Current Concepts in Caries Prevention
Dental caries is a national and global public health epidemic, affecting both children and adults from all races, ethnicities, and socioeconomic levels. Oral health professionals, as well as medical providers, play critical roles in identifying high-risk behaviors and providing patient-specific education and counseling to improve prevention rates. See how familiar you are with strategies for caries prevention.
Preventing Dental Caries
Dental caries is a national and global public health epidemic, affecting both children and adults from all races, ethnicities, and socioeconomic levels. Oral health professionals, as well as medical providers, play critical roles in identifying high-risk behaviors and providing patient-specific education and counseling to improve prevention rates. See how familiar you are with strategies for caries prevention.
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Sobering Statistics
Among children in the United States, caries is the most common unmet health need, with a prevalence of more than 25% among children age 24 months to 60 months. Children between the ages of 12 months and 30 months have a unique pattern of caries development that differs from older children. Early childhood caries within this age group is distinguished by lesions found on the maxillary primary incisors and first primary molars, reflecting the pattern of eruption.
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Risk Assessment
Identifying a child’s caries risk is an effective and evidence-based approach to disease prevention and management. Caries management by risk assessment (CAMBRA) enables oral health professionals to recommend patient-tailored therapeutic, restorative, oral hygiene, educational, and nutritional approaches for pediatric patients and their parents/caregivers.
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Fluoride Protection
Protective modalities, specifically topical fluoride, should be employed to inhibit demineralization, promote remineralization, and obstruct the formation of cariogenic plaque especially among high-risk patients. The AAPD recommends that all children use fluoride toothpaste twice daily, regardless of caries risk. The frequency of fluoride varnish (5% NaF) application is determined by the child’s caries risk. Application intervals for pediatric patients at high-caries risk are typically every 3 months to 6 months.
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Establish a Dental Home
The dental home should be established no later than 12 months and includes referral to specialists when appropriate. An anticipatory approach emphasizing oral health promotion through guidance and parental/caregiver education is likely to have the greatest impact on children’s oral health. Preventive care visits can be used to reinforce the necessity and importance of maintaining routine dental examinations and prophylaxes, as well as to educate parents/caregivers on proper oral hygiene techniques and behavioral and social risk factors.
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Collaboration Is Key
Medical professionals need to incorporate oral health assessments into their preventive appointments to reinforce oral health-promoting behaviors, apply fluoride varnish, and facilitate the establishment of a dental home. The majority of states reimburse nondental professionals for caries-prevention services performed during the medical appointment.
What about adults that are high risk? Should fluoride be provided to all despite the risk?
sad the Silver Diamine Fluoride was overlooked and included in this article. It really is the most effective way to arrest caries prevent more from starting. Perhaps another more up to date article should be written.
Thank you so much