Caries prevention methods

1. Strategies for controlling
dental caries
GROUP MEMBERS:
ALISTAIR WALKER
MICKELLA HOULBERT
CURT DALEY
SHANIQUE DUNSTAN
TAHJAY RODRIQUES
GAIL WILLIAMS
MARLON JUNIOR WILLIAMS

2. Dental Caries
 According to Shafer it is defined microbial disease of calcified tissues of the teeth,
characterized by demineralization of the calcified tissues and destruction of the
organic teeth
 According to Sturdevant it is an infectious microbiological disease of the teeth
that results in localized dissolution and destruction of calcified tissues.

3. Stages of Dental caries
 Dental Caries have different stages as listed below
 Stage 1: White Spots- appearance of chalky white areas on the surface of the
tooth due to the loss of calcium and build-up of plaque.
 Stage 2: Enamel Decay- enamel starts breaking underneath tooth’s surface,
remineralization process is unable to restore proper enamel and minerals
 Stage 3: Dentin Decay: when dentin becomes affected, persons may experience a
sharp pain

4.  Stage 4: Pulp Involvement- infected pulp of tooth with bacteria can result in an
abscess which inadvertently kills blood vessels and nerves in the tooth.
 Stage 5: Abscess Formation: Final stage of tooth decay and extremely painful. Oral
surgery may be recommended based on the extent of the abscess
 Stage 6: Tooth loss- If dental caries is left untreated, tooth loss may happen as a
result

5. Strategies for
caries prevention

6.  Fluoride treatment
 Reduci frequent consumption of sugary food
 Application of pits and fissure sealants
 Caries vaccination
 Good oral hygiene

7. Fluoride treatment
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8. What is fluoride?
 Fluoride is a natural mineral that
builds strong teeth and prevents
cavities. It’s been an essential oral
health treatment for decades. Fluoride
supports healthy tooth enamel and
fights the bacteria that harm teeth and
gums.

9. How much
fluoride do you
need?
 The American Dental Association (ADA)
recommends a professional fluoride
treatment at your dentist’s office every 3, 6,
or 12 months, depending on your oral
health. If you’re at high risk for cavities, your
dentist may also prescribe a special fluoride
rinse or gel to use regularly at home.

10. Common
sources of
dietary
fluoride
include:
tea
water
food cooked in water
fish eaten with their bones
infant formula
Fluoridated toothpaste and mouth rinses are also
major sources of fluoride

11.  Optimal fluoride intake comes from food, water, and supplements. The Mayo
Clinic states the following recommended daily amounts of fluoride:
 Birth to 3 years of age: 0.1 to 1.5 milligrams (mg)
 4 to 6 years of age: 1 to 2.5 mg
 7 to 10 years of age: 1.5 to 2.5 mg
 Adolescents and adults: 1.5 to 4 mg

12. What happens during a professional fluoride
treatment?
 Dentists provide professional fluoride treatments in the form of a highly
concentrated rinse, foam, gel, or varnish. The treatment may be applied with a
swab, brush, tray, or mouthwash.
 Fluoride treatment is recommended for children ages 6 months to 16 years.
 These treatments have much more fluoride than what’s in your water or
toothpaste. They only take a few minutes to apply. You may be asked to avoid
eating or drinking for 30 minutes after the treatment so the fluoride can fully
absorb.

13. Reduce the consumption of
sugary foods

14. Sugary foods
Reduce frequent consumption of sugary food to prevent bacteria from producing an acidic
environment which causes the tooth to be demineralise and more susceptible to caries.
REDUCE FREQUENT
CONSUMPTION OF
SUGARY FOOD AND
DRINKS SUCH AS:
COOKIES SWEETS CAKES CHIPS ICE CREAM
SODAS

15. Increase the cosumption of cariostatic or anticariogenic food. These food prevent
bacterial fermentation inhibiting acid production thus preventing demineralisation.
Raw high fibre
vegetable (spinach,
lettuce cucumber)
Eggs
Nuts Cheese Milk
Water

16. Pits and fissure sealants

17. Pit and Fissure Sealants
 Dental Sealants or Pit and Fissure sealants are named after the location they are
placed in, these are materials that are placed and bonded in the occlusal pits and
fissures of teeth which are susceptible to caries.

18. The dental sealants are classified into
different types based on four factors:
 Based on Polymerization methods:
 . First Generation: UV light
 . Second Generation: Self Cure
 . Third Generation: Visible light
 . Fourth Generation: Fluoride releasing
 Based on Resin Systems:
 . BIS-GMA
 . Urethane acrylate

19.  Based on the presence of a filler:
 . Filled
 . Semi-Filled
 Based on Color:
 . Clear
 . Tinted

20. Materials Used in Pit and Fissure Sealants:
 . GIC or Glass Ionomer Cement
 . Flowable resin composite
 . Compomer

21. Ideal Requirements of Sealants:
 High Flow properties
 Good and prolonged adhesion to Enamel
 Good working time
 Low sorption and solubility to oral fluids

22. Steps to Apply Pit and Fissure Sealants:
 Cleaning and Isolation of Tooth: Clear any food debris which might be stuck in the
fissures, next use a prophy cup and pumice with water or any tooth paste to clean
the occlusal surface of the tooth. Clean the surface with water spray and dry using
air syringe.
 Enamel Etching: This is an important step to achieve microporosities within the
enamel. Apply 37% phosphoric acid gel or liquid form to the pits and fissures for
20 seconds and then wash and dry the tooth surface.

23.  Application of Sealant: Apply sealant material based on the material used Use a
probe or painting brush to guide the sealant material into the fissures. In case of
self-curing sealants like GIC you need to keep the area isolated to prevent any
contamination with saliva and avoid air bubbles. In the case of using a light
activated sealant you need to cure the material in visible light.

24.  Re-evaluation of Sealant: This is an important step to inspect the sealant
placement, on some cases there might be pockets or pits left over even after
placement of sealant. Make sure that all pits and fissures are covered, do not let
sealant extend over marginal ridge of the tooth. Check for high points to prevent
occlusal interference using articulating paper.

25. Caries

26. WHAT IS THE CARIES VACCINE?
 Caries vaccine is a vaccine to prevent and protect against tooth decay

27. Mechanism of Action of the Vaccine
 Salivary Immunoglobulins may interact with bacterial surface receptors and inhibit
colonization. This would reduce plaque formation by inactivating surface
glucosyltransferases thus reducing synthesis of extracellular glucans.
 Secretory IgA from salivary glands due to direct immunization of gut associated
lymphoid tissue (GALT). This will inhibit the activity of glucosyltransferase by
preventing the formation of dextran.
 Gingival crevicular mechanism- All humoral and cellular components of the
systemic immune system that exerts its function at the tooth surface.

28. ROUTES OF IMMUNIZATION
 ORAL ROUTE
 SUBCUTANEOUS (SYSTEMIC ROUTE)
 PASSIVE DENTAL IMMUNIZATION ROUTE
 INTRANASAL ROUTE

29. INTRANASAL ROUTE
 The vaccine is introduced to the mucosal immune system via nasal spray.
 This causes increased production of IgA which helps to prevent dental caries by
interrupting the colonization of S. Mutans.
 This induces both systemic and mucosal immunity.


30. PASSIVE DENTAL IMMUNIZATION
 This route external or passive supplementation of antibodies and carries the
disadvantage of repeated applications bacause the immunity provided is
temporary.


31. SUBCUTANEOUS ROUTE
 This was successfully administered in monkeys and evoked predominately IgA,
IgG, and IgM. The antibodies use the gingival crevicular fluid to locate the oral
cavity and effectively prevent dental caries


32. ORAL ROUTE
 The antigen may be introduced orally via, oral feeding, gastric intubation, or in
vaccine containing capsules or liposomes.
 This route failed to reduce caries significantly (when compared to the
subcutaneous route). Experiments in humans of ingestion of S. Mutans in gelatin
capsules resulted in the rise of secretory antibodies although a small mount and
of short duration.
 Immunological memory in secretory IgA is limited.


33. ADVANTAGES
 Cost effective
 Has the potential to be incorporated universally with an immunization programme
 Prevents caries in children
 Is said to provide life-long immunity


34. DISADVANTAGES
 Microbial resistance
 The effectiveness of the vaccine may be considered questionable because caries is
multifactorial and the clinical trials are few and concentrate mostly on Strep.
Mutans.
 Risk of hypersensitivity
 Risk of cross reactivity of certain antigenic components of S. Mutans with heart
tissue (structurally similar to myosin)

35. Good Oral hygiene

36. Brush Regularly but NOT Aggressively
 Most people are aware that brushing their teeth twice a day is one of the most
important practices for removing plaque and bacteria and keeping teeth clean.
 However, brushing may only be effective if people use the correct technique.

37.  People should brush using small circular motions, taking care to brush the front,
back, and top of every tooth.
 This process takes between 2 and 3 minutes.
 People should avoid sawing back-and-forth motions.

38.  Brushing too hard or using a hard-bristled toothbrush can damage tooth enamel
and the gums.
 The effects of this may include tooth sensitivity, permanent damage to the
protective enamel on the teeth, and gum erosion.

39.  The American Dental Association (ADA) recommend using a toothbrush that has
soft bristles.
 They also state that people should change their toothbrush every 3 months or
when the ends start to look frayed, whichever comes first.

40. Floss once a day
 Flossing can remove plaque and bacteria from between the teeth, where a
toothbrush is unable to reach.
 It can also help prevent bad breath by removing debris and food that has become
trapped between the teeth.

41.  Most dental health professionals recommend gently pushing the floss all the way
down to the gum-line before hugging the side of the tooth with up-and-down
motions.
 It is important to avoid snapping the floss up and down between the teeth, which
can cause pain and will not remove plaque as effectively.

42. See a Dentist Regularly
 Experts recommend that people see a dentist every 6 months for a checkup.
During a routine dental examination, a hygienist will clean the teeth and remove
plaque and calculus (hardened tartar).
 The dentist will check for visual signs of cavities, gum disease, mouth cancer and
other oral health issues. They may sometimes also use dental X-rays to check for
cavities.

43. Consider A Mouthwash
 Some studies indicate that certain mouthwashes can benefit oral health.
 For example, one review found that mouthwash containing chlorhexidine, an
antibacterial ingredient, helps control plaque which may lead to tooth decay.

44. Tips for kids
 Wipe a baby’s gums with a warm, wet washcloth every day, even before they have
any teeth.
 Babies and toddlers should not go to bed with bottles or sippy cups.
 As a baby approaches 1 year of age, start getting them used to a sippy cup.
 Allow toddlers to sip water from sippy cups between meals, but save juice or milk
for meal times only.

45.  Once a baby has teeth, brush them twice a day with a soft baby toothbrush.
 Parents or caregivers should brush the child’s teeth for them until they can clean
all of their teeth thoroughly without help.
 Keep the toothpaste out of children’s reach when it is not in use.
 The ADA recommend that children see a dentist within 6 months of their first
tooth appearing or at 1 year of age, whichever comes first.

46.  Parents and caregivers should not share eating utensils with a child or clean
pacifiers by putting them in their mouth.

47. References
 Admin. (2016, July 20). Six Top Tips To Maintain Good Oral Hygiene And Take Care
Of Your Teeth And Mouth! Retrieved from
https://www.grandcanaldentalclinic.ie/six-top-tips-maintain-good-oral-hygiene-
take-care-teeth-mouth/
 Friedman, M. (2019, March 19). Tooth Decay Prevention: 8 Daily Dental Care Tips.
Retrieved from https://www.webmd.com/oral-health/guide/tooth-decay-
prevention