Preventive Dentistry
The basis of preventive dentistry lies in the efficient and thorough removal of plaque,
combined with restriction of dietary sugars, and the appropriate use of fluoride
preparations and anti-plaque agents.
Success in preventive dentistry depends on the patient's acceptance that only they
can look after their dental health between check-ups.
Primary prevention of caries is well understood. The
great improvements seen in children in the recent years is certainly
as a result of fluoride tooth pastes and changes in patterns of sugar
consumption. Fissure sealing is also important as a primary preventive measure.
The maintenance of healthy gingival tissues can be achieved by following
a good oral hygiene routine.
At a secondary level in the disease progression prevention is still
possible and the decay process is reversible. The re-mineralisation
of early decay, ie. of the enamel only, is a well established
fact. While spot lesions that do not progress are in need of nothing
more than preventive care and observation. Fissure sealing may also have
a role at this stage. The reversal of early gingivitis and the prevention of further
breakdown is possible through good oral hygiene, supplemented by regular
scaling and polishing.
At a tertiary stage, even when caries has progressed to cavity formation
and the dentine is involved, the arrest of decay is frequently possible
, especially where the cavity is accessible to tooth brushing and
hence the regular application of fluoride. At this stage gum disease
can also be arrested and possibly reversed with good oral hygiene
combined with more extensive scaling, root planing and the removal
of plaque-retentive factors, such as poor restorations. The use of anti-microbial mouth rinses
containing Chlorhexidine, such as Corsodyl or Chlorohex can be very
beneficial. In severe cases more elaborate methods may be needed,
perhaps with referral to a specialist.
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