Preventive Measures Take Center Stage in Fight Against Caries

According to recent statistics, 2.5 billion people worldwide have untreated caries in their permanent teeth. Additionally, tooth decay is present in the primary teeth of 573 million children.

Caries develops when the oral cavity becomes acidic as a result of the breakdown of sugars and fermentable carbohydrates by bacteria such as Streptococcus mutans. This lowers the pH in the mouth, leaving teeth vulnerable to acid attack. Unfortunately, the typical American diet is loaded with these foods.

TRADITIONAL REMEDIES

Damage caused by caries has long been addressed through restorative care. In fact, developments in restorative materials have resulted in biodynamic resins and other formulations, including silver diamine fluoride, that are capable of defending tooth structure from further assault and even effecting repairs.

But for cases of incipient caries lesions, the drill-and-fill mindset is being replaced in many instances by innovative, preventive measures.

PREVENTION INTERVENTIONS

Designed to ward off the development of dental caries, multifaceted preventive approaches include improvements in diagnostics and access to care; dietary evaluations; collaborative approaches to treatment; early screening of young children; identification of those most at risk through caries management by risk assessment; regular dental visits and prophylaxes; and clinical application of fluoride varnishes and sealants.

But much can be done by patients at home to prevent tooth decay. Dental hygienists are especially well equipped to educate patients on proper and consistent self-care regimens using good brushing and interdental cleaning techniques, and the use of fluoride. Helping caregivers/patients choose a toothbrush with a handle that supports correct brushing technique and that includes tapered bristles is key. Toothbrushes designed for kids can go a long way in nudging young patients into good oral care. Designed for small hands, colorful toothbrushes may resemble crayons or cartoon characters, and some feature timer lights to help educate young children about how long to brush.

For patients who are averse to flossing, suggesting interdental cleaners, such as brushes and picks, can make all the difference in promoting oral health and preventing caries.

CHEW ON THIS

In addition to the traditional dental artillery aimed at curbing cariogenic activity, recent evidence appears to confirm that in sugar-free chewing gum, oral health practitioners have a friend. Research done at King’s College London indicates that sugar-free gum reduced the incidence of caries in children and adults.

“No recent conclusive evidence existed prior to this review that showed the relationship between slowing the development of caries and chewing sugar-free gum,” explains the study’s lead author, Avijit Banerjee, BDS MSc PhD (Lond) LDS FDS (Rest Dent) FDSRCS (Eng) FHEA, professor of cariology and operative dentistry at King’s College London in the study published in the November issue of the Journal of Dental Research: Clinical and Translational Research. “Both the stimulation of saliva, which can act as a natural barrier to protect teeth, and the mechanical plaque control that results from the act of chewing, can contribute to the prevention of dental caries.”

In short, while caries may plague humankind for a long time to come, through creative preventive measures, it is possible to stop it in its tracks before it makes its mark.