Dental Caries Oral Hygiene and Preventive Measures

Published on December 26, 2011 by

“Dental caries can be prevented by good oral hygiene and regular professional care, and can be effectively treated by adequate brushing and flossing of the teeth and by the use of fluoride based oral care products.” Mouth rinses, gels, and toothpastes, when used in conjunction with tooth brushing and flossing, are probably adequate to deliver the needed preventive measures. If the carious lesion reaches the underlying dentin layer of the tooth a dentist will treat it. The dentist will place a filling (amalgam or composite) to restore proper functioning of the tooth.  
The role of fluoride in caries prevention has been extensively documented. The decrease in dental caries that occurs after adding fluoride to the water supply is by and large accredited to the fluoride molecule being substituted for hydroxyl molecules in the tooth enamel, forming fluorapatite in the place of hydroxyapatite. Fluorapatite is less acid soluble than hydroxyapatite, causing enamel to demineralise more slowly when under attack by plaque. Fluoride containing enamel also remineralizes more quickly between the times it is being bombarded with sugar. This does not explain all of the mechanisms of action of fluoride.
More recently the spotlight has shifted to deleterious effect on fluoride on tooth development. The prevalence of fluorosis in infants and young children is increasing. The increase in fluorosis among infants and children in both fluoridated and non-fluoridate communities has led to the following recommendations: 1) the use of low-fluoride water in infant formulas; 2) adult supervision of children during brushing; and 3) rigid fluoride application standards when administering fluoride supplements to children. Nonetheless, community water supply fluoridation is the most effective way to prevent dental caries.
When neutral 1.0% sodium fluoride was used on a daily basis by high risk adults (i.e., those with mouth dryness after jaw carcinoma radiation), the finding was minimal to zero dental caries. Children, aged five to six years were treated with 1.2% F- fluoride gel versus a placebo gel twice daily, and the children receiving fluoride showed approximately 40% caries reduction when compared to the placebo group after a 2 year period; S mutans (the bacteria that causes decay) were also lower.  Thorough cleaning with the fluoride paste significantly reduced the streptococci (sanguismitis, and mutans), preventing colonization of these bacteria. Higher fluoride paste doses (i.e., 5%) instantly stop these bacteria. Also interesting, is that fluoride levels of 1-5 ppm stopped oral streptococci at low pH levels. These doses are commonly found in people using fluoridated oral care products and/or fluoridated water. For more in depth prevention measures, visit your dentist!

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