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 in depth caries phases

• Managing caries danger components

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

• Bettering well being consequence for sufferers 

Bettering the oral well being routine and eating regimen

Each affected person must be educated in how one can care for his or her tooth and gums. The dental staff must be answerable for serving to sufferers perceive what’s concerned in an efficient every day routine. ¹

This consists of oral hygiene practices resembling toothbrushing with a 1450ppm fluoride toothpaste final thing at evening 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 danger of caries, a fluoride mouthwash could also be suggested. Sufferers must 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 must also be suggested to cut back the quantity and frequency of sugar (carbohydrate) consumption. ¹ This consists of limiting sugar consumption to mealtimes and being discouraged from unhealthy snacking.

One other behaviour behavior that may assist sufferers at elevated danger of caries embody chewing sugar free gum with xylitol. This may also help promote saliva move. ²

Excessive fluoride toothpaste

Prescription excessive fluoride toothpaste is a straightforward, evidenced-based means for serving to forestall 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 technique of early intervention. ¹

It’s a proactive answer for these sufferers at a number of caries danger ^{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 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) remedies are extra typically utilized to youngsters who’re liable to caries, or who’ve energetic caries. Nevertheless, many peer reviewed research present that caries in adults is corresponding to that of younger folks. ⁷

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

Fluoride varnish is without doubt one of the greatest choices for growing the supply 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 recognized with decay during the last 24 months must be thought of at elevated danger for caries and will be thought of for top fluoride varnish therapy. ⁸

Clinicians must be conscious that there are a lot of fluoride varnishes in the marketplace that might not be licensed for caries management, though they might have related formulations. This must 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 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 kinds a tough defend that retains meals and micro organism from moving into the tiny grooves within the tooth and inflicting decay. ¹⁰

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

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

---

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 Evaluate and Meta-Evaluation of the Function 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.Okay.) 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.Okay.) 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.Okay.) 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 massive 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. Revealed November 01, 2013.
9. Colgate-Palmolive (U.Okay.) 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.