Caries Prevention Modalities


Fluoride exposure must first be considered in an optimal environment, individual drinking water should be around 0.7-1.2mg/L, it has been found that non-fluoridated communities are in the range of 0-0.3 mg/L.  To remedy this other methods must be considered to help protect the teeth; fluoridated(F-) tooth paste, F-mouth rinses, F- their own water, higher recall for preventative placement all needs to be considered.

Further measures include Tooth Mousse (CPP-ACP)-> Super-saturated concentration of Ca+ and phosphate / is effective for the reminierization within tooth structure, such as dentine / helps to arrest + stop any continued demineralization / inhibits cariogenic bacteria.

Skygate Dental Emergency Cavity

Skygate Dental Emergency Cavity

Duraphat -> A resin based high concentration 22,300 ppm F-, is effective for long term exposure (months) slowly releasing F / ideal larger lesions + breakdown / high concentration F is also has an inhibitory affect on cariogenic bacteria.

Fluoride -> Preventative measure such as topical F- 9000 ppm -> help to provide an initial topical F affect, help to arrest any current lesions + provide future protection

Oral Hygiene -> Along with emphasis on blushing, flossing, etc must be included -> To reduce the time that plaque is in contact with tooth surfaces / to limit demineralisation

A dietary analysis and salivary test may be of benefit -> It may be that the child has a very high cariogenic diet this should be remedied / further / it maybe that a pathological cause is effecting his/her saliva / this should be diagnosed + assessed / through saliva function test / then determine if saliva substituted + other measures are warranted.

Initially a high recall 3 months, to monitor the disease process -> help to continue to monitor / apply conservative treatment to limit any further progression of disease.

Methods to Ensure Adequate Fluoridation And Appropriate Age

 Drinking Water

– Ensure home water is 0.6-1.1 mg/L fluoridated

                  – If non-F community -> Dissolve 1 mg F (1 2.2 mg NaF) in 1L water

– Encourage water in preference to sweet drinks

Rinses

– Not Applicable -> Only for > 6 Years Old / elevated risk / not a substitute for brushing / not to be swallowed

Gels and Foam

– Not Applicable -> Only for > 10 Years Old / High risk / other F- vehicles not available

Tablets + Drops

– Not Applicable -> No longer advocated -> high risk of Fluorosis / little evidence of benefit if optimal drinking water

Toothpastes

– Criteria: >18 months to 5 years, cleaned twice a day with toothpaste 0.4-0.5 mg F/g / based on the risk guidelines maybe varied if No F in water /

– Rationale: Very effective in caries prevention / successful population strategy / added benefit

– Mode: To soft child tooth brush / child should spit not swallow

– Application: Pea sized amount 250 ppm-400ppm

Varnishes  

– Criteria: Varnish / elevated risk / can be used under age of 10

– Rationale: Hypersensitive / WSL / High risk / Primary + Permanent / No fluorosis with 2x years

– Mode (1): Duraphat / F in alcohol + resin / plaque acts as reservoir / 22,600 ppm / bind to enamel / slow release

– Mode (2): Clinpro XT / Resin modified GIC / F+Ca+P / slow F / 22600ppm

– Application: Primary dentition: 0.25 mL

If you wish for more information on dental emergency or if you have any dental queries please do not hesitate to contact Skygate Dental today on (07) 3114 1199 or 0406 579 197.