Cariology for the 21st Century: current caries management concepts for dental practice

Department of Cariology, Restorative Sciences and Endodontics, University of Michigan School of Dentistry, Ann Arbor, USA.
The Journal of the Michigan Dental Association 04/2013; 95(4):32-40.
Source: PubMed


The objective of this manuscript is to provide an overview of currently accepted, evidence-based and/or expert opinion recommendations for the prevention and management of dental caries in dental practice. Discussions are centered on current concepts for caries lesion detection (e.g., cavitated and non-cavitated lesions) and diagnosis (e.g., active vs. arrested lesions), including thresholds for non-surgical (e.g., fluorides, sealant) and surgical (i.e., restorative) interventions, risk assessment, and a review of caries management interventions for caries disease management. The goal is to prevent and manage the caries disease process using patient-centered, risk-based interventions supported by the best available evidence, taking into account the dentist's clinical expertise and the patient's treatment needs and preferences, in order to maintain or re-establish health and preserve tooth structure.

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    ABSTRACT: For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.
    Full-text · Article · Nov 2015 · General dentistry