Dental caries management strategies
Prevention and minimal intervention management of dental caries (before cavitation has occurred) can involve several strategies that promote remineralisation and arrest further decay. Individualise the management approach by tailoring strategies to the patient’s risk factors, such as:
- dietary modification, avoiding sucrose in sticky forms and limiting other sugars (eg acidic drinks) and carbohydrates as snacks between meals
-
plaque reduction by cleaning the teeth
- brushing at least twice a day with a toothpaste containing fluoride
- interdental cleaning (eg flossing), preferably immediately before brushing1
-
tooth surface modification
- using remineralising agents (eg fluoride)
- placing fissure sealants and other adhesive materials that protect the tooth surface
-
saliva modification
- addressing causes of dry mouth
- using low-acid, sugar-free chewing gum or lozenges, or nonacidic coarse foods (eg carrots) to increase salivary flow and buffering capacity of saliva.
Additional strategies for patients at elevated risk of dental caries include acidulated or higher concentration fluoride products, non-fluoride remineralising agents or chlorhexidine. Perform a thorough assessment of the patient (eg age, other medications, disease risk) and use clinical judgment to determine an appropriate individualised management strategy. For further information on individual dental caries management protocols, see the
International Caries Classification and Management System
.
If cavitation has occurred, remove the infected tooth structure and restore the cavity using minimally destructive methods and adhesive dental materials.