MANAGEMENT OF DENTAL CARIES

A)CHEMICAL MEASURES FOR CARIES CONTROL
Use of:
1) substances which alter the tooth surface or tooth structure
a) fluoride exposure/application
üFluoridation of water supply ( with 1 ppm of F-)
üTopical application of fluoride
i) self-application
§Low dose/high frequency rinses
(0.05% NaF daily)
§High potency/low frequency rinses
(0.2% NaF weekly)
§ fluoridated dentifrices / toothpastes
(twice daily)

ii) professional application
§ acidulated phosphate fluoride gel (APF gel)
(1.23% annually or semi-annually)
§ NaF solution (2%)
§ stannous fluoride (8%)
b) bis- biguanides ( like chlorhexidine , alexidine)
c) silver nitrate
d) zinc chloride and pottasium ferrocyanide solution


2) SUBSTANCES WHICH INTERFERE WITH CARBOHYDRATE DEGRADATION THROUGH ENZYMATIC ALTERATION
a) vitamin k – use of synthetic vit K (2-methyl-1,4-naphtoquinone)
b)sarcoside - Na lauroyl sarcosinate,
Na palmitoyl sarcosinate,
Na dehydro acetate



3) SUBSTANCES WHICH INTERFERE WITH BACTERIAL GROWTH AND METABOLISM
a)Urea and ammonium compounds
b)Chlorophyll
c)Penicillin
d)Other antibiotics ( erythromycin, kanamycin, spiromycin, tetracycline, tyrothricin, vancomycin)
e)Caries vaccine
f)Nitrofurans – furacin,
furadroxyl



B) MECHANICAL MEASURES FOR CARIES CONTROL
1) dental prophylaxis (routine scaling and polishing)
2) toothbrushing
3) mouth rinsing
4) dental floss
5) oral irrigators
6) chewing xylitol gums (for 5 to 30 mints after meal)
7) detergent foods in diet (hard, fibrous foods)
8) pit and fisure sealants


C) NUTRITIONAL MEASURES FOR CARIES CONTROL
1) diet counselling
2) restriction of soft, sticky refined carbohydrate
intake
3) limiting in between meals.