Primary prevention

 A large and comprehensive evaluation of caries

risk assessment has demonstrated that,
although there are limits to the sensitivity and
specificity attainable, practical caries risk
assessment in this age group is achievable

 Ex: { scaling and polishing / oral hygiene

instructions/ fissure selants}
 Secondary prevention
 Promoting early intervention to hault the
progression of the initial disease
a. management of gingivitis
b. Flouride application for non-cavitaed carious
lesions
c. oRthodontic treatment
 Tertiary prevention
 Treatment of a well established diease to retore
function.
a. Prothodontics {fixed/ removable}
b. Fillings
c. RCT
RISK FACTORS FOR DENTAL CARIES
 Previous caries experience
 Diet
1. Several dietary factors are associated with caries incidence:
2. amount of fermentable carbohydrate consumed
3. sugar concentration of food
4. physical form of carbohydrate
5. oral retentiveness (length of time teeth are exposed to
decreased plaque pH)
6. frequency of eating meals and snacks
7. length of interval between eating
8. sequence of food consumption
 MEDICAL HISTORY AND DISABILITY A
range of factors in a child’s medical history
may be associated with increased caries risk (
A learning disability is not, per se, a predictor of
increased caries risk
 Saliva

 Plaque control

 Use fo flouride

 Social factors
 A thorough clinical examination of clean, dried
teeth should be carried out to assist caries
diagnosis and to identify the patient’s caries risk
category prior to deciding whether to take a
radiograph.
This examination may include:
 transillumination
 flossing
 temporary separation of the teeth (e.g. with a
wooden wedge or orthodontic separator).
 A Bitewing radiographs are recommended as an
essential adjunct to a patient’s first clinical
examination.
 Stephan curve
 Measures the change in the plaque PH represented
graphically over a period of time following the
glucose rinse
 Critical PH: below which demineralization occurs 5.5
 Diet analysis: high caries/ suspeted erosion/
unusual caries pattern
 A consecutive { 3,4 day anaysis including a weekend
1. Ring the meal meals
2. Underline food with high sugurs
3. Identify in between meal snacks
 Dental health education
 The mass media
 Community programes
 One to one { best form}
 Classification of sugars
 Intrinsic sugars: sugars forms an integral part
of certain unprocessed food. They are enclosed
within the cell { fruits/ vegetables}
 Extrinsic sugars {milk sugars}
Milk sugars: in milk and milk containing products mainly
lactose
 Extrinsic sugars {Non-milk sugars}
Confectionery/ soft drinks/ biscuits/cakes}
 Most cariogenic carbohydrate is sucrose
 Caries studies
 The Vipeholm experiments:
Vipeholm Mental Hospital in Lund, Sweden were fed large amounts of sweets to
provoke dental caries 

 Xylitol sugar study