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Prevention

Recently there have been several advances in the effort to prevent tooth decay.The following is a summary the of regimen we use with patients that are highly susceptible to tooth decay. These are general guidelines which need to be modified to the individual patient by the dentist.

Caries (decay) Reduction Protocol -In years past, dentists have concentrated their treatment on restoring decayed teeth. This treatment usually consisted of repairing teeth with silver or white materials. Preventive care consisted of the toothbrush, floss, professional cleaning, and fluoride.

Recent advancement has allowed researchers to determine that decay is actually an infection caused by the bacteria Strep. Mutans. This bacteria uses carbohydrates (sugars) to produce acid. The acid in turn works on the tooth surface to leach out the minerals, causing the tooth to soften and produce a cavity (hole) in the tooth.

Since we now know that decay is caused by an infection, common sense tells us our focus should turn to eliminating the infection, rather than filling holes. This can be done by using the following in addition to professional cleaning, fluoride, and routine home care.

Bacteriologic Testing - Similar to what your physician does when he tests you for strep throat. A sample of bacteria is taken from the saliva, incubated and then analyzed for the amount of decay causing bacteria.
Sealants - the bacteria that cause the dental decay infection colonize (chose to live in) the deep grooves on posterior teeth. By "sealing" off these areas we take away one area the bacteria can live and produce its acid.
Restoration of previously decayed teeth. Again eliminating a living area for the bacteria.
Prescription Mouth Rinse - Peridex or perioguard mouth rinse may be prescribed to be used to help reduce the amount of bacteria present.
Home Fluoride Rinse - To be used before bedtime to help remineralize teeth and make them more resistant to decay.
Gum - Xylifresh Gum contains a chemical that affects the decay causing bacteria to be unable to produce as much acid. Trident Kids with Recaldent helps to remineralize the tooth.

One final factor is very important in preventing decay and that is the eating patterns of the patient. As one eats, the decay causing bacteria are supplied with a source of energy to produce acid that stays in the mouth for approximately twenty minutes and begins to leach minerals out the teeth. Your saliva then comes along and dilutes the acid and begins to remineralize the teeth. Now if food and drink are being supplied to the bacteria continually (not just at mealtime), the saliva never gets a chance to remineralize the teeth and the decay process accelerates. This leads us to recommend limiting eating to mealtime, so that the teeth are not continually bathed in acid.

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