Treatment protocols: nonfluoride management of the caries disease process and available diagnostics.
This article reviews the evidence for saliva diagnostics and some antibacterial concepts with potential to interfere with the caries process. It concludes that there is incomplete evidence to evaluate the role of chair-side tests and to recommend general topical applications of antibacterial agents to prevent caries lesions. However, such measures may be considered to control the disease in caries-active individuals. There is evidence that xylitol has antibacterial properties that alter the oral ecology but the clinical evidence for caries prevention is rated as fair. However, preventive programs should include as many complementary strategies as possible, especially when directed toward caries-active patients. Therefore, any antibacterial intervention should always be combined with a fluoride program, until stronger evidence for its use in caries prevention and management becomes available.
Twetman
Svante
S
Department of Cariology and Endodontics, Institute of Odontology, Faculty of Health Sciences, University of Copenhagen, DK-2200 Copenhagen N, Denmark. stwe@sund.ku.dk
D000891:Anti-Infective Agents, Local / Q000145:classification* / Q000627:therapeutic use*; D018441:Biofilms / Q000187:drug effects; D003731:Dental Caries / Q000175:diagnosis / Q000517:prevention & control / Q000628:therapy*; D003732:Dental Caries Activity Tests / Q000295:instrumentation / Q000379:methods*; D003773:Dental Plaque / Q000517:prevention & control; D055094:Evidence-Based Dentistry; D006801:Humans; D011322:Primary Prevention / Q000379:methods; D012463:Saliva / Q000378:metabolism / Q000382:microbiology; D012471:Salivary Proteins and Peptides / Q000378:metabolism; D055502:Secondary Prevention / Q000379:methods
D000891:Anti-Infective Agents, Local; D012471:Salivary Proteins and Peptides