Stopping and managing dental caries in sufferers can fall below many classes. These are:

• Stopping new caries lesions from showing

• Stopping present lesions from advancing additional

• Preserving tooth construction with

• Non-operative care at extra preliminary phases

• Conservative operative care at extra intensive caries phases

• Managing caries danger components

• Being alert to adjustments at each tooth and affected person danger ranges via periodic monitoring

• Bettering well being final result for sufferers 

Bettering the oral well being routine and weight-reduction plan

Each affected person ought to be educated in methods to care for his or her tooth and gums. The dental crew ought to be in control of serving to sufferers perceive what’s concerned in an efficient each day routine. ¹

This contains oral hygiene practices similar to toothbrushing with a 1450ppm fluoride toothpaste very last thing at evening and at one different day in the course of the day. Sufferers also needs to be inspired to wash in between their tooth interdentally as soon as a day. ¹

For these sufferers at greater danger of caries, a fluoride mouthwash could also be suggested. Sufferers ought to be urged to make use of mouthwash as soon as a day, at any time in between brushes. ¹

Affected person teams at excessive danger of caries, or with earlier historical past of caries also needs to be suggested to cut back the quantity and frequency of sugar (carbohydrate) consumption. ¹ This contains limiting sugar consumption to mealtimes and being discouraged from unhealthy snacking.

One other behaviour behavior that may assist sufferers at elevated danger of caries embrace chewing sugar free gum with xylitol. This can assist promote saliva stream. ²

Excessive fluoride toothpaste

Prescription excessive fluoride toothpaste is an easy, evidenced-based means for serving to stop dental caries in adolescents and adults. ^{3, 4, 5} It’s notably suggested for sufferers in danger from a number of caries (coronal and/or root caries). ^{4, 6} 

Excessive fluoride toothpaste is an evidenced-based methodology of early intervention. ¹

It’s a proactive resolution for these sufferers at a number of caries danger ^{4, 5, 6} which have had interrupted care on account of lockdown, to assist keep away from caries deterioration.

Public Well being England’s ‘Delivering Higher Oral Well being’ advises prescription excessive fluoride toothpaste at 5000ppm for sufferers over 16 years previous at excessive danger of caries, both at current or sooner or later. ¹

Study extra about prescribing excessive fluoride toothpaste right here.

Excessive fluoride varnish

Fluoride varnish 2.2% NaF (sodium fluoride) therapies are extra typically utilized to kids who’re susceptible to caries, or who’ve lively caries. Nonetheless, many peer reviewed research present that caries in adults is corresponding to that of younger folks. ⁷

Consequently, Delivering Higher Oral Well being recommends using professionally utilized topical fluorides for all ages.  Adults with apparent present lively caries, dry mouth, these with particular wants, or with different caries danger components, are all suggested to undertake twice-yearly fluoride varnish remedy. ¹

Fluoride varnish is among the finest choices for rising the provision of topical fluoride, whatever the ranges of fluoride within the water provide. There’s additionally high-quality proof of the caries-preventive effectiveness of fluoride varnish in each everlasting and first dentitions. ¹

Any affected person who has been recognized with decay over the past 24 months ought to be thought-about at elevated danger for caries and may be thought-about for prime fluoride varnish remedy. ⁸

Clinicians ought to be conscious that there are numerous fluoride varnishes in the marketplace that is probably not licensed for caries management, though they could have related formulations. This ought to be considered with respect to prescriber’s tasks. ¹ Colgate® Duraphat® Varnish is the one medically licensed (Prescription Solely Medication, POM) varnish which has been clinically confirmed for the prevention of caries. ⁹

Pit and fissure sealants

Dental sealants had been launched within the Nineteen Sixties to assist stop dental caries, primarily within the pits and fissures of occlusal tooth surfaces.  Sealants act to forestall micro organism development that may result in dental decay. ³

A sealant is a protecting composite coating, which is utilized to occlusal surfaces of molars. The sealant kinds a tough protect that retains meals and micro organism from entering into the tiny grooves within the tooth and inflicting decay. ¹⁰

It is strongly recommended that pit and fissure sealants be utilized to average or excessive caries danger kids. ³

You may inform sufferers which tooth are being sealed after you’ve examined them and checked whether or not the fissures are deep sufficient for sealing to assist. Some tooth naturally have deep grooves which is able to must be sealed; others have shallow ones which won’t want sealing. ¹⁰

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Sources

1. Public Well being England (2017) ‘Delivering higher oral well being: an evidence-based toolkit for prevention’, Third Version, UK.
2. Newton JT, Awojobi O, Nasseripour M, et al. A Systematic Assessment and Meta-Evaluation of the Function of Sugar-Free Chewing Gum in Dental Caries. JDR Scientific & Translational Analysis. 2020;5(3):214-223. doi:10.1177/2380084419887178
3. Ahovuo-Saloranta A, Forss H, Walsh T, Nordblad A, Mäkelä M, Worthington HV. Pit and fissure sealants for stopping dental decay in everlasting tooth. Cochrane Database Syst Rev. 2017 Jul 31;7(7):CD001830. doi: 10.1002/14651858.CD001830.pub5. PMID: 28759120; PMCID: PMC6483295.
4. Colgate-Palmolive (U.Ok.) Ltd (2020) ‘Abstract of Product Traits’, Duraphat 5000ppm fluoride toothpaste. On-line at https://mhraproducts4853.blob.core.home windows.internet/docs/993ca2d10345c940c4649fd8c98042f68fe00d51
5. Colgate-Palmolive (U.Ok.) Ltd (2014) ‘Duraphat® 5000ppm Fluoride Toothpaste’, Package deal Leaflet: Data for the person, on-line at https://mhraproducts4853.blob.core.home windows.internet/docs/f7686217b083fc71959d19152bb6eab6ea5dad82.
6. Colgate-Palmolive (U.Ok.) Ltd (2020) ‘Abstract of Product Traits,’ Duraphat 2800ppm fluoride toothpaste. On-line at https://mhraproducts4853.blob.core.home windows.internet/docs/c0e452136f37b21ae14dae330bc55c62b0e931fb
7. Thomson WM. Dental caries expertise in older folks over time: what can the big cohort research inform us? Br Dent J. 2004;196(2):89-92.
8. ADA Scientific Panel points evidence-based scientific suggestions: Sufferers at elevated danger for growing cavities profit from making use of topical fluoride. American Dental Affiliation web site. https://www.ada.org/en/press-room/news-releases/2013-archive/november/ada-scientific-panel-issues-evidence-based-clinical-recommendations. Printed November 01, 2013.
9. Colgate-Palmolive (U.Ok.) Ltd (2020) ‘Colgate® Duraphat® Varnish 50mg/ml Dental Suspension’, on-line at https://www.colgateprofessional.co.uk/merchandise/products-list/colgate-durphat-varnish-50-toothpaste, accessed October 2020.
10. Oral Well being Basis (2020) ‘Pit and fissure sealants’, on-line at https://www.dentalhealth.org/pit-and-fissure-sealants, accessed October 2020.