L14 Management of Dental Caries

Question 1

What is the purpose of dental caries management?

Answer 1

Aims to control the disease and to prevent a lesion from becoming clinically detectable, and for those lesions detectable clinically, prevent their advancement.

Question 2

Which factors influence oral pH?

Answer 2

• Type of plaque, thickness, predominate bacteria
• Susbstrate type
• Time
• Host (rate of saliva flow, quality of saliva)

Question 3

What is the critical pH of dentine?

Answer 3

6.2

Question 4

What is the critical pH of enamel?

Answer 4

5.5

Question 5

What is the critical pH of fluorapatite?

Answer 5

4.5

Question 6

Dental caries management can target which factors?

Answer 6

• Cariogenic bacteria (reduce microbial load, plaque control)
• Diet modifications
• Time (control frequency and duration of exposure)
• Susceptible tooth (fluoride incorporation)

Question 7

How can we reduce microbial load?

Answer 7

• OHI
• Mouthwash (chemical plaque control)
• Demonstrate and motivate patient e.g. disclosing, plaque indices
• Exposure to fluoride to increase tooth resistance to plaque metabolites

Question 8

How can a patient modify their diet to reduce caries risk/arrest lesions?

Answer 8

• Diet diary including a weekend
• Reduce sugar consumption
• Reduce frequency and duration of exposure
• Consider clearance time of foods
• Consider hidden sugars and acids
• EatWell plate recommendation

Question 9

How can we reduce the susceptibility of teeth to caries attack?

Answer 9

• Replace or repair poor restorations (plaque retentive)
• Manage malocculsion/imbrication (crowding) to improve cleaning
• Inform patient to clean stagnation areas e.g. fissures, orthodontic appliances, contact points
• Prescribe saliva replacements for patients with xerostomia