Dental Caries Health Article

Health care team roles

Dental assistants can provide patients and their families with education in caries prevention. This often includes instructions for home care and fluoride information. Dental assistants often participate in the treatment of dental caries, performing such tasks as taking x rays, assisting with materials during treatment, and setting up and maintaining treatment rooms. In some dental practices, dental hygienists assist with patient charting and taking x rays. Dental hygienists interpret findings and are often the first to see the decay during routine cleanings.

Prevention

It is easier and less expensive to prevent tooth decay than to treat it. The four major prevention strategies include: proper oral hygiene, fluoride, sealants, and attention to diet.

Oral hygiene

GENERAL CARE OF THE MOUTH. The best way to prevent tooth decay is to brush the teeth at least twice a day, preferably after every meal and snack, and to floss daily. Cavities develop most easily in spaces that are hard to clean. These areas include surface grooves, spaces between teeth, and the area below the gum line. Effective brushing cleans each outer tooth surface, inner tooth surface, and the horizontal chewing surfaces of the back teeth, as well as the tongue. Flossing once a day also helps prevent gum disease by removing food particles and plaque at and below the gum line, as well as between teeth. Patients should visit their dentist every six months for an oral examination and professional cleaning.

MOUTH CARE IN OLDER ADULTS. Older adults who have lost teeth or had them removed still need to maintain a clean mouth. Bridges and dentures must be kept clean to prevent gum disease. Dentures should be relined and adjusted by a dentist whenever necessary to maintain a proper fit. These adjustments help to keep the gums from becoming red, swollen, and tender.

MOUTH CARE IN CHILDREN. Parents can easily prevent baby bottle tooth decay by not allowing a child to fall asleep with a bottle containing sweetened liquid. Bottles should be filled with plain, unsweetened water. A child should be starting to drink from a cup at around six months of age, and weaned from bottles at 12 months. If an infant seems to need oral comfort between feedings, a pacifier specially designed for the mouth may be used. Pacifiers, however, should never be dipped in honey, corn syrup, or other sweet liquids. After the eruption of the first tooth, parents should begin routinely wiping an infant's teeth and gums with a moist piece of gauze or soft cloth, especially before bedtime. Parents may begin brushing a child's teeth with a small, soft toothbrush at about two years of age, when most of the primary teeth have come in. They should apply only a very small amount (the size of a pea) of toothpaste containing fluoride. Too much fluoride may cause spotting (fluorosis) of the tooth enamel. As the child grows, he or she will learn to handle the toothbrush, but parents should control the application of toothpaste and do the follow-up brushing until the child is about seven years old.

Fluoride application

Fluoride is a natural substance that slows the destruction of enamel and helps to repair minor tooth decay damage by remineralizing tooth structure. Toothpaste, mouthwash, fluoridated public drinking water, and vitamin supplements are all possible sources of fluoride. It is important to note that bottled water and water from home purifiers often does not contain fluoride, so people who drink from these sources may have to supplement their fluoride use. Children living in areas without fluoridated water should receive 0.5 mg/day of fluoride (0.25 mg/day if using a toothpaste containing fluoride), from three to five years of age, and 1 mg/day from 6-12 years.

While fluoride is important for protecting children's developing teeth, it is also of benefit to older adults with receding gums. It helps to protect the newly exposed tooth surfaces from decay. Older adults can be treated by a dentist with a fluoride solution that is painted onto selected portions of the teeth or poured into a fitted tray and held against all the teeth.