Dental Caries-Part 6: Prevention

Fig1: Caries free beautiful teeth with proper maintenance #

The carious process can be termed as metabolic activity in the plaque. The result of the metabolic activity may not be anything to see or there may be demineralisation resulting in a visible carious lesion. As we have discussed earlier, plaque is the cause of caries and a tooth completely free of plaque will not have caries. However, it is not always possible to show a strong association between the presence of dental plaque and caries. Mostly because people are unable to completely remove plaque themselves, even when guided properly. In addition, although the bacterial biofilm is the cause of caries, there are other factors involved. This is the reason that caries is described as a multifactorial disease. These factors, when combined, may increase or decrease the rate of demineralization. 

This whole concept can be explained by one example; increased sugar intake and decreased salivary flow enhances the carious process. On the contrary, fluoride tends to decrease the rate of mineral loss. Thus, it is not only the amount of plaque that matters, but the combined effect of all the factors, and the combination of factors, which will vary from patient to patient.

Brushing the teeth two times daily with a fluoride toothpaste has been recommended by the profession for a long time, and this behaviour is a routine part of many people’s behaviour. This daily brushing with a fluoride toothpaste is accepted to be the most important reason for the decline of caries observed in many populations since the 1970s. The behaviour of tooth brushing should not be taken for granted. Patients should always be asked whether, and how many times, they brush their teeth and the type of tooth paste regarding fluoride.  

A well-known brand of toothpaste for sensitive teeth is produced in a number of flavours, and not all these products contain fluoride. Since cavities in teeth can be sensitive to hot and cold, it is not unusual for patients with caries to select a toothpaste for sensitive teeth. Thus, the particular person who most needs a fluoride toothpaste is at times not using it. Some herbal toothpastes are also formulated in a fluoride-free form. 

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