Tooth Decay, Risk Level and Preventive Strategies
Tooth decay is the condition we most commonly encounter in our office. It typically advances without pain, affecting biting surfaces, interdental spaces, areas under fillings, or exposed tooth roots. If left untreated, it may result in tooth destruction, discomfort, infection, and eventually, loss of the tooth. Decay significantly affects both dental and overall health. Our preventive strategy includes evaluating your risk of caries during the initial examination and at every preventive appointment thereafter, using the CAMBRA system. Your susceptibility to decay involves a balance of numerous oral hygiene habits, lifestyle habits and health factors shown in the table below, which will either protect against or contribute to decay. Some of these factors are controllable, while others are not..
Protective Factors *Proper brushing and flossing *A healthy diet low in sugar *Limiting sugary between meal snacks *Using toothpastes and mouth rinses high in fluoride *Drinking fluoridated water *Consuming products with xylitol *Seeing the dentist regularly for check-ups and preventive care Disease-Contributing Factors *Poor oral hygiene, heavy plaque on teeth *Gingivitis *Teeth that trap food, Deep pits and fissures, untreated cavities *Receded gums and exposed root surfaces *Multiple fillings, crowns and/or bridge work *Partial denture wear |
*Dietary *Frequent consumption/snacking of high sugar/starchy foods, candies, gums and drink *Limited exposure to fluoride Habits: *Smoking, *recreational drug use Health conditions *GERDs, Acid reflux, *Chemotherapy or radiation therapy *Poor dexterity that limits proper brushing and flossing *Reduced salivary function *Take medications that reduce salivary function Mouth breathing Strong family history of dental decay Orthodontic care |
Once we have assessed your risk by weighing all factors, we will recommend oral hygiene strategies to protect your teeth and prevent further dental caries. Based on the criteria outlined below, you will be categorized as having either a Low, Moderate, or High Risk for decay.
LOW*No cavities in the last 24 months
*NO ENAMEL DEMINERALIZATION *NO VISIBLE PLAQUE *NO GINGIVITIS no disease promoting factors |
MODERATE*HAVE HAD CAVITIES IN LAST 24 MONTHS
*HAVE ENAMEL DEMINERALIZATION *SOME DISEASE PROMOTING FACTORS |
HIGH*HAVE HAD CAVITIES IN LAST 12 MONTHS *HAVE EXTENSIVE ENAMEL DEMINERALIZATION *ENAMEL DECAY ON THE RADIOGRAPHS *HAVE SEVERAL OF THE DISEASE PROMOTING FACTORS |
General Prevention
Home Care
Brush twice daily - use a soft toothbrush with an over-the-counter fluoride-containing toothpaste
Floss daily to clean between teeth- if you cannot floss use a Gum Soft-Pick instead
Instructions on how : CDA brushing and Flossing
Dietary Tips:
- Limit between-meal sweet snacks and sugary drinks. It's the duration of sugar exposure to your teeth that matters, not the quantity consumed.
- Avoid acidic foods and beverages between meals.
- End your breakfast, lunch, or dinner with cheese, nuts, seeds, or peanut butter to reduce mouth acidity.
- Do not brush your teeth immediately after eating. Brushing while acid is present can wear down tooth enamel. Waiting an hour allows saliva to neutralize the acid, making it safe to brush.
- To neutralize acids post-meal, rinse with a mixture of 1 tsp baking soda in a cup of water.
- Consider chewing xylitol-containing gum after eating.
Floss daily to clean between teeth- if you cannot floss use a Gum Soft-Pick instead
Instructions on how : CDA brushing and Flossing
Dietary Tips:
- Limit between-meal sweet snacks and sugary drinks. It's the duration of sugar exposure to your teeth that matters, not the quantity consumed.
- Avoid acidic foods and beverages between meals.
- End your breakfast, lunch, or dinner with cheese, nuts, seeds, or peanut butter to reduce mouth acidity.
- Do not brush your teeth immediately after eating. Brushing while acid is present can wear down tooth enamel. Waiting an hour allows saliva to neutralize the acid, making it safe to brush.
- To neutralize acids post-meal, rinse with a mixture of 1 tsp baking soda in a cup of water.
- Consider chewing xylitol-containing gum after eating.
Preventive Maintenance Visits
Good home care is essential to maintaining healthy teeth and gums but must be supplemented with regular dental visits at least every six to nine months. Depending on the status of your oral health, your dentist may recommend more frequent visits.
A preventive visit may include the following:
A preventive visit may include the following:
- Addressing any concerns you may be having
- Examining the soft tissues of your mouth for oral cancer indicators.
- Inspecting your teeth for decay, broken fillings, fractures, excessive wear, abrasion, erosion, and abscesses.
- Checking for loose contacts between teeth.
- Evaluating gums for inflammation, infection, tooth mobility, recession, and pockets.
- Looking for signs and symptoms of excessive grinding and clenching.
- Assessing oral hygiene and re-evaluate your current caries risk. .oral hygiene education.
- Examining the fit of existing dentures, retainers, and splints.
- Taking digital radiographs at intervals tailored to your individual needs.
- Dental cleaning, or prophylaxis, which includes scaling, polishing, flossing, and
- fluoride treatment,
- Arranging a follow-up visit, if necessary, to address any issues discovered during the examination.
Dental Care
-Complete any necessary restorative dental work, such as fillings or crowns.
- If suitable, have sealants placed on the chewing surfaces of your molars to prevent bacterial infection and dental decay.
- If suitable, have sealants placed on the chewing surfaces of your molars to prevent bacterial infection and dental decay.
Prevention by Risk Level
Low Risk
Consider using a Power-assisted toothbrush– See The Benefits of Electric Toothbrush vs. ManualPreventive Visits
Please keep regular dental checkups at 6 to 12 month intervals to:
Get new bitewing radiographs (X-rays) about every 24-36 months to check for cavities.
Get a fluoride varnish treatment after your teeth cleanings.
Please keep regular dental checkups at 6 to 12 month intervals to:
Get new bitewing radiographs (X-rays) about every 24-36 months to check for cavities.
Get a fluoride varnish treatment after your teeth cleanings.
Moderate Risk - Additional measures
Use a Power-assisted toothbrush– See The Benefits of Electric Toothbrush vs. Manual
Consider a high-fluoride toothpaste -such as Colgate PreviDent 5000 toothpaste (5000 parts per million fluoride)
X-pur Opti-Rinse 0.05% or .2% sodium fluoride rinse and rinse with 10 ml (one cap full) once or twice daily after you have used your fluoride toothpaste. Continue daily until your next dental exam.
Use Xylitol candies or gum four times daily. X-Pur or Pur.
Consider a high-fluoride toothpaste -such as Colgate PreviDent 5000 toothpaste (5000 parts per million fluoride)
X-pur Opti-Rinse 0.05% or .2% sodium fluoride rinse and rinse with 10 ml (one cap full) once or twice daily after you have used your fluoride toothpaste. Continue daily until your next dental exam.
Use Xylitol candies or gum four times daily. X-Pur or Pur.
High Risk - Additional measures
Peridex- Rinse for one minute, once a day with an antibacterial mouthrinse Peridex, which has an active ingredient called chlorhexidine gluconate at 0.12 percent. Use this once daily just before bed at night (10 ml for one minute), but only for one week each month. You must use this at least one hour after brushing with the 5,000 ppm fluoride toothpaste.
Recaldent paste - contains calcium and phosphate (e.g., MI paste). Apply it several times daily to your teeth.
Baking soda rinse (or similar neutralizing product)- Use four to six times daily during the day. You can make this yourself by shaking up two teaspoons of baking soda in an eight-ounce bottle of water.
Keep regular dental checkups at 3 to 4 month intervals to:
Allow us to review your use of chlorhexidine, Prevident and oral hygiene at that visit.
Get new bitewing radiographs (X-rays) about every six to 18 months to check for cavities.
Get a fluoride varnish during preventive visits.
Recaldent paste - contains calcium and phosphate (e.g., MI paste). Apply it several times daily to your teeth.
Baking soda rinse (or similar neutralizing product)- Use four to six times daily during the day. You can make this yourself by shaking up two teaspoons of baking soda in an eight-ounce bottle of water.
Keep regular dental checkups at 3 to 4 month intervals to:
Allow us to review your use of chlorhexidine, Prevident and oral hygiene at that visit.
Get new bitewing radiographs (X-rays) about every six to 18 months to check for cavities.
Get a fluoride varnish during preventive visits.