Prevention of

dental caries
Dr. Ruba Ahmad Aqel
Pediatric dentist resident
contents

 Introduction
 Definition of prevention
 Aims of prevention
 Levels of prevention
 Methods of prevention
Introduction
 Dental caries :
 Is a multifactorial microbial infectous
disease
 Charachterisezed by demineralization
of the inorganic and destruction of
organic substance of the tooth .
Defenition of prevention

 Stopping the disease from happening by

either avoiding the reoccurrence of
disease or by avoiding things known to
cause the disease.
 by eliminating the causative factor or
putting a barrier to prevent the causative
factor to do any damage.
Aims of prevention
 Limiting pathogen growth and
metabolism
 Limitation of caries activity
 Early detection of incipient caries
 identification of high risk patient
Terminology of prevention
(primary , secondary , tertiary )
 Primary prevention: is protecting the individual
from diseases by removing etiological agent
or placing a barrier between agent causing
disease and the host .
 example: fissure sealant a barrier between
plaque, bacteria and the fissure. Giving an
advice, removing one of the factors causing
the disease “sugars”.
 Secondary prevention : is aiming to limit the progression
and effect of the disease at an early stage , this is where
early detection comes in , if I have early signs of disease I
need to limit the progression of disease.
 Example: when there are caries within enamel, I can limit
this from progression, but there is no
need to always remove tooth structure
e.g.: demineralization. Or in white spots lesion there is no
need to hold the headpiece and do a cavity, you can
arrest the lesion with fluoride and good oral hygiene and
make it stop.
The main idea in secondary prevention is EARLY detection
to limit progress the disease.
 Tertiary prevention: is limiting the extent of
disability from diseases once it is occurred,
want to assure that there are no
functional limitations from the disease.
Give treatment to minimize impact of the
disease.
 Example: if there is caries, and it was
treated properly, it should not progress,
do not wait for it toprogress, prevent pulp
necrosis, and Treat it early enough, being
treated in clinic is better that having the
tooth extracted.
Methods of prevention
 Chemicalmethods
 Mechanical methods
 Diet
 Chemical methods
 Substances which alter tooth surface or structure .
 E.g : Fluoride
Fluoride
 Fluoride has an effect during tooth formation
by substitution of hydroxyl ions by fluoride ions,
so reducing the solubility of tooth tissue
 Inhibit plaque bacterial growth and glycolysis
 Inhibit demineralization of tooth mineral
 enhances remineralization by combining with
calcium and phosphate to form fluoroapitite
 (critical Ph for fluorapitite is 3.5)
 Provided in form of tablets and drops , caries
reduction vary from 20 % to 80 %
 The fluoride supplement doses depend on
age of the pt and the level of fluoride in the
drinking water
 No supplement should be prescribed if the
water fluoride level is greater than 0.7 ppm
 The tablets should be allowed to dissolve
slowly by mouth , thus providing atopical
application of fluoride to the mouth
Systemic fluoride
Topical fluoride
2 ) Nutritional methods
 Restriction of refined carbohydrates intake
 Confectionery and such foods should be used at
meal times as a dessert rather than consumed
between meals.
 Only milk or water should be given to children in
baby bottle
 For the consumption of soft drinks the following
recommendations should be followed :
Ideally serve only at meal times
Use a straw whenever possible
Don’t give at bed time or during the night
 Foods with anticariogenic effects :
 Milk
 Cheese
 Sugar substitutes & artificial sweeteners
Xylitol , manitol , sorbitol
Xylitol
 Prevents streptococcus mutans
from binding to sucrose.
 Neutralizes plaque acids
 Increase salivary flow
 Enhance remineraliztion
 Xylitol is available in many forms (
e.g gums , mints , chewable
tablets,lozenges, toothpastes,
mouthwashes,cough mixtures,
oral wipes )
Dental erosion
Dietry acids 
Soft drinks 
Prevention : not to brush teeth for at least 
1 hour after consumption of such drinks .
Mechanical methods
 Tooth brushing
 Interdental cleaning aid
 Pit and fissure sealent
Tooth brushing
 Children don’t have the manual
dexterity to brush their teeth
effectively until they can tie their
own shoelaces or write their name
(about 7 years of age)
Fissure sealant
A material which are applied in order to
obliterate the fissure and remove the
sheltered environment in which caries can
thrive .

 Theplacement of sealant is relatively

simple but is technique sensitive
Thank
You