As a human lives longer also teeth are expected to last and serve us longer.
Prevention of disease is the most cost-effective means of controlling systemic diseases and improving one’s health. The same applies in oral health.
Dental caries or tooth decay can be prevented.
Historically dental caries were primarily treated solely by surgical removal and restoring the tooth with dental filling but research has shown that we can also use medical approach.
Various factors influence dental health. Important is the interaction between harmful and protective factors. Microorganisms, sugar, and unhealthy eating habits are detrimental to dental health, whereas saliva, oral hygiene, and the natural resistance of the teeth represent the protective counterweight. Microorganisms play a key role in the development and progression of caries. Usually, the various types of bacteria in the oral cavity are in equilibrium. The risk of developing disease increases if the number of certain bacteria, i.e. mutans streptococci or lactobacilli, substantially rises, while the protective factors cease to function optimally.
Previous caries experience is a strong predictor of future caries experience. For example, adolescents who had caries in their primary teeth are at higher risk for caries in permanent teeth than those without previous caries.
The Caries Risk Assessment and Prevention Management Program
Dental caries or tooth decay can be prevented and tooth decay in early stages can be arrested or healed. Cavities do not need to be a part of our lives. We use new knowledge and best available evidence in caries and periodontal disease prevention. Teeth can be preserved better throughout the life by careful diagnosis and Caries Management Program (CMP), a preventative program designed for each of our patients. It is a systematic approach designed to recognize individual susceptibility, reduce bacteria and control other factors that cause dental caries. The CMP is highly effective to minimize the risk of developing caries for patients at high caries risk category.
The Caries Risk Test (CRT) is a test of the patient’s saliva performed in the office to measure the levels of the Streptococcus Mutans and Lactobacillus Bacteria present in a patient’s mouth and the salivary flow rate of the patient. This test is done at the first examination and also at recall visits for high risk patients since caries risk changes with stress, diet, medication, illness, saliva flow and pregnancy.
Diet Evaluation
We provide diet assessment and evaluation which part may have been contributing to decay. Foods that contain carbohydrates (sugars and starches) include soda, ice cream, candy, milk, cake, rice, fruits, vegetables and juices. Acidogenic bacteria require sugar or the breakdown of carbohydrates into sugars to thrive. In an oral environment rich in sugars, these bacteria produce acid byproducts that demineralize the tooth surface. This is a dynamic process that is affected by other factors such as frequency of sugar ingestion, salivary buffering, and the presence or absence of arginolytic (alkali-producing) bacteria in the dental plaque biofilm.
The frequency and time of day you ingest carbohydrates can also be a factor.
White Spots/Incipient lesions and Tooth Demineralization
White spots are non-cavitated carious lesions in enamel. White spot lesions, like other incipient lesions, may be actively demineralizing, remineralizing, or arrested. We evaluate white spot and other incipient lesions carefully, record them in the patient’s record, and watch their progress for cavitation or healing. The presence of demineralizing white spot and other incipient lesions may cause us to place the patient in a higher-risk category, set a shorter recall interval for recall, or both.
We design specific preventive protocol for each patient to that helps to heal decay and strengthen tooth structure.
Home Care
Daily home care is especially important before bedtime. We help teach our patients what is best for their particular situation. There are a number of effective brushing techniques. We determine which one is best for you since tooth position and gum conditions vary. In general a toothbrush head should be small, 1″ x ½” for easy access with soft nylon bristles with round ends. Some brushes are too abrasive and wear down teeth. It is more important to brush 2x a day for 3-4 minutes than 5x a day for 1 minute. We recommend brushing at work- keeping a brush at your desk. If you brush with toothpaste in the morning and before going to bed, you don’t need to use toothpaste at work- you can just brush with water and rinse before heading back to your desk. If you don’t have a toothbrush, rinsing with water for 30 seconds -1 minute after lunch is also helpful. Getting the debris off teeth right away is important in stopping sugar snacks and starchy foods from turning into cavity causing sugars and acids. We will make a recommendation on which type of toothbrush, manual or ultrasonic is best for you and let you know how often they should be replaced given the condition of your mouth. Flossing and irrigation removes plaque and debris between teeth. Dental floss comes in many forms, which all clean and remove plaque about the same. Waxed floss or ribbon floss (tape) might be easier to slide between tight teeth or tight restorations. However the unwaxed floss makes a squeaking sound to let you know your teeth are clean. We will review which floss method is best for your mouth, including floss holders, threaders and how often.
