various methods for preventions of dental caries 4
TRANSCRIPT
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VARIOUS METHODS FOR PREVENTION OF DENTAL
CARIES
Presentation by:Ritam Chakraborty
3rd year BDS studentHALDIA INSTITUTE OF DENTAL SCIENCES AND
RESEARCH
Guided by:Dr. Rajarshi Banerjee(MDS,MOMS RCPS)
Professor, Dept. of Oral and Maxillofacial Surgery, HIDSAR
Dr. Rupam Sinha(MDS)Professor & HOD, Dept. of Oral Medicine & Radiology, HIDSAR
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INTRODUCTIONIn spite of widespread awareness, dental caries is still the second
most common disease of human civilization after common cold-According to WHO
Dental caries is a preventable disease of the mineralized tissues of the teeth with a multi-functional etiology related to the interactions over time between tooth substance & certain micro-organisms & dietary carbohydrates producing plaque acids.
This paper aims to throw light on various modalities of caries prevention
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Steps of caries preventionPRIMARY PREVENTION
SECONDARY PREVENTION
TERTIARY PREVENTION
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&…… VACCINATION
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PRIMARY PREVENTION
Primary prevention protects individuals against disease,often by placing barriers between the
aetiological agent and the host.
Primary prevention is about keeping children’s teeth free from dental caries.
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PREVENTION IS BETTER THAN CURE
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Risk factors of Dental cariesClinical evidence
Dietary habits
Social history
Use of fluoride
Plaque control
Saliva Medical history
High risk
New lesionsNo fissure sealantsFixed appliance orthodonticsPartial denturesAnterior caries or restorations
Frequent sugar intake
Social deprivationLow knowledgeReady availability of snacksHigh caries in siblings
Drinking water not fluoridated
No fluoride toothpaste
Infrequent, ineffective cleaning
Poor manual control
Low flow rate
Low buffering capacity
High S. mutans & lactobacilli count
Medically compromised
Physical disability
Long term cariogenic medicine
Low risk
No new lesionsFissure sealedNo applianceSound anterior teethNo or few restorations
Infrequent sugar intake
Social advantageDentally awareLimited intake of snacksLow caries in siblings
Drinking water fluoridated
Fluoride toothpaste & supplements used
Frequent, effective cleaning
Good manual control
Normal flow rate
High buffering capacity
Low S. mutans & lactobacilli count
No medical problems
No physical problems
No long term medication
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IDENTIFYING CHILDREN AT HIGH CARIES RISK
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BEHAVIOUR MODIFICATION ON HIGH CARIES
Dental health education
Oral hygine
Diet & sugar consumption
XYLITOL
Sugar-free chewing gum
Sugar-free medicines
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TOOTH PROTECTION IN HIGH CARIES RISK
Sealants
Fluoride tablets & toothpastes
Topical vaccines
Chlorhexidine
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SECONDARY PREVENTION
Secondary prevention aims to limit the progression and effect of a disease at as early a
stage as possible after onset. It includes further primary prevention
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TERTIARY PREVENTION It is concerned with limiting the extent of
disability once a disease has caused some functional limitation.
The patient’s health status doesn’t return to the pre-diseased state.
It must include further primary and secondary prevention in order to prevent
further carious attack
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DIAGNOSIS
Accurate diagnosis & monitoring of lesions over time is required for effective prevention
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CLINICAL DIAGNOSIS
o Transillumination
o Flossing
o Temporary restoration of the tooth (eg. With a wooden wedge or orthodontic separator)
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Management of carious lesions
Can be divided into three carious sites ->
Occlusal caries
Approximal caries
Smooth surface caries
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MANAGEMENT OF OCCLUSAL CARIES
If only part of the fissure system is involved in small to moderate dentine lesions with limited extension,the treatment of choice is a composite sealant restoration.
If caries extends clinically into dentine,then carious dentine should be removed & the tooth restored.
Dental amalgam is an effective filling material which remains the treatment of choice in many clinical conditions. There is no evidence that amalgam restorations are hazardous to the general health.
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MANAGEMENT OF APROXIMAL CARIES
Preventive care (eg. topical fluoride varnish)rather than operative care is recommended when approximal caries is confined(radiographically or visually)to
enamel.
Management strategies should also include:
Twice daily use of a toothpaste containing 1000 ppm fluoride.
• Flossing
Dietary advice
In an approximal lesion requiring restoration, a conventional class II restoration should be preferred.
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MANAGEMENT OF SMOOTH-SURFACE CARIES
o Twice daily use of a toothpaste containing 1ooo ppm
of fluoride.
o Plaque removal
o Dietary advice
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RE-RESTORATIONThe diagnosis of secondary caries is extremely
difficult & clear evidence of involvement of active disease should be ascertained before
replacing a restoration.
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INFORMATION FOR NON-DENTAL HEALTH PROFESSIONALS
Dental caries development
Sugar consumption
Dry mouth
Sugar-free medicines
Those who don’t attend a dentist regularly
Medically compromised
Orthodontic appliances
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Vaccines
Vaccines are an immuno-biological substance designed to produce
specific protection against a given disease.
Stimulates the production of protective antibodies.
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o Main causative organism for dental caries is
Streptococcus mutans
ROUTES OF IMMUNIZATION
In general,two types of immunization have been used with S. mutans :
Active immunization
Passive immunization
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ACTIVE IMMUNIZATION
Common mucosal Systemic route of Active gingivo-Immune system Immunization salivary route
Oral route
Intranasal route
Tonsillar route
Minor salivary gland
Rectal
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PASSIVE IMMUNIZATION
Monoclonal antibodies
Bovine milk and whey
Egg- yolk antibodies
Transgenic plants (genetically modified tobacco plant)
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ADVANTAGES OF VACCINE
Genetic material can be easily exchanged
It is possible to manipulate the antibody structure thus avoiding cross reaction
Large scale production is possible
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NEWER APPROACHES
Synthetic peptides
Coupling with cholera toxin subunits
Fusing with salmonella
Microcapsules and microparticles
Liposomes
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RISKS OF USING CARIES VACCINE
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INFERENCE
With all these advancements, we hope, in recent future, we can enroute dental caries out of the human civilization
Then we can shed off the allegation -
DENTAL CARIES IS THE DISEASE OF CIVILIZATION
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THANK YOU ALL