This presentation discusses strategies for preventing dental caries, including primary, secondary, and tertiary prevention. It outlines risk factors for dental caries and methods for clinical diagnosis. It also discusses management approaches for different types of caries and the potential use of vaccines to stimulate protective antibodies against Streptococcus mutans to help prevent dental caries.

1. Presentation by:
Ritam Chakraborty
3rd year BDS student
HALDIA 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

2. In spite of widespread awareness, dental caries is still the second most common
disease of human civilization after common cold
-According to WHO
Dental caries is a preventable disease of the mineralized tissues of the teeth with
a multi-functional etiology related to the interactions over time between tooth
substance & certain micro-organisms & dietary carbohydrates producing plaque
acids.
This paper aims to throw light on various modalities of caries prevention

3. Steps of caries prevention

4. &……
VACCINATION

5. PRIMARY PREVENTION
Primary 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.

7. 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 buffering
High 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 cleaning
Low 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

10.  Dental health education
 Oral hygine
 Diet & sugar consumption
 XYLITOL
 Sugar-free chewing gum
 Sugar-free medicines

11.  Sealants
 Fluoride tablets & toothpastes
 Topical vaccines
 Chlorhexidine

12. SECONDARY PREVENTION
Secondary 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

13. 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

14.  Accurate diagnosis & monitoring of
lesions over time is required for
effective prevention

15. CLINICAL DIAGNOSIS
o Transillumination
o Flossing
o Temporary restoration of the tooth
(eg. With a wooden wedge or
orthodontic separator)

16. Can be divided into three carious sites ->
 Occlusal caries
 Approximal caries
 Smooth surface caries

17. 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.

18. 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.

19. MANAGEMENT OF SMOOTH-SURFACE CARIES
o Twice daily use of a toothpaste containing 1ooo ppm
of fluoride.
o Plaque removal
o Dietary advice

20. The diagnosis of secondary caries is extremely difficult
& clear evidence of involvement of active disease
should be ascertained before replacing a restoration.

21. 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

22.  Vaccines are an immuno-biological substance designed to produce
specific protection against a given disease.
 Stimulates the production of protective antibodies.

23. ROUTES OF IMMUNIZATION
In general,two types of immunization have been used with S. mutans :
 Active immunization
 Passive immunization

24. Common mucosal Systemic route of Active gingivo-
Immune system Immunization salivary route
 Oral route
 Intranasal route
 Tonsillar route
 Minor salivary gland
 Rectal

25.  Monoclonal antibodies
 Bovine milk and whey
 Egg- yolk antibodies
 Transgenic plants
(genetically modified tobacco plant)

26. 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

27.  Synthetic peptides
 Coupling with cholera toxin subunits
 Fusing with salmonella
 Microcapsules and microparticles
 Liposomes

29. 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