Dental Problems

How to Prevent Caries Using Different Techniques?

A lot of research has been directed towards efforts to develop different techniques to prevent caries, which have ranged from simple to sophisticated techniques. In this article, there is a brief discussion on how to prevent caries using different techniques. Let us examine them.

The current approaches are still under trial, and are based on the following 3 prong-strategies.

  1. Combating caries inducing micro-organisms.
  2. Increasing tooth resistance against acid attack.
  3. Modifying cariogenic diet ingredients.

Hydrogen Peroxide White Teethning at HomeHow to prevent caries using different techniques

  1. Anti-plaque agents:

    • The role of plaque in the formation of dental caries is well documented. Thus, anti adherence agents and anti-bacterial are being tested as the plaque building blockers.
    • Glucosyltranferase (GFT), an enzyme may be inhibited by the use of sucrose analogues interfering with the glucan synthesis.
    • In the recent times some fungal and plant products that alter the adhesion of cell surface glucans are also being identified.
    • In this context, cheaper modalities that are accessible to the masses are being tested in the form of indigenous products.
    • They tested the efficacy if mango leaf, Neem leaf and Tea extracts and they found that all these three products were effective in reducing the plaque formation as well as the streptococcus mutans count.
    • The antibacterial products may have the drawback of being rapidly eliminated from the oral cavity. For this purpose, polymers or Controlled Release Devices (CRD) are being used to increase the substantivity in the oral cavity.
  2. Altering surface morphology or Increasing tooth surface:

    • A so called surface active polymeric agents for surface adhesive binding has been developed by Bowen (1995) comprising of applications in 2 stages for increasing tooth resistance to dental decay.
    • Monomer which would have a chemical bond followed by a polymeric top coat which would enhance durability and esthetics’s.
    • Tooth resistance is improved using two steps procedure: By enhancing the fluoride uptake in enamel. This method involves initial application of an acidified calcium phosphate solution followed by suitable fluoride solution.
    • Such a two component system can be used as a professional topical application or self applied mouth rinse or alternately using chewing gum of an amorphous calcium phosphate (ACP) and tooth paste containing fluoride.
  3. Lasers:

    COâ‚‚ lasers can be used to alter the tooth surface of enamel and make it less prone to caries. Concern however exists regarding the depth control and optimum irradiation conditions. Pits and fissures and root surfaces may be the areas targeted by the lasers.

  4. Benign microorganisms or Replacement therapy:

    • Using the ‘use a thorn to draw a thorn’philosophy, an approach would be to supersede the cariogenic bacteria by more benign ones.
    • The lactic acid (dominant acid) produced by S. mutans is controlled by the gene that can be mutated.
    • But, Genetic engineering provides a better alternative for producing theinactivated forms and then cloning them.
    • For example, a new approach has been used to transfer these genes from bacteria that naturally produce these enzymes such as mutanase that degrades the extra-cellular polymers (sticky) that are involved in the plaque adhesion and build up into bacteria such as Sterptococcus gordoni.
    • An attempt to transfer the gene – arginine diminase, that produces base in Streptococcus sanguis, into S. mutans, to counter its acidogenic potential which has been made.
  5. SAP (Self assembling polypeptides):

    • Preliminary reports have suggested the use of self assembling polypeptides (Strafford et al 1999) for augmentating host resistance.
    • These may be useful in promoting enamel remineralization, presumably as a result of their nucleating potential.
    • Following incubation in the mineralizing solution, large crystal deposits were found within the SAP.
    • These protective peptides are used as pacifiers for young children to help modify the bacterial flora against baby bottle caries.
    • These peptides have also been used in mouth rinses and dentifrices.
  6. Chewing gums:

    • A novel technique involves the use of chewing gums after meals in order to counter the pH drop that occurs with the intake of sugar.
    • Various sugar free gums have been tried out, with additions such as xylitol, lactitol and Urea.
    • A clinical trial compared by Gopinath and Tandon (1996) compared the plaque pH change in the groups using urea, fluoride and sugars.
    • The result indicated that the chewing gum containing urea showed the highest pH followed by fluoride and sugar.
    • Thus, the study concluded that chewing gums containing therapeutic agents such as urea may be recommended for children with high risk caries.
  7. Tooth friendly sweets:

    • Use of non-cariogenic sweeteners have proved to be excellent measures in the control of caries.
    • A short term plaque study was undertaken by Tandon (1997) to evaluate effect of lactitol 4-O (b- Galactosy) -D-glucitol on plaque by incorporating it as a sweetener in biscuits.
    • Significant reduction was found in plaque formation, when compared with the control of carbohydrate content, increase in calcium, phosphate and proteins with lactitol.
  8. Micro-dentistry:

    • In this case, treatment begins before the conditions arise.
    • It enables the use of a microscope to detect conditions invisible to the naked eye.
    • This can again be used as an educational and motivational tool by helping the patient observe his own oral conditions. For example, letting the patient see the microorganisms in the plaque.
  9. Teledentistry:

    • It is the provision of dental care where the patient and provider are not physically in the same location.
    • This is a relatively new field of study, which can also be used as an adjunct in providing preventive home care advices.
  10. Indigenous products:

    • Recently a lot of emphasis has been placed on the utilization of the rich natural resources present in India.
    • In this case, studies have been conducted on the use of various products such as Neem, Mango leaf and Tea.
    • These have been found to have anti-plaque and anti-cariogenic potential.

The above article discusses briefly about the ways to prevent caries using different techniques.

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