Dental Caries

This is a microbial disease of hard tissues of teeth characterized by demineralization of inorganic and destruction of organic part of the tooth.

Salient features

  • Usually asymptomatic in early stages. Patient presents with tooth sensitivity and tooth ache

Treatment

Examine for stage of caries and treat accordingly.

Nonpharmacological

In non-cavitated lesion and low risk patient with good oral hygiene practices, no treatment is given. In cavitated lesion, restoration is done

Pharmacological

Where caries is likely to progress (in high risk patient) pit and fissure sealout

  1. Topical 2% Sodium fluoride
  2. 0.2% Chlorhexidine mouth wash twice a day

Assessment of response to therapy

  • For caries active patient – follow up visit every 3 months and to check the progression of white spot on the teeth.
  • For normal patients – follow up every 6 months to 1 year to check the development of the white spot/cavitation

Patient education/prevention

For caries active/high risk patient preferably

  • Diet control and avoidance of sugar containing food
  • Frequent ingestion of food containing sucrose should be substituted by sugar free foods
  • Oral hygiene: a) brushing of teeth twice a day b) flossing c) thorough rinsing after every meal
  • Fluoride application using Topical 2% Sodium fluoride (by dentist) 4 applications at weekly intervals at the age of 3, 7, 11 and 13 years.
    0.05% sodium fluoride daily rinse, (should not be swallowed)
    0.2% sodium fluoride supervised weekly rinse in school (age of children >7 years) only if these children have been identified as caries active patients

References

  1. Sturdevant CM. Roberson TM, Heymann HO, Sturdevant JR. In: The Art and Science of Operative Dentistry, 3rd edition, Mosby 1995, pp 100-120.
  2. Mitchell DA, Mitchel L. In: Oxford Handbook of Clinical Dentistry, 2nd edition, reprint 1996, pp 28.