Chapter 7

Preventive and Desensitizing

Materials

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 Lesson 7.1
2

Preventive and Desensitizing Materials

Fluoride and Caries Control
1. Describe the applications of fluoride in prevention.
2. Explain how fluoride protects teeth from caries.
3. Discuss the various methods of fluoride delivery.
4. Explain the benefit of using an antibacterial rinse in conjunction with fluoride.
5. Describe the antibacterial effects of chlorhexidine.
6. Apply topical fluoride gel, foam, or varnish correctly (as permitted by state law).

Sealants
7. Describe how sealants protect pits and fissures from dental caries.
8. List the components of sealant material.
9. Recite the steps for applying sealants.
10. Apply sealants to teeth (as permitted by state law).
Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.
 Lesson 7.1
3

Preventive and Desensitizing Materials

Desensitizing Agents
1. Recite causes of tooth sensitivity.
2. Explain how desensitizing agents work.
3. List the types of materials used to treat sensitive teeth.
4. Apply desensitizing agents to sensitive teeth (as permitted by state
law).
Remineralization Products
5. Explain the process of remineralization of enamel.
6. Describe how products for remineralization work.
7. Explain how resin infiltration of the early white spot lesion works.
Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.
 4

 Dental assistants and hygienists play

important roles in assisting the dentist to
Prevention/Preventive prevent disease and maintain the health of

Aids patients
 Important preventive measures for caries
management: Fluorides, antibacterial mouth
rinses, and sealants

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 5

 Naturally occurring mineral

 Effective and safe in preventing dental decay
Fluoride  May occur naturally or by supplement

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 6

 Too much fluoride: Condition known as

fluorosis
 Causes of fluorosis

Fluorosis

Courtesy of Steve Eakle, University of California, San Francisco (San Francisco, CA).

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 7

 Demineralization
 Remineralization
Topical and  Fluorapatite
Systemic Effects  Cariogenic

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 8

 Highly acidic foods contribute to loss of

tooth mineral
 Bacteria not involved
 Most mineral loss is at the surface
 Medical conditions causing erosion

Protection Against
Erosion

Courtesy of Steve Eakle, University of California, San Francisco (San Francisco, CA).

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 9

 Fluoride interferes with essential enzyme

Bacterial Inhibition activity of bacteria

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 10

 Fluoride alone not as effective in managing

Fluoride and dental caries
 Helps suppress bacteria associated with
Antibacterial dental caries when used in conjunction with
Rinses antibacterial mouth rinse

for the Control of 


Chlorhexidine gluconate
Substantivity
Dental Caries  Side effects

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 11

 Dietary fluoride supplements

 In-office fluoride applications (topical)
 Gels and foams

Methods of 
 Varnish
Self-applied topical gels and pastes
Delivery  Over-the-counter fluoride rinses
 Fluoride-containing toothpaste
 Fluoride-containing prophylaxis pastes

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 12

 Use as directed
 Keep away from small children
Safety

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 13

 Unfilled or lightly filled resins

 Prevent dental caries in the pits and fissures
 Found primarily on the occlusal surfaces of
posterior teeth

Pit and Fissure

Sealants

Courtesy of Steve Eakle, University of California, San Francisco (San Francisco, CA).

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 14

 Not all teeth need sealants

 Recommended for teeth with:
Indications for  Steep cuspal inclines
Sealants  Deep, sticky fissures

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 15

 Similar to composite resin

 Resin component based on a dimethacrylate
monomer:
 Bisphenol A-glycidyl methacrylate (bis-GMA)
 Urethane dimethacrylate (UDMA)
 Polymerization
 Small filler particles
Composition of
Sealants

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 16

Self-cured sealant
Light-cured material
Working Time

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 17

 Variety of colors
 Examined at each visit for stability
 Wear from occlusion
Color and Wear

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 18

 Requires attention to detail

 Technique has many steps:
 Clean surface with pumice
 Etch enamel with 37% phosphoric acid
Sealant Placement  Rinse with water
 Dry the enamel
 Bonding (optional)
 Place sealant
 Cure
 Wipe cured surface with gauze or a cotton roll
 Oxygen-inhibited layer

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 19

Exposed dentinal tubules to the oral cavity

Temperature (usually cold)
Causes of Tooth Sugar
Sensitivity Acidic food
Exposed root structure

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 20

 Desensitizing agents: Used to reduce or

Treatment for eliminate sensitivity
Sensitivity  Two main modalities:
 Occluding (plugging) the open tubules
 Desensitizing the nerve endings

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 21

 Toothpastes
 Fluoride gels and varnishes
 Inorganic salt solutions
 Resin primers and bonding agents
 Mineralizing agents
Various  Glass ionomer surface sealer

Desensitizing
Agents

Courtesy of GlaxoSmithKline ([Brentford, UK); courtesy of

Procter & Gamble Co. (Cincinnati, OH).

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 22

 Repair of the tooth structure surface

 Products
 Fluorides
 Amorphous calcium phosphate
Remineralization  Calcium sodium phosphosilicate
 Resin infiltration

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.

 23

 Preventive practices in dentistry:

 Extend far beyond normal cleaning and fluoride
application every 6 months
Summary  Caries arrested and tooth structure remineralized by
performing caries risk assessment and using topical
applications of fluoride
 Sealants to protect pits and fissures
 Desensitizing agents important because people
retaining their teeth longer

Copyright © 2016 by Saunders, an imprint of Elsevier Inc. All rights reserved.