Preventive dentistry emphasizes the importance of ongoing hygiene procedures and daily practices to prevent tooth decay and other dental diseases and conditions. Effective preventive dentistry combines at-home oral care by patients with chairside treatments and counseling by dental professionals.
For example, the American Dental Association (ADA) recommends a minimum of two dental checkups each year for professional cleaning and management of any developing conditions. Adhering to this recommendation can help your dentist stop dental disease in its earliest stages, protecting your smile and limiting your expense.
Begin daily tooth cleaning as soon as your child’s first tooth erupts. Visit a pediatric dentist when the first tooth erupts, or no later than 12 months of age, to establish a comprehensive oral health prevention program for your child.
Preventive Dentistry Strategies
Preventive oral care strategies for children and adults include a number of in-office and home care activities, including:
At-home oral hygiene. The most important prevention technique is brushing and flossing at least twice a day (or after every meal) to remove dental plaque, a film-like coating that forms on your teeth. If not removed, plaque can build up and produce dental tartar, a hardened, sticky substance with acid-producing bacteria that cause tooth decay and lead to gum disease.
Fluoride use. Fluoride strengthens teeth and prevents tooth decay. Fluoride treatments are provided in dental offices, and dentists recommend using fluoride toothpastes and mouth rinses at home. Public water fluoridation – ranked as one of the 20th century’s 10 great public health achievements – provides a major source of fluoride.
Diet. A balanced diet is a dental health essential. Foods with sugars and carbohydrates feed the bacteria that produce dental plaque, while calcium-poor diets increase your chances of developing gum (periodontal) disease and jaw deterioration.
Regular dental visits. Since most dental conditions are painless at first, if you don’t regularly visit your dentist, you may not be aware of dental problems until they cause significant damage. For best results, schedule regular dental check-ups every six months; more often if you’re at higher risk for oral diseases. Your dentist should also perform oral cancer screenings to check for signs of abnormal tissues. Especially for children, checking oral growth and development (including an assessment for caries development) should be part of dental evaluations.
Dental cleanings and screenings. A dental cleaning (prophylaxis) is recommended every six months to remove dental plaque and stains you’re unable to remove yourself, as well as to check for signs of tooth decay.
X-rays. X-rays enable dentists to look for signs of dental problems that are not visible to the naked eye, such as cavities between teeth and problems below the gum line.
Mouth guards. Mouth guards – particularly a custom-made mouth guard prescribed by your dentist to provide a better fit – can be worn during sports activities to protect against broken teeth. Mouth guards also are used to treat teeth grinding (bruxism), which can wear down teeth and contribute to temporomandibular joint (TMJ) disorder.
Orthodontics. A bad bite (malocclusion) can impair eating and speaking, and crooked teeth are hard to keep clean. Correcting an improper bite with orthodontics that may include the use of dental braces or clear teeth aligners (invisible braces), such as Invisalign or Invisalign Teen, limits the possibility of future dental problems.
Sealants. Sealants are thin composite coatings placed on the chewing surfaces of back permanent teeth to protect your child from tooth decay.
Avoid smoking and drinking. Smoking, chewing tobacco and alcohol consumption can negatively affect your oral health. Apart from dry mouth, tooth discoloration and plaque buildup, smoking causes gum disease, tooth loss and even oral cancer.
Oral health management. Consistent dental care for chronic dental diseases/conditions is essential for arresting or reversing their harmful effects.
Patient education. Patients who understand the outcome of poor dental health are likelier to see their dentist for preventive dentistry treatments. Instilling excellent oral hygiene habits significantly helps ensure a lifetime of dental health.
Importance of Fluoride
Fluoride is absorbed easily into tooth enamel, especially in children’s growing teeth. Once teeth are developed, fluoride strengthens tooth structure, making teeth more resistant to decay. Fluoride also repairs or remineralizes areas in which decay has already begun, thus reversing the process and creating a decay-resistant tooth surface.
Types of Fluoride
Fluoride is available in two forms: topical and systemic.
Topical fluorides strengthen existing teeth, making them more decay-resistant. Topical fluorides include toothpastes, mouth rinses and professionally applied fluoride therapies (gels, foams, rinses or varnishes). Many dentists give topical fluoride treatment to children up to age 18. For people with rampant cavities or predispositions to decay – such as people wearing orthodontic appliances and those with dry mouth – dentists may prescribe a special gel for daily home use.
Systemic fluorides are ingested into the body and incorporate into forming tooth structures. Systemic fluorides also can give topical protection because fluoride is present in saliva, which constantly moistens teeth. Systemic fluorides include public water fluoridation or dietary fluoride supplements in the form of tablets, drops or lozenges. However, keep in mind that the type of naturally occurring and added fluoride in the water supply can vary from area to area. Consult with your child’s pedodontist to learn which form will be best for your child based on your area.
The ADA recommends that adults and children two years and older use a fluoride toothpaste bearing the ADA Seal of Acceptance. Consult with your child’s dentist if considering the use of toothpaste before age two. The ADA also recommends the use of fluoride mouth rinses, but not for children under six years old, since they may swallow the rinse.
Other Preventive Dental Substances
Used as a dental treatment, amorphous calcium phosphate (ACP) might help in restoring the necessary mineral balance of calcium and phosphate – natural building blocks of teeth – in the mouth. When applied to tooth surfaces, ACP strengthens tooth enamel before and after bleaching, and can protect dentin after professional dental cleaning and during orthodontic treatment, helping to prevent dentin hypersensitivity. ACP is currently found in toothpaste (Arm & Hammer’s Enamel Care Toothpaste) and bleaching gels, as well as professional sealants (Aegis Pit and Fissure Sealant) available in dental offices.
Many dentists also recommend xylitol, a natural sweetener made from birch trees, which has been clinically shown to reduce cavities and help prevent tooth decay and gum disease. Xylitol can be used as a sugar substitute in cooking and baking, or beverages. It also is included in toothpastes, mouth rinses, chewing gums and candies.
Technology for Dental Disease Prevention
Intraoral cameras, which can be used in conjunction with computers or television monitors, take pictures of the outside of the tooth. Digital radiography is a form of X-ray imaging where digital X-ray sensors are used instead of traditional photographic film X-ray images. Faster and easier than conventional X-rays, they offer the ability to digitally transfer and enhance images of problem areas on a computer screen next to the patient’s chair, allowing for better detection and patient education. Most importantly, they emit up to 90 percent less radiation than conventional radiography.
Air abrasion is a drill-less technique used to remove tooth decay, superficial stains and discolorations, or to prepare a tooth surface for composite bonding or sealants. During air abrasion, a fine stream of particles (silica, aluminum oxide or a baking soda mixture) is aimed at the decayed portion of the tooth, and propelled toward the tooth surface by compressed air or a gas that runs through the handpiece of an instrument that works similar to a mini sandblaster. When the particle stream strikes the tooth, small particles of stain and decay are removed and suctioned off.
Diagnostic tools such as Caries I.D. and Diagnodent help detect dental caries at the earliest stage before they progress further. Caries I.D. uses Light Emitting Diode (LED) and fiber optic technologies to detect caries. The Diagnodent is a fluorescent laser that finds cavities beneath the tooth’s surface that are typically not visible with X-rays.
Importance of Caries Risk Assessment
Your dentist can customize a prevention program based on your individual caries risk assessment profile. Caries risk assessment, which involves observing the patient’s clinical appearance, also takes into account the following:
- Number of existing carious lesions (someone with two or more may be considered at high risk of developing future caries)
- Fluoride exposure
- Salivary flow rate
- Medication use. Some medicines can contribute to cavities since many contain high amounts of sugar or may decrease saliva flow.
- Each age group – children, teens, adults and seniors – has its own set of associated risks.
- Income, education and oral health attitude. Research shows that those who have low incomes or lower education and achievement are likelier to have severe and untreated dental decay.
- Clinical variables such as number of filled/restored or missing teeth
- Laboratory factors such as salivary calcium levels
Benefits of Preventive Dentistry
Considering that oral health is linked to overall health, preventive dentistry is important to your overall well being. Oral diseases can interfere with eating, speaking, daily activities and self-esteem.
In children, severe decay can affect growth and development. Preventive dentistry can result in less extensive – and less expensive – treatment for any dental conditions that may develop, and help you keep your natural teeth for a lifetime.