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Caries Prevention

It is important for non-dental health practitioners to understand the basic concepts and historically proven preventive methods that have been available to the profession to decrease the negative outcomes of dental disease. Because dental disease is a bacterial infection, all interventions are aimed to affect the causative bacteria, increase the resistance of the host (teeth and gums) and reduce the substrate required by bacteria.

This section addresses preventive techniques for removing plaque.

Plaque

Plaque (biofilm) is a sticky film of bacteria, food debris and salivary components that adhere to the tooth. General components of plaque are calcium and phosphorus. The cariogenic bacteria produces polysaccharides that improve adherence of the plaque to the tooth enamel. Although plaque can initially protect enamel because of its mineral content, if left undisturbed, it will increase in size and in the number of bacteria. When a substrate is available, such as sugars and other fermentable carbohydrates, an acid is produced that attacks the enamel with loss of calcium and phosphate. This initial demineralized area is referred to as a white spot lesion. Depending on many factors including saliva pH, presence of fluoride, removing plaque and modifying the substrate, this lesion can either become remineralized, or with time can lead to cavitation.

Plaque Removal for School going children

Brushing should be started as soon as teeth erupt. Parents should brush the child’s teeth till the age of four years and then supervised brushing should be encouraged using a fluoridated tooth paste. Teeth should be brushed twice a day – in the morning after breakfast and at night before going to bed. In addition, teeth should preferably be brushed after eating any sweet and sticky food items. A rotary scrubbing method is the preferred motion to use for brushing teeth.