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CARIES RISK
ASSESSMENT AND
MANAGEMENT FOR THE
PROSTHODONTIC
PATIENT
5조 60. Kanguk Joo
Purpose of this article
 To review how caries risk assessment of the
prosthodontic patient can result in meaningful
caries management and a more favorable
prosthodontic outcome.
 To outline considerations on caries risk
assessment for improved caries management
in the prosthodontic patient.
Risk factos for caries
Protective factors for caries
Preventive treatment plan
 Involve the patient in disease control
 The importance of a caries reduction program
during and following prosthodontic treatment
should be thoroughly discussed with the patient
prior to initiating treatment.
 Fluoride in various forms
 In prosthodontic patients with gingival recession
with other risk factors for caries, a fluoride varnish
on root surfaces three times annually is warranted.
Preventive treatment plan
 Chlorhexidine
 Because of staining and impact on
taste, chlorhexidine use should be limited to
seven consecutive days a month. Recommended
dosage is 10 ml of a 0.12% rinse for 1 minute at
night at least 1 hour after brushing with
fluoridated toothpaste and after removing any
prosthesis.
Preventive treatment plan
 Xylitol
 Although the independent variables of unit dose,
frequency of chewing, and time chewing have not
been thoroughly evaluated, patients at high risk
for caries should chew xylitol-containing gum
twice daily for 15 minutes with a total xylitol dose
of 7 to 10 g per day.
Preventive treatment plan
 Combination of xylitol and chlorhexidine
 Elderly partially and completely edentulous
patients with caries and denture stomatitis and/or
angular cheilitis would benefit from chewing gum
containing both xylitol and chlorhexidine. Since
the product studied by Simons et al is not
currently available in the United States, the use of
xylitol gum daily and 10 ml of a 0.12% rinse of
chlorhexidine 1 day a week is a viable alternative.
Preventive treatment plan
 Amorphous calcium phosphate
 Although studies of CCP-ACP are somewhat
controversial, there appears sufficient evidence of
caries reduction potential to recommend its use,
especially in patients with root exposure.
Application follows the use of fluoridated
toothpaste twice a day using a cotton swab, a
finger, or a custom tray.
Preventive treatment plan
 Stimulation of salivary flow
 Patients with diminished saliva flow should be
counseled managing the condition, including the
advantages of a low-sugar diet and on possible
relief provided by the products discussed above.
Sipping frequently on water that contains two
teaspoons of baking soda in 8 oz of water will
help hydrate the mouth and neutralize bacterial
acids generated in the plaque.
Conclusion
 Management of caries risk may include patient
behavioral modification, chemical control of
the biofilm, stimulation of salivary flow, and/or
the supplement of constituents to favor
remineralization over demineralization.
 Successful management of the patient’s caries
risk will ultimately result in more enduring
prosthodontic outcomes.

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60번 주강욱 예방논문2 발표

  • 1. CARIES RISK ASSESSMENT AND MANAGEMENT FOR THE PROSTHODONTIC PATIENT 5조 60. Kanguk Joo
  • 2. Purpose of this article  To review how caries risk assessment of the prosthodontic patient can result in meaningful caries management and a more favorable prosthodontic outcome.  To outline considerations on caries risk assessment for improved caries management in the prosthodontic patient.
  • 5. Preventive treatment plan  Involve the patient in disease control  The importance of a caries reduction program during and following prosthodontic treatment should be thoroughly discussed with the patient prior to initiating treatment.  Fluoride in various forms  In prosthodontic patients with gingival recession with other risk factors for caries, a fluoride varnish on root surfaces three times annually is warranted.
  • 6. Preventive treatment plan  Chlorhexidine  Because of staining and impact on taste, chlorhexidine use should be limited to seven consecutive days a month. Recommended dosage is 10 ml of a 0.12% rinse for 1 minute at night at least 1 hour after brushing with fluoridated toothpaste and after removing any prosthesis.
  • 7. Preventive treatment plan  Xylitol  Although the independent variables of unit dose, frequency of chewing, and time chewing have not been thoroughly evaluated, patients at high risk for caries should chew xylitol-containing gum twice daily for 15 minutes with a total xylitol dose of 7 to 10 g per day.
  • 8. Preventive treatment plan  Combination of xylitol and chlorhexidine  Elderly partially and completely edentulous patients with caries and denture stomatitis and/or angular cheilitis would benefit from chewing gum containing both xylitol and chlorhexidine. Since the product studied by Simons et al is not currently available in the United States, the use of xylitol gum daily and 10 ml of a 0.12% rinse of chlorhexidine 1 day a week is a viable alternative.
  • 9. Preventive treatment plan  Amorphous calcium phosphate  Although studies of CCP-ACP are somewhat controversial, there appears sufficient evidence of caries reduction potential to recommend its use, especially in patients with root exposure. Application follows the use of fluoridated toothpaste twice a day using a cotton swab, a finger, or a custom tray.
  • 10. Preventive treatment plan  Stimulation of salivary flow  Patients with diminished saliva flow should be counseled managing the condition, including the advantages of a low-sugar diet and on possible relief provided by the products discussed above. Sipping frequently on water that contains two teaspoons of baking soda in 8 oz of water will help hydrate the mouth and neutralize bacterial acids generated in the plaque.
  • 11. Conclusion  Management of caries risk may include patient behavioral modification, chemical control of the biofilm, stimulation of salivary flow, and/or the supplement of constituents to favor remineralization over demineralization.  Successful management of the patient’s caries risk will ultimately result in more enduring prosthodontic outcomes.