title: Evidence-based prevention, management, and monitoring of dental caries.
abstract: 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.
authors.affiliation: Tufts University School of Dental Medicine, Boston, Massachusetts, USA.
authors.forename: Lois Rigmont
authors.initials: LR
authors.lastname: Barber
authors.forename: Esther M
authors.initials: EM
authors.lastname: Wilkins
mesh_terms: 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
chemical_list: D000891:Anti-Infective Agents, Local; D002327:Cariostatic Agents; D010895:Pit and Fissure Sealants; D005459:Fluorides; D002710:Chlorhexidine; D014993:Xylitol