Caries prevention and reversal based on the caries balance

Author(s): Featherstone J
Journal: Pediatric Dentistry
Volume (number): 28:2
Month, Year: 2006
Major topic: Caries Prevention
Minor topic(s:
Type of Article: Conference Review
Main Purpose: To review the caries balance concept and use it as a guide for caries prevention
Overview of method of research: N/A
Findings: N/A
Key points/Summary : The caries process can be easily summarized as a balance between pathological factors such as cariogenic bacteria, fermentable carbohydrates, and salivary dysfunction and protective factors such as saliva components and flow, fluoride, and antibacterial therapy. Tooth morphology, oral hygiene, sealant application, and fluoride releasing dental materials are also important factors that play a role in the caries process. The goal is to reduce the pathological factors and increase the protective factors. A caries risk assessment should be done for every patient and should evaluate the following risk factors: visible cavitation or caries into dentin by radiograph, carious lesions restored in the last three years, readily visible heavy plaque on the teeth, frequent between meal snacks of fermentable carbohydrates, saliva reducing factors, fixed or removable appliances. If the patient is high risk .12% chlorhexidine gluconate mouthrinse one a day for 1 week for 6 months can be prescribed along with a high fluoride toothpaste 5,000 ppm. Fluoride varnish for children under 5 placed 3x a year has also been shown to be very effective.
Assessment of article: Very interesting article with some great ideas for us to use on our patients.