PREVENTION OF DENTAL CARIES

NAME:HUDA KHAN ROLL # : 753

DENTAL CARIES
irreversible infection usually bacterial in origin that causes demineralization of the hard tissues (enamel, dentin and cementum) and destruction of the organic matter of the tooth, usually by production of acid by hydrolysis of the food debris accumulated on the tooth surface .

ETIOLOGIC FACTORS IN DENTAL CARIES

Dental caries is a multifactorial disease in which there is an interplay of 3 principle factors. I. The host ( teeth, saliva etc.) II. Micro flora (bacteria ,streptococcus mutan) III. Substrate (diet) In addition the fourth factor, time must be considered.

CRITERIA OF CLASSIFICATION

Location Rate Of Progression According to whether lesion is new one or is occuring around restoration G.V. Blacks classification

According to Location
Pit and Fissure Caries

Smooth Surface Caries

Root caries

ACCORDING TO RATE OF PROGRESSION

Acute Dental Caries

Chronic Dental Caries Arrested dental caries

According to whether lesion is new one or is occuring around restoration

PRIMARY (virgin) CARIES : Any new carious lesion on tooth surface

SECONDARY (recurrent) CARIES:Caries of enamel beginning at the dentoenamel junction due to a rapid lateral spread of decay from the original decay

G.V. BLACKS CLASSIFICATION

Class I Occlusal Pit and fissure of molars and pre molars Buccal and lingual grooves of molars Lingual surface of anterior tooth Class II Proximal surface of posteriors Class III Proximal surface of anteriors Class IV Proximal surface of anteriors including incisal edge Class V Gingival third of facial and lingual surfaces of all teeth Class VI Self cleansable area of the tooth that is Cusp tip

Dental caries is an irreversible process. It is a disease of modern man and its manifestation persist throughout life. There are various methods of control and prevention of disease. It is always better to prevent rather than to cure.

METHODS TO PREVENT CARIES

1.

2.
3.

Chemical measures Nutritional measures Mechanical measures

Chemical measures include:

I.

Substances which alter tooth surface or tooth structure e.g flourides and iodine

II.

Substances which interfere with bacterial growth and metabolism e.g antibiotic

Fluoride Role in Caries Prevention

Fluoride Most widely used and promising chemical in this category Fluorides have been administrated principally in two ways
a.

b.

Systemic application eg:- School water fluoridation, community water fluoridation, milk fluoridation Topical application eg:- Sodium fluoride, stannous fluoride

A fluoride concentration of 1 ppm in drinking water is associated with a marked decrease in dental caries

Other methods of using fluorides are

As dietary supplementation of fluoride Fluoride dentifrices e.g toothpastes Fluoride in mouth washes/ rinses Fluoride incorporated in chewing gums and dental floss

The effect of fluoride influencing its anticaries actions are:Interference in enzymatic process of bacteria Direct bactericidal action Reduction of plaque formation Enhancement of enamel remineralization Stimulation of formation of large appetite crystal Lowers the solubility of enamel

Iodine Used as a antibactericidal mouth rinses Kills microorganisms immediately Disadvantages : metallic taste, stain metallic or composite restorations

Antibiotics

Penicillin:- as an anticariogenic compound, act on cell wall synthesis disadvantage: resistance Erythromycin:- act on bacterial protein synthesis Disadvantage: diarrhoea and resistance

Kanamycin:- act on bacterial protein synthesis. It reduced S. Mutans and S. Sanguis population in plaque Disadvantage: nephrotoxicity and ototoxicity Others:- spiramycin, tetrcycline, vancomycin

NUTRITIONAL MEASURES
The chief nutritional measures advocated for the control of dental caries is restriction of refined carbohydrate intake.

Other measures include - Avoiding sugar that retains of teeth surface - Avoiding sugar in between meals - Eating of phosphated diets

MECHANICAL MEASURES

1. 2. 3. 4. 5.

This refers to procedures specifically designed for and aimed at removal of plaque from tooth surface methods for cleaning tooth mechanically are: Prophylaxis by dentist Tooth brushing Mouth rinsing Use of dental floss or tooth picks Pit and fissure sealants

Dental prophylaxis Careful polishing of roughened smooth surface and correction of faulty restoration decreases the formation of bacterial plaque and there by reducing the development of new carious lesion
Tooth brushing Types of tooth brushing Manual
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Powered

How Much Toothpaste?

Mouth rinsing

Use of mouth wash for the benefit of its action in loosening food debris from teeth has been suggested to be of value as caries control measures.

Dental floss
Dental

flossing is effective in removing plaque and dislodge the irritating matter that is real source of disease.

Pit and Fissure Sealants

A dental sealant is a clear or white, liquid-plastic material applied on the chewing surfaces of the back teeth. This plastic resin bonds into the depressions and grooves (pit and fissure) of the teeth surfaces making them smooth and much easier to clean by brushing.

Purpose of Sealant

Resin sealant acts as a physical barrier to prevent oral bacteria and their nutrients from collecting within a pit or fissure and creating the acid which initiates dental caries

Sealants ;