caries prevention i


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Preventive Dentistry
Third Year

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caries prevention i

  1. 1. ‫بسم ال الرحمن الرحيم‬ Prevention of dental caries I Preventive Dentistry PDS 332
  2. 2. Lecture outline     Levels of prevention Dental caries Clinical approaches for caries prevention Professionally applied preventive agents and procedures Fluorides  Pits and fissure sealants 
  3. 3. Learning outcomes     Describe differences between primary, secondary, and tertiary prevention Understand dental caries as an infectious disease and the associated risk factors Outline different clinical preventive services for the treatment of dental caries Detail the different types of fluoride and other products available for the prevention of dental caries and their use in prevention by professionals and individuals
  4. 4.  Prevention of dental caries includes:  measures to prevent the occurrence of disease  Risk factor reduction Arrest the progress of the disease  Reduce the consequences of the disease 
  5. 5.  Dental caries is an infectious bacterial disease that has plagued humans since the beginning of recorded history. What is dental caries? Simply stated, it is Tooth Decay
  6. 6. Dental Caries: A Bacterial Infection  There are two specific groups of bacteria found in the mouth that are responsible for dental caries:  Mutans streptococci (Streptococcus mutans)  Lactobacilli
  7. 7. Dental Plaque  Dental plaque is a colorless, soft, sticky coating that adheres to the teeth
  8. 8. Dental caries
  9. 9. Venn diagram
  10. 10. Purpose of caries risk assessment in clinical practice        Evaluate the degree of patient risk of developing caries Identify the main etiological agents Determine whether additional diagnostic testing is required Aid in preventive or restorative treatment decisions Improve the reliability of the prognosis of the planned interventions Provide a basis for oral health promotion Assess the efficacy at re-eval/recall visits
  11. 11. Areas for Development of Caries     Pit and fissure caries Smooth surface Root surface Secondary, or recurrent
  12. 12. Stages of Caries Development  It is an ongoing process, characterized by alternating periods of demineralization and remineralization  Demineralization is the dissolving of the calcium and phosphate from the hydroxyapatite crystals  Remineralization is the calcium and phosphate being redeposited in previously demineralized areas
  13. 13. Dental Caries
  14. 14. Stages of Caries Development  Incipient lesion  Cavitated lesion  Rampant
  15. 15. The Role of Saliva     Physical protection Chemical protection Antibacterial If salivary function is reduced for any reason, such as from illness or medications or due to radiation therapy, the teeth are at increased risk
  16. 16. Diagnosis of Dental Caries     Visual Tactile sensation Radiographs Caries technological detectors
  17. 17. Change in Paradigm for Dealing with Dental Caries Old Paradigm --> Surgical / ‘Drill and Fill’ (deal with the consequences of the disease) ⇓ Later Paradigm: Prevention!!! (but generally “one size fits all”) ⇓ “Current” Paradigm: Early Intervention, Risk Assessment, Anticipatory Guidance, Individualized Prevention and Disease Management
  18. 18. Prevention and treatment protocols of initial carious lesions University of Texas Health Science Center
  19. 19. Fissured surfaces
  20. 20. Proximal surfaces
  21. 21. Smooth surfaces
  22. 22. Root surfaces
  23. 23. Clinical approaches for caries prevention
  24. 24. Clinical approaches for caries prevention  Risk-based preventive strategies depend on two assumptions: Identification of patients at increased risk  The patient will receive appropriate preventive care based on etiological factors   What are the risk factors for dental caries?
  25. 25. Risk factors for dental caries     Bacteria Tooth/Host Diet Time
  26. 26. Professionally applied preventive agents and procedures
  27. 27. Fluorides
  28. 28. Fluoride: What does it do?    It inhibits the process by which cariogenic bacteria metabolize carbohydrates to produce acid It re-mineralizes the enamel of the tooth (e.g., white spot) Community water fluoridation should have 0.7-1.2 ppm fluoride to be effective
  29. 29.    Fluoride remains one hallmark of dental caries prevention 20% to 40% caries reduction rate by professional application Commonly used fluorides 1.23% Acidulated Phosphate Fluoride (AFP)  2% Neutral Sodium Fluoride  5% fluoride varnish 
  30. 30. Fluoride varnish  Protective coating that is painted on the surfaces of teeth to prevent new cavities from forming and to help stop cavities that have already started  The protective effect of the fluoride varnish will continue to work for several months
  31. 31. Dental Sealants
  32. 32.  Highly effective in preventing dental caries in the pit and fissure areas of the teeth Made of a resin material  Noninvasive technique  Success rate high if firm adhesion to the enamel surface 
  33. 33. Summary      Three levels of prevention Dental caries as an infectious disease Clinical approaches for caries prevention Professionally applied fluorides Professionally applied sealants