 Can we prevent dental caries?

Both dental caries and periodontal diseases are preventable, caries can be
prevented by the following:
1. Oral hygiene:
Since dental caries do not progress without the bacteria present in dental
plaques, daily plaque removal by brushing, flossing, and rinsing is one of the best
ways to prevent dental caries and periodontal disease.
2. Fluoride application:
Fluoride prevents dental caries by inhibiting demineralization of the crystal
structures inside the tooth and enhancing remineralization. The remineralized
surface is resistant to acid attack. Methods of fluoride application include water
fluoridation, tooth paste, mouth rinse, dietary fluoride supplements, and
professionally applied fluoride compounds such as gels and varnishes.
3. Pit and fissure sealants:
The majority of dental caries in young children occur in pits and fissures because
the anatomy favors plaque accumulation; these areas are often too narrow for
any oral hygiene measures to be effective. By filling such irregularities with
flowable restorative material, the area becomes less morphologically susceptible.
4. Xylitol :
Xylitol is one of these sugar substitutes. Xylitol has a sweet flavor comparable to
sugar, and it is not only non-cariogenic, but also anti-cariogenic. It keeps sucrose
molecules from binding with MS, thereby blocking its metabolism. It also reduces
the adhesion ability and number of MS. The anti-cariogenicity of xylitol is affected
more by the frequency of intake than by the amount consumed.
5. Role of the primary caregiver in children:
As dental caries is an infectious disease, the primary caregiver of infants (most
often the mother) can transmit caries-causing microorganisms to a child, resulting
in the colonization of MS in the infant’s oral cavity. In fact, there is a direct
relationship between MS levels in parents and their children. Therefore, efforts to
reduce the MS level in the parent, including maintaining oral hygiene and
undergoing dental treatment when necessary, are also important for prevention of
dental caries in young children.

 Caries risk factors

Risk factor is defined as an environmental, behavioral or biological factor
confirmed by temporal sequence, usually in longitudinal studies, which if present
directly increases the probability of disease occurring and if absent or removed
reduces the probability. Risk factors are part of the causal chain, or expose the
host to the causal chain. Once disease occurs,removal of risk may not result in
cure.
1. Tooth location
Decay most often occurs in your back teeth (molars and premolars). These teeth
have lots of grooves, pits and crannies, and multiple roots that can collect food
particles. As a result, they're harder to keep clean than your smoother, easy-to-
reach front teeth.
2. Certain foods and drinks
Foods that cling to your teeth for a long time — such as milk, ice cream, honey,
sugar, soda, dried fruit, cake, cookies, hard candy and mints, dry cereal, and chips
— are more likely to cause decay than foods that are easily washed away by saliva.
3. Frequent snacking or sipping
When you steadily snack or sip sugary drinks, you give mouth bacteria more fuel
to produce acids that attack your teeth and wear them down. And sipping soda or
other acidic drinks throughout the day helps create a continual acid bath over your
teeth.
4. Bedtime infant feeding
When babies are given bedtime bottles filled with milk, formula, juice or other
sugar-containing liquids, these beverages remain on their teeth for hours while they
sleep, feeding decay-causing bacteria. This damage is often called baby bottle
tooth decay. Similar damage can occur when toddlers wander around drinking
from a sippy cup filled with these beverages.
5. Inadequate brushing
If you don't clean your teeth soon after eating and drinking, plaque forms quickly
and the first stages of decay can begin.
6. Dry mouth
Dry mouth is caused by a lack of saliva, which helps prevent tooth decay by
washing away food and plaque from your teeth. Substances found in saliva also
help counter the acid produced by bacteria. Certain medications, some medical
conditions, radiation to your head or neck, or certain chemotherapy drugs can
increase your risk of cavities by reducing saliva production.
7. Worn fillings or dental devices.
Over the years, dental fillings can weaken, begin to break down or develop rough
edges. This allows plaque to build up more easily and makes it harder to remove.
Dental devices can stop fitting well, allowing decay to begin underneath them.
8. Eating disorders.
 Anorexia and bulimia can lead to significant tooth erosion and cavities. Stomach
acid from repeated vomiting (purging) washes over the teeth and begins dissolving
the enamel. Eating disorders also can interfere with saliva production.
9. Heartburn.
Heartburn or gastroesophageal reflux disease (GERD) can cause stomach acid to
flow into your mouth (reflux), wearing away the enamel of your teeth and causing
significant tooth damage. This exposes more of the dentin to attack by bacteria,
creating tooth decay. Your dentist may recommend that you consult your doctor to
see if gastric reflux is the cause of your enamel loss.
 Caries risk indicators
Are existing signs of thedisease process. They are examples of what is happening
with the patient’s current state of oral health, not how disease occurred.
1. Dietary factors
-Frequent between meal snacking.
-Prolonged night-time or at will bottle/breast feeding of infant.
-Multiple sugar exposures through the day.
-Infant Ready availability of cariogenic snacks.
2. Socioeconomic factors
-High caries risk in siblings/parents.
-Children from socioeconomically deprived or immigrant backgrounds.
-High maternal MS levels.
-Low dental aspirations especially on the importance of maintaining caries free
primary dentition.
3. Fluoride exposure
-No exposure to fluoridated drinking water.
-No access to professionally applied topical fluorides especially when
permanent molars erupt delaying post-eruptive maturation.
4. Medical factors
-Special child (i.e. a child with a physical,mental, or medically compromising
condition that may limit oral health care measures or make the child more
susceptible to caries.)
-Salivary dysfunction caused by medications, radiation therapy or general
systemic conditions.
-Long term cariogenic medication.
5. Salivary factors
-High salivary MS & Lactobacilli counts.
-Poor salivary flow rate impeding clearance
6. Clinical factors
-Early colonization of infants teeth by MS.
-Presence of dental appliances or restorations.
-Deep retentive pits and fissures.
-New carious lesions or white spot lesions every 6 months.