Evidence-based prevention, management, and monitoring of dental caries.
Dental caries, not unlike periodontal diseases, is now recognized as an infectious, transmissible, multifactorial disease of bacterial origin. Current evidence-based emphasis is on the need to recognize a carious lesion in its earliest stage before demineralization has produced a cavitated lesion that requires restoration by a dentist. As a result of current understanding of caries control, the dental hygienist's role as a prevention specialist is to determine the dental caries risk factors for patients of all ages and to introduce remineralization strategies into the patient's dental hygiene care plan. Conservative strategies of a concentrated program include initial infection control with a chlorhexidine rinse; extra daily fluoride exposures; placement of pit and fissure sealants where indicated; control of sucrose exposures; use of sugar substitutes, particularly xylitol-containing sugar-free chewing gum; and an emphasis on a daily bacterial plaque removal routine. Evidence supports the management and monitoring of dental caries. Caries risk level must be reevaluated at each maintenance appointment. Appropriate in-office strategies to preserve tooth structure should be carried out and followed by applicable home regimens that are based on need, not age.
Barber
Lois Rigmont
LR
Tufts University School of Dental Medicine, Boston, Massachusetts, USA.
Wilkins
Esther M
EM
D000293:Adolescent; D000328:Adult; D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002327:Cariostatic Agents / Q000627:therapeutic use*; D002648:Child; D002710:Chlorhexidine / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003731:Dental Caries / Q000175:diagnosis / Q000517:prevention & control*; D003733:Dental Caries Susceptibility; D003756:Dental Hygienists; D019317:Evidence-Based Medicine; D005459:Fluorides / Q000627:therapeutic use*; D006801:Humans; D010895:Pit and Fissure Sealants / Q000627:therapeutic use; D012648:Self Care; D014993:Xylitol / Q000627:therapeutic use
D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants; D005459:Fluorides; D002710:Chlorhexidine; D014993:Xylitol