term teeth Low caries in used medication No or few siblings Low S. mutans restorations & lactobacilli count
SECONDARY PREVENTIONSecondary prevention aims to limit the progression and effect of a disease at as early a stage as possible after onset. It includes further primary prevention
TERTIARY PREVENTION It is concerned with limiting the extent of disability once a disease has caused some functional limitation. The patient’s health status doesn’t return to the pre- diseased state. It must include further primary and secondary prevention in order to prevent further carious attack
Accurate diagnosis & monitoring oflesions over time is required for effective prevention
CLINICAL DIAGNOSISo Transilluminationo Flossingo Temporary restoration of the tooth (eg. With a wooden wedge or orthodontic separator)
Can be divided into three carious sites -> Occlusal caries Approximal caries Smooth surface caries
MANAGEMENT OF OCCLUSAL CARIES If only part of the fissure system is involved in small to moderate dentine lesions with limited extension,the treatment of choice is a composite sealant restoration. If caries extends clinically into dentine,then carious dentine should be removed & the tooth restored. Dental amalgam is an effective filling material which remains the treatment of choice in many clinical conditions. There is no evidence that amalgam restorations are hazardous to the general health.
MANAGEMENT OF APROXIMAL CARIES Preventive care (eg. topical fluoride varnish)rather than operative care is recommended when approximal caries is confined(radiographically or visually)to enamel.Management strategies should also include: Twice daily use of a toothpaste containing 1000 ppm fluoride.• Flossing Dietary advice In an approximal lesion requiring restoration, a conventional class II restoration should be preferred.
MANAGEMENT OF SMOOTH-SURFACE CARIESo Twice daily use of a toothpaste containing 1ooo ppm of fluoride.o Plaque removalo Dietary advice
The diagnosis of secondary caries is extremely difficult & clear evidence of involvement of active disease should be ascertained before replacing a restoration.
INFORMATION FOR NON-DENTAL HEALTH PROFESSIONALS Dental caries development Sugar consumption Dry mouth Sugar-free medicines Those who don’t attend a dentist regularly Medically compromised Orthodontic appliances
Vaccines are an immuno-biological substance designed to produce specific protection against a given disease. Stimulates the production of protective antibodies.
ROUTES OF IMMUNIZATIONIn general,two types of immunization have been used with S. mutans : Active immunization Passive immunization
Common mucosal Systemic route of Active gingivo-Immune system Immunization salivary route Oral route Intranasal route Tonsillar route Minor salivary gland Rectal
ADVANTAGES OF VACCINE Genetic material can be easily exchanged It is possible to manipulate the antibody structure thus avoiding cross reaction Large scale production is possible
Synthetic peptides Coupling with cholera toxin subunits Fusing with salmonella Microcapsules and microparticles Liposomes
With all these advancements, we hope, in recent future, we can enroute dental caries out of the human civilization Then we can shed off the allegation - DENTAL CARIES IS THE DISEASE OF CIVILIZATION
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