What is Caries Control?

Caries, also known as dental decay or cavities, is caused by the interplay between the resistance of the tooth to decay, the bacteria present, the exposure to decay causing foods (sugars and carbohydrates), and salivary flow.The bacteria living in the mouth take fermentable carbohydrates (sugars and starches) and break them down into acids, which then demineralize the tooth structure. It essentially burns holes in the teeth. A healthy person with a low bacteria count and a low frequency of exposure to sugars will remineralize these areas utilizing the calcium in saliva. As a result the teeth will remain sound.

 

Risk Factors

  • Previous history of decay
  • Dry mouth due to smoking, coffee consumption, age related, medications, stress, Auto Immune Disorders such as Sjogrens Syndrome, Rheumatoid Arthritis, Lupus, uncontrolled Diabetes, or radiation treatment therapy to the head and neck
  • Sugar and Carbohydrate consumption – candy, pastries, soft drinks, Gatorade, any sweetened beverages, crackers, pretzels, any refined carbohydrate; risk increases as number of exposures increases ***going to bed without cleaning teeth or getting up in the night and eating can be particularly detrimental***
  • Dental appliances, Poor marginal adaptation of partial dentures, overdentures, crowns, bridges, and fillings increases risks; exposed root surfaces are less decay resistant
  • Poor Oral hygiene, ineffective daily plaque removal by limited dexterity or limited effort

Oral Hygiene Recommendations for All Patients:

    • Over the counter fluoride toothpaste 2 x per day (Arm and Hammer recommended)
    • Daily interproximal cleaning floss or proxibrush
    • Daily irrigation if applicable
    • Xylitol or Recaldent gum after snacks

Recommendations for patients with high caries risk:

  • Fluoride rinse ( ACT ) at bedtime
  • Yearly Bitewing x-rays for 3 years
  • Clinpro toothpaste (by prescription) at bedtime for 2 minutes, expectorate but do not rinse
  • Custom fluoride trays for any patient who wants an alternative to brushing and compromised patients who are unable to brush, wear 10 mins per day