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

• Stopping new caries lesions from showing

• Stopping current 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 threat elements

• Being alert to modifications at each tooth and affected person threat ranges by way of periodic monitoring

• Bettering well being consequence for sufferers 

Bettering the oral well being routine and weight loss program

Each affected person needs to be educated in learn how to care for his or her tooth and gums.  The dental group needs to be in control of serving to sufferers perceive what’s concerned in an efficient every day routine. ¹

This contains oral hygiene practices equivalent to toothbrushing with a 1450ppm fluoride toothpaste very last thing at night time and at one different day through the day.  Sufferers must also be inspired to wash in between their tooth interdentally as soon as a day. ¹

For these sufferers at larger threat of caries, a fluoride mouthwash could also be suggested.  Sufferers needs 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 threat of caries, or with earlier historical past of caries must also 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 threat of caries embody chewing sugar free gum with xylitol. This can assist promote saliva movement. ²

Excessive fluoride toothpaste

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

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

It’s a proactive resolution for these sufferers at a number of caries threat ^{4, 5, 6} which have had interrupted care because 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 outdated at excessive threat of caries, both at current or sooner or later. ¹

Be taught extra about prescribing excessive fluoride toothpaste right here: Excessive fluoride toothpaste on prescription [hyperlink]

Excessive fluoride varnish

Fluoride varnish 2.2% NaF (sodium fluoride) therapies are extra typically utilized to youngsters who’re vulnerable to caries, or who’ve lively caries.  Nonetheless, many peer reviewed research present that caries in adults is similar to that of younger individuals. 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 threat elements, are all suggested to undertake twice-yearly fluoride varnish therapy. ¹

Fluoride varnish is among the greatest choices for rising the provision of topical fluoride, whatever the ranges of fluoride within the water provide.   There may be 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 identified with decay during the last 24 months needs to be thought-about at elevated threat for caries and could be thought-about for prime fluoride varnish therapy. ⁸

Clinicians needs to be conscious that there are a lot of fluoride varnishes available on the market that is probably not licensed for caries management, though they could have comparable formulations. This needs to be considered with respect to prescriber’s duties. 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 have been launched within the Nineteen Sixties to assist forestall 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 varieties a tough defend that retains meals and micro organism from stepping into the tiny grooves within the tooth and inflicting decay. ¹⁰

It’s endorsed that pit and fissure sealants be utilized to reasonable or excessive caries threat youngsters. ³

You’ll be able to inform sufferers which tooth are being sealed after you’ve gotten examined them and checked whether or not the fissures are deep sufficient for sealing to assist.  Some tooth naturally have deep grooves which can should be sealed; others have shallow ones which is not going to 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 Evaluation and Meta-Evaluation of the Position of Sugar-Free Chewing Gum in Dental Caries. JDR Medical & 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.windows.net/docs/993ca2d10345c940c4649fd8c98042f68fe00d51
5. Colgate-Palmolive (U.Ok.) Ltd (2014) ‘Duraphat® 5000ppm Fluoride Toothpaste’, Package deal Leaflet: Info for the consumer, on-line at https://mhraproducts4853.blob.core.windows.net/docs/f7686217b083fc71959d19152bb6eab6ea5dad82.
6. Colgate-Palmolive (U.Ok.) Ltd (2020) ‘Abstract of Product Traits,’ Duraphat 2800ppm fluoride toothpaste. On-line at https://mhraproducts4853.blob.core.windows.net/docs/c0e452136f37b21ae14dae330bc55c62b0e931fb
7. Thomson WM. Dental caries expertise in older individuals 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 medical suggestions: Sufferers at elevated threat for creating 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. Revealed 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/products/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.

This marketing campaign is delivered by the Oral Well being Basis, a charity creating more healthy communities by delivering higher oral well being. The marketing campaign is sponsored by Colgate-Palmolive.