Prevention initial caries Dental fissures are carried out using special materials - dental sealants (sealants). Sealing agents are divided into four groups:
Cements - vitacryl, polycarboxylate, ionomer cements, aluminosilicate cements, etc.
Plastics - carbondent, acrylic oxide, epodent, etc.
Composite materials - Evicrol, Consize, Adaptik, Diamond, etc.
Sealants.
By chemical composition:
A. Based on Bis GMA - Oralin (SS White Dental Products), Visio Sea] (ESPE), Sealite (Kerr), Estiseal (Kulzer).
B. Based on UDMA and other polymers - Prisma-Shield (Dentsplay), Fluro Shield (Dentsplay).
According to the hardening mechanism:
A. Self-hardening - Contact-Seal (Vivadent), Prisma-Shield (Dentsplay), Evicrol-Fissur (Spofa-Dental), Delton (Jonson-Jonson, USA).
B. Photopolymer - Fissurit, Fissurit F (VOCO), Helio Seal, Helio Seal F (Vivadent), Visio Seal (ESPE), Esti Seal LC (Kulzer), Ultra Seal (ESPE), Pit and Fissure Sealant (Bisco), Dentalex (Stoma-Technology, Kharkov).
According to the presence of filler:
A. Unfilled (filler content does not exceed 26-28%) - Helio Seal (Vivadent), White light, Oralin (SS White Dental Products), Del-ton (Jonson-Jonson, USA), Visio Seal (ESPE).
B. Filled (filler content is 50%) - Prisma-Shield (Dentsplay) - 50%, Esti Seal LC (Kulzer) - 32%, Sealite (Kerr) -40%, Fluro Shield (Dentsplay) - 50%.
Basic requirements for sealants:
persistent adhesion to tooth tissue in a humid environment;
high resistance to pressure and abrasion;
hardening at room temperature in a humid environment for 2-3 minutes;
color stability and the impossibility of changing the color of tooth tissue;
5) manufacturability for use in a clinic setting. The fissure sealing technique is as follows:
1. Brushing your teeth with a toothpaste that does not contain fluoride, since it blocks the enamel pores and reduces the effect of the acid etching of the enamel provided by the technique, which in turn leads to an increased risk of sealant loss and the development of caries.
Additional cleaning of the chewing surface of the tooth with rotating brushes and rubber cups using various abrasive pastes.
Removing plaque residues from the tooth surface with a water-air jet.
Isolation of the tooth from saliva using cotton swabs and a saliva ejector.
Thoroughly dry the tooth surface with air for 30 seconds.
Etching tooth enamel with 35-37% phosphoric acid for 15-20 seconds.
Washing acid from the tooth surface with a water-air jet. The flushing time should correspond to the acid etching time.
Repeated isolation of the tooth from saliva using cotton rolls and a saliva ejector (saliva getting on the etched surface leads to contamination of the enamel pores and worsens the retention of the sealant).
Drying the etched surface with air. Etched enamel should be a dull, matte, chalky white color. In the absence of this reaction, the enamel etching steps must be repeated.
Application of sealant must be carried out immediately thin layer throughout the fissure-pit network of the chewing surface, eliminating the formation of air bubbles and overestimation of the occlusal height of the tooth. When using light-curing materials, illuminate them for 40 seconds.
Control of occlusion and elimination of overbite, surface polishing.
Monitoring of the installation of sealant is carried out in the following periods: after a week, a month, six months and a year.
Endogenous prevention of dental caries (Fig. 41) consists of introducing Ca, F and P preparations, microelements and vitamins into the child’s body. It is divided into medicinal and non-medicinal.
The basis of drug-free prevention of dental caries in children is correct, balanced diet as a source of qualitatively complete metabolism. Endogenous drug prophylaxis - This is the administration of Ca, F, P salts of microelements in combination with vitamins into the child’s body in age-appropriate dosages. Prevention of dental caries should begin during the formation of the organ-
If the concentration of fluoride in drinking water is insufficient, it is recommended to prescribe fluoride preparations. The required daily dose of the drug is established depending on the age of the child and the fluoride content in the drinking water. If a child receives approximately 0.3-0.5 fluoride per day from food, then, therefore, it is necessary to introduce up to 1 mg of fluoride into the body.
If the fluoride content in drinking water is 0.1-0.3 mg/l, it is recommended that a child under 3 years of age be prescribed 0.25 mg of fluoride orally, from 3 to 5 years old 0.5 mg, and over 5 years old - 1 mg. Reception sodium fluoride in tablets should start from the 2nd year of a child’s life and continue until 13-15 years. A contraindication for their use is the fluoride content in drinking water exceeding 0.8 mg/l. It is recommended to take the tablets daily immediately after breakfast for at least 250 days a year (it is better to chew them with water). It is not recommended to simultaneously take medications containing Ca.
Sodium fluoride is produced in tablets of 0.0011 and 0.0022 g.
Rp: Tab. Natrii fluoridi 0.0022 N 50 D.S. 1 tablet per day (children 7-14 years old) #
Rp: Tab. Sodium fluoridi 0.0011 N50.
D.S. 1 tablet per day (children 2 years old)
Taking sodium fluoride tablets 2-3 times a year can be alternated with taking Vitafluor.
Vitaftor - combination drug, containing sodium fluoride and a complex of vitamins A, D 2, C. Sodium fluoride has an anti-caries effect and accumulates in bones, teeth and cartilage. Vitamin C limits the deposition of fluoride in tissues and thereby prevents fluoride intoxication. Vitamin A contributes to the normal development of teeth and the proper formation of the skeleton. Vitamin D 2 regulates the exchange of phosphorus and calcium in the body.
Vitaftor is taken orally during meals or 10-15 minutes after meals once a day. Children from 1 year to 6 years are prescribed 1/2 teaspoon, from 7 to 14 years - 1 teaspoon daily for 1 month, after a 2-week break the course of treatment is repeated. Repeated courses are recommended to be carried out 4-6 times a year with a break in the summer months. The drug is contraindicated when the fluoride content in drinking water is over 1.5 mg/l and in cases of A- and D-hypervitaminosis. Release form - in dark glass bottles of 100 ml.
Rp: Vitaftori 100 ml
D.S. 1/2-1 teaspoon 1 time per day with meals for 1 month.
nic matrix of temporary and permanent teeth, their mineralization and continue after eruption until the enamel is completely mature.
Rice. 41. Types of endogenous prevention of dental caries.
Prescription of fluoride preparations orally
When administered enterally and parenterally, fluoride affects mineral and protein metabolism in the body as a whole and in dental tissues. However, it should be remembered that fluorine is a protoplasmic poison that inhibits metabolic processes in tissues. Chronic fluoride poisoning manifests itself various symptoms when its concentration in water is more than 10 mg/l. Fluoride compounds enter the body with water and food in the form of fluorides. The daily need for them for children of different ages is: 1 year - 0.7 mg; 2 years - 0.8 mg; up to 4 years - 1 mg, up to 10 years - 1.3 mg; over 10 years - 1.5 mg.
For general prevention, fluoride is prescribed orally in the form of sodium fluoride tablets, fluoridated milk, table salt or drinking water. The average fluorine concentration in artificially fluoridated water in temperate climates should be 0.8-1.2 mg/l. Natural sources of fluoride are also used mineral waters with its high content.
Caries is the most common disease in the world, representing pathological process destruction of hard dental tissues due to a number of unfavorable factors. This dental problem Depending on the stage of the disease, it is treated with a variety of methods - both innovative and gentle, and conservative, often very painful for the patient. How to prevent the development of caries and reduce the risks of its occurrence in the long term? You can read about this and much more below.
The simplicity and reliability of determining caries very much depends on the stage of its development, as well as the localization of foci of destruction on the dentition. At home, at the stage of a carious spot, when the pathology is located in the cervical, rib or root zone, it is almost impossible to visually notice the disease. Only a clear outer location on the visible part of the enamel suggests the presence of a small area of chalky color.
During the transition from the basic stage to classic superficial caries, the affected area acquires a more pronounced whitish tint, while the localization loses its shine compared to the rest of the enamel - active demineralization and destruction of the outer layer of the tooth begins, which is still focal. Over time, the diseased tooth begins to react to too cold, hot, sour, sweet foods and drinks, forming a temporary pain syndrome.
In medium and deep forms of the disease, the pathology is visible to the naked eye - these are darkening, holes and black cavities, partial tooth destruction, etc.
Especially important stage effective fight With caries, it is customary to diagnose the problem as early as possible - only an experienced dentist can carry it out properly, through both a thorough visual examination using a special mirror and instrumental research techniques. Most often in modern dentistry To solve this problem the following is used:
Adult men and women who do not have serious chronic diseases, shows the full range of possible preventive measures aimed at counteracting the possible manifestation of caries.
Comprehensive prevention usually includes the elimination of a potentially dangerous cariogenic situation, as well as a significant increase in disease resistance of all structures of the oral cavity, both generally and locally.
Main activities include:
Children from one to 14 years old are included in special group risk for caries - as modern medical statistics show, it is they who most often quickly acquire this pathology, and the carious process itself on milk teeth develops rapidly - sometimes the timing of the transition from the stain stage to deep defeat dentin takes only a few months.
When to start the first preventive measures? Dentists recommend paying attention to the potential risk after the baby’s first teeth erupt.
Where to start? To begin with, introduce drugs with a high calcium content into the child’s diet, adjusting the diet in parallel, limiting as much as possible the use of products based on simple carbohydrates. Chips, carbonated water, inexpensive candies, industrial baked goods - all this negatively affects the condition of a child’s teeth. Be sure to include milk, cottage cheese, hard cheeses in your diet, and don’t forget about vitamins - it is advisable to eat fruits that are not very sweet, and in the autumn-winter period it becomes mandatory to take vitamin-mineral complexes.
Almost every child does not like brushing their teeth too much - try to organize this monotonous process in a game form, carefully monitoring the cleaning time (it should not be less than 3–4 minutes). Teach your child the correct treatment of the cavity with manipulation of all parts/elements of the dentition.
As an addition, for children over 5 years old, regular rinsing of the mouth with fluoridated water is allowed - this will speed up the processes of natural mineralization of enamel and protect not too resistant milk teeth from the potential negative effects of bacteria.
Cardinal in children - non-invasive sealing fissure It is on the chewing surfaces that teeth are most susceptible to caries, since food debris enters small spaces and microflora actively multiplies. The procedure itself consists of a number of stages:
Prevention of caries in the fair sex during pregnancy has a double meaning - first of all, the woman’s teeth, which are losing their resistance due to changes, are protected from potential carious processes. hormonal levels and lack of essential minerals/vitamins, and are also carried out preventive measures, aimed at reducing the risk of developing pathology in the unborn child during the antenatal period.
The basic principles include the following:
Modern medicine knows many methods and types of caries prevention. Their effectiveness in most cases is due to a number of factors - from genetic predisposition to pathology before external influence. Basically, all activities can be divided into two large groups - endogenous (general) and exogenous prevention.
It is the prevention of dental caries by general health improvement and increasing the body's resistance.
In turn, it is divided into prevention with medications and non-drug measures. Drug-free endogenous prevention carried out in two directions.
Drug endogenous prophylaxis is carried out strictly under medical supervision. The dentist prescribes optimal doses of medications taking into account age, the current state of the body, and the presence of concomitant chronic and acute diseases.
Typical representatives:
By the term “exogenous caries prevention,” dentists mean local methods of preventing dental caries. Despite high efficiency a systematic approach to reducing the risk of carious processes, due to economic, technical and physiological reasons, as well as the characteristics of the body, there is a need for additional direct treatment of the oral cavity and dentition.
Two main areas of exogenous prevention include oral hygiene and the use of direct-acting special means:
As modern medical statistics show, the trend towards a decrease in the incidence of caries diagnosis in developing countries is associated with the beginning of the total use of fluoride-containing pastes - about 90 percent of such products on the market contain this substance. Also, an important contribution is made by the use of additional hygienic oral devices - sugar-free chewing gum based on xylitol, organic and synthetic products removing plaque from the enamel, under which carious processes are formed, is an increasing passion among the population professional methods cleaning the oral cavity in a dental office.
Any methods will not help get rid of the risk of caries if you do not use highly effective means to carry out basic activities. First of all, these include toothpastes - the most affordable consumer goods.
Modern toothpaste almost always contains fluoride compounds (fluoride). At correct use of this product (using at least 2 times a day, 3 minutes of intensive cleaning of the entire dentition and adjacent areas) the risk of carious processes is reduced by 40 percent.
One more effective method Local counteraction to the possible manifestation of caries is considered to be the treatment of teeth with fluoride compounds. Especially relevant this remedy in children over 5 years of age during the maturation of tooth enamel.
Other typical drugs used as a means of preventing caries, modern dentists include:
The basic basis for local caries prevention, regardless of any circumstances, is comprehensive proper oral hygiene. It is in this localization that all carious pathologies begin and develop, and the disease itself originates under plaque and the action of the natural microflora of the mouth and teeth.
Basic hygiene techniques:
Quite often, people who think they practice oral hygiene on a regular basis still develop tooth decay. Why is this happening? Most often, the cause is banal errors during procedures, which constantly increase the risk of carious processes. The most famous and typical:
What can be done to prevent caries at home, in addition to classic teeth brushing, correcting your diet, taking vitamin-mineral complexes and immunomodulators, and using floss? Most often these are folk remedies.
It should be understood that conservative medicine does not recognize “traditional methods” as an effective and reliable concept of prevention, although a number of recipes under certain circumstances can help counteract the development of carious processes if they are used as a supplement to the main approved methods. Before using any of the methods described below, be sure to consult with your dentist.
A proper diet is one of the important components of endogenous caries prevention in people of any age. It is the daily diet, if it is poorly chosen, that can provoke the formation of plaque and create an optimal environment for the growth of bacteria in the oral cavity, which, in the presence of a large amount of simple carbohydrates, produce organic acids that negatively affect the enamel.
What should you give up? First of all, limit as much as possible the consumption of sweet black tea and coffee, chips, salted peanuts, crackers, muffins, donuts, milk chocolate and other products that provoke the formation of plaque and contain a large amount of simple carbohydrates.
Add dairy and fermented milk products, vegetables and unsweetened fruits, as well as all types of meat to your daily diet. Eat a balanced diet (equal proportions of proteins, fats and complex carbohydrates), fractionally, at least 5–6 times a day, but in small portions. Try not to pass it on at night and, if possible, brush your teeth after each meal. If this is not possible, use sugarless chewing gum with xylitol and rinse from time to time. antiseptic solutions fluoride-based (but do not replace brushing your teeth on a regular basis).
Caries is one of the most common dental diseases, which affects the teeth and has serious consequences. In order to avoid irreparable consequences, it is necessary to carry out preventive measures in a timely manner. Preventing a disease is much easier than treating it later. Let's take a closer look at what caries prevention includes.
In dentistry, there are many methods for preventing caries. The goal of each of them is to eliminate the disease itself and the causes of its occurrence. There is even antenatal prevention of dental caries - for the fetus in the womb, which consists in maintaining healthy image pregnant woman's life.
Classification of methods to combat the disease:
Primary methods are divided into the following sets of measures:
The first and second types of caries control are carried out both with and without the use of drugs. A correctly selected method gives a positive result in 95% of cases.
This article talks about typical ways to solve your issues, but each case is unique! If you want to find out from me how to solve your particular problem, ask your question. It's fast and free!
Of considerable importance in the appearance and further development diseases play a role in the following circumstances:
The development of caries largely depends on oral hygiene. When carrying out the prevention of dental disease, it is necessary to take into account the following factors that can trigger its development:
By addressing these causes, it is possible to prevent the occurrence of caries in both adults and children. Prevention of this dental disease will be most effective if this effect is directed at all three factors simultaneously. This approach is called “comprehensive prevention.”
Action common methods The fight against caries is aimed directly at the body and consists of the following procedures:
Local (local) methods of combating caries involve a direct effect on the teeth and oral cavity. This includes the following procedures:
There is another classification, according to which the prevention of caries is divided into:
Primary is a set of measures aimed at preventing the development of caries, eliminating the conditions and causes of its occurrence. The purpose of this dental prophylaxis is to increase immunity to resist unfavorable environmental factors, which can lead to pathological modifications.
The task of secondary prevention is to identify caries in early stages and preventing its reappearance. This type of prevention of oral diseases involves effective treatment an existing disease and its exacerbations.
Tertiary prevention of dental diseases consists of a set of measures, the main goal of which is to restore the integrity of dental units and their functional abilities. In other words, carrying out these measures helps to restore the lost functions of the dental system.
Endogenous prevention of caries is a set of methods whose main task is to strengthen the dentition. The activities carried out affect the entire body.
These are:
Endogenous ways to prevent the disease are:
To reduce the risk of developing the disease, it is necessary to adjust the daily diet. It is necessary to exclude or minimize the consumption of those foods that have a detrimental effect on tooth enamel. Banned:
The listed products not only disrupt the functioning of the gastrointestinal tract, but also lead to acid imbalance in the mouth. They can be easily replaced with those that have a beneficial effect on the condition of the teeth. Consider the list of the most useful products:
To reduce the risk of caries development, it is necessary to exclude snacks that disrupt the entire diet. As a result, such preventative measure the duration of the influence of acids and sugars on teeth will decrease.
If the body lacks any microelements or vitamins, this quite often provokes demineralization of the teeth and subsequently leads to the development of caries. For this reason, it is important to replenish the body’s daily needs for vitamins C and D. Don’t forget about calcium.
Modern man does not always have the opportunity to eat regularly and nutritiously. However, the problem is easily solved. Special complexes of vitamins and minerals become a lifesaver here. To prevent the development of caries, a system of fluoride prevention methods is used, which consists of:
In addition to the described methods, endogenous prevention of dental caries consists of:
Everyone knows that a decrease in immunity does not have the best effect on the condition of teeth. It is for this reason that when common diseases it is necessary to consult a doctor in a timely manner. He will make a diagnosis and prescribe the necessary medications for the treatment of the disease and recovery. protective forces body (immunomodulators). The latter, in addition to their direct purpose, are a good preventive measure for the development of caries.
If you urgently need to brush your teeth, but don’t have a toothbrush at hand, chewing gum is a good way out of this situation. Although she is not medicine and will not eliminate existing caries, but it will be able to remove accumulated plaque and food debris from the teeth without much difficulty. In addition, chewing gum will give your breath freshness, just like after a standard teeth brushing procedure.
It is very important to chew food well while eating. To do this, you need to chew each piece slowly and thoroughly. The diet should include solid vegetables and raw fruits.
Remember that the absence of stress has a beneficial effect not only on the central nervous system, but also on the entire body. Teeth are no exception here.
Exogenous methods of caries prevention are dental care (for their surface), which is based on chemical and mechanical effects on them. The technique includes the following procedures:
To take good care of your teeth, you should know how to choose a toothbrush. How not to make a mistake with your choice? You need to pay attention to the degree of stiffness of her stubble. Depending on this, brushes are divided into:
When choosing this hygiene item, you should take into account the condition of your teeth and gums. If they are healthy, then you can safely use a brush with stiff bristles. For children and those with gum problems, it is necessary to choose a brush with soft bristles. Suitable for most people average degree rigidity, since it is optimal. Brushes that are too hard should be chosen by those who suffer from increased plaque formation on the enamel surface.
The size of the toothbrush head is also important when choosing. It should not cover more than 3 teeth. That is, its length should be within 2.5 - 3.5 cm. The head should bend well, and the tufts of bristles on it should be different lengths and placed in the form of an X.
Don't forget that toothbrush Requires replacement every three months. During this time, it loses the ability to clean the tooth surface well, as it wears out greatly. In addition, a lot of pathogenic microbes collect in the bristles.
Toothpaste is a good product for oral hygiene. It not only cleanses your teeth, but also freshens your breath. Special attention deserve medicinal paste preventive action. They not only strengthen the enamel, but also reduce the risk of caries. Such toothpastes usually contain many useful components that can prevent dental diseases. These include:
In the modern world, pastes with fluorides (fluoride ions) have become popular, which saturate tooth enamel and, thus, form fluorapatite (the hardest compound of the enamel crystal lattice).
Thanks to this, teeth become resistant to acids and bacteria, and the likelihood of caries is noticeably reduced.
Fluorine has mass beneficial properties. He is simply irreplaceable for human body and for teeth in particular. To prevent caries, a fluoridation procedure is carried out, which is divided into:
Simple fluoridation involves placing mouth guards with a fluoride preparation on the teeth. One procedure takes no more than 20 minutes. There should be at least 10 such sessions.
Deep fluoridation- This is a coating of the tooth surface with a special varnish that contains fluoride. Fluorides then gradually move from the varnish into the tooth enamel. The procedure must be carried out at least twice a year. Remineralization is another method by which enamel can be strengthened. It consists in saturating it with calcium, magnesium, fluorine and many other elements in ionized form.
Fissures are indentations and grooves on the chewing side of the teeth. They are considered the most vulnerable areas, as tiny particles of food accumulate in them, which are difficult to clean out. Such accumulations negatively affect the microflora of the oral cavity and lead to the appearance of plaque and stone. After them, caries appears.
To prevent such problems, the fissure is sealed. The chewing side of the teeth is coated with a fluoropolymer sealant that is resistant to acids. The treated surface becomes flat, so plaque no longer accumulates on it.
Fissure sealing is used mainly in children, but not always. Adults, if desired, can spend it up to 55 years of age.
Oral hygiene, or rather, its observance, is not the least important in the prevention of caries. Brushing is good, but it is not enough to effectively remove food debris and plaque from the surface of the teeth. In such cases use the following means for oral care:
There are many preventive procedures that reduce the risk of developing the disease:
To prevent caries from reaching children's teeth, it is necessary to carry out its prevention. As in the case of “adult” caries, endogenous and exogenous methods are suitable.
The first includes:
The exogenous technique is:
PREVENTION OF DENTAL CARIES
It can be carried out by a set of measures aimed, on the one hand, at eliminating the cariogenic situation in the oral cavity, and on the other, at increasing the resistance of tooth tissues. In accordance with the current objectives, caries prevention should be carried out from the prenatal period of fetal development and continue throughout a person’s life. In prenatal period The formation of teeth and the development of the entire masticatory apparatus occur, which largely determine their further condition. In particular, the formation of a complete structure and the degree of mineralization of hard tooth tissues determine their resistance to caries. Due to the fact that the development of the fetus largely depends on the condition of the pregnant woman, the first stage of caries prevention is caring for the health of the expectant mother: a rational general regimen, a balanced diet, prevention of the occurrence of general somatic diseases, and if they occur, early and active treatment-all this forms the basis of health education work among expectant mothers. A pregnant woman's diet should include a wide range of proteins (primarily plant origin), carbohydrates, fats. A significant portion of these substances should be easily digestible (milk, cheese, butter). The products consumed must also contain sufficient amounts of mineral components and vitamins. The optimal content of the microelement fluorine in drinking water is important (at least 1 mg per 1 liter).
After the birth of a child, the creation of full-fledged tooth tissue structures depends on the state of his health (the negative role of concomitant diseases). Maintains the value and supply of necessary substances to the body nutrients, sufficient both qualitatively and quantitatively. The most valuable nutrition for a newborn is breast milk, as it contains an optimal set of essential nutrients. In turn, the nutrition of a nursing mother should also be complete, that is, a rational general regimen is necessary. In this regard, active sanitary and educational work should be carried out among both parents and employees of the relevant organized children's groups.
During lactation, nursing mothers have a need for mineral salts, microelements, and vitamins. It can be ensured by consuming cottage cheese, cheese, milk (at least 500 g per day), eggs (1-2 pcs.), vegetables ( fresh cucumbers, carrots, radishes, etc. in an amount of at least 800 g per day). It is advisable to include fruits, berries, and fresh herbs (sorrel, lettuce, etc.) in the diet of nursing mothers. It is better to eat bread made from wholemeal flour. Fluid intake should be limited to 2 liters per day. You should avoid eating spicy foods, as well as foods that have a bitter taste and strong odor that can change the taste of breast milk.
The daily diet of a child aged 1-3 years should include milk (at least 700 g), cottage cheese (35-40 g), vegetables (at least 150 g in addition to potatoes), and fruits (at least 100 g). The amount of sugar should not exceed 60 g, and sweets should not exceed 10 g per day. Limiting carbohydrates in the diet of both infants and older children and replacing sugar with non-cariogenic products (sorbitol, xylitol) in infant formula and confectionery products is a promising direction in the prevention of caries in preschool children.
School age coincides with the replacement of temporary (baby) teeth with permanent ones. Teething and subsequent maturation (mineralization) of enamel continue mainly until 15-17 years of age. This must be taken into account when determining the optimal diet for a schoolchild. It is necessary to include in this diet a sufficient amount of vegetables, fruits, which are rich in vitamins and mineral salts. Bakery and pasta products, cereals, carbohydrates should not exceed the recommended standards. Diet is also extremely important. A strictly defined number of meals during the day and the exclusion of sweets in the intervals between them significantly reduce the possibility of developing caries.
A significant role in the prevention of dental caries is played by the prevention and elimination of developed dentoalveolar deformities. Orthodontic treatment, aimed at normalizing the bite, eliminating crowding of teeth, reducing the likelihood of caries. Along with this, long-term use of orthodontic appliances creates favorable conditions for retention around them. food leftovers, makes it difficult for teeth to self-clean, which, if not properly cared for, increases the risk of carious lesions. Careful care of teeth and orthodontic appliances during their use eliminates the conditions for the development of caries and inflammation of the marginal periodontium.
Of the numerous microelements entering the human body with food products And drinking water, fluoride has the greatest anti-caries effect. The most pronounced effect is observed with its optimal intake into the body during the period of development, mineralization and subsequent maturation of tooth enamel. The most common method of preventing dental caries at present is artificial fluoridation of drinking water (up to a concentration of 1 mg/l), which reduces the incidence of caries by 30-50%. The World Health Organization (WHO) has recommended the use of water fluoridation in all countries. The mechanism of the anti-caries effect of fluorine is explained primarily by the formation of resistant structures in the enamel that are resistant to acids due to the conversion of hydroxyl apatite into fluorapatite when the hydroxyl group (OH-) is replaced by fluorine (F-). Along with this, a number of authors provide data that fluoride has a direct effect on dental plaque, suppressing the acid-forming effect of microorganisms of the so-called dental plaque.
In conditions where it is not possible to fluoridate drinking water or certain food products (milk, salt, etc.), fluoride can be introduced into the body in the form of tablets based on the optimal daily intake of 1.2-1.6 mg. The anticarious effect of using fluoride tablets depends primarily on the age at which they begin to be taken, as well as the duration of their use. Fluoride tablets should be prescribed immediately after the birth of the child and continued until 15-17 years of age (the approximate period of formation and mineralization of permanent molars). There is evidence that when using fluoride-containing tablets, starting from the age of 7, the rates of dental caries are reduced not only in those teeth that erupt after starting to take sodium fluoride, but also in previously erupted ones. The disadvantages of this method of administering fluoride include the difficulty of monitoring the regular intake of tablets in unorganized groups of children. The effectiveness of using fluoride tablets depends on how often you take them. Daily use of tablets containing 2 mg of sodium fluoride for 21/2 years reduces the intensity of caries of permanent teeth in 7-8 year old children by an average of 57%.
Fluoridation of drinking water and the use of tableted fluoride for the prevention of caries is necessary only if the content of this element in the water is insufficient.
The forms of local application of fluoride compounds can be different: application of solutions, rinsing, applying special varnishes to the surface of teeth, brushing teeth with fluoride-containing pastes, etc. Some authors include fluoride-containing chewing gum in the same group.
I.G. Lukomsky (1936) proposed local treatment of teeth with 75% fluoride paste 2 times a year (1 minute on each surface of the tooth crown) to prevent caries.
The disadvantage of this method is the significant complexity of the paste application procedure. I. O. Novik (1958) recommended applying a 1% sodium fluoride solution to teeth for prevention purposes. For longer contact of fluoride with dental tissues, the use of fluoride-containing varnishes based on polymer compounds is promising. The varnish, applied in a thin layer to a thoroughly cleaned and dried tooth surface, remains on it for several hours, which ensures the diffusion of fluoride ions into the enamel. Teeth are coated with varnish two or three times every 6 months. The advantage of this method is its simplicity of application and low time consumption with significant efficiency.
In addition to the above methods of introducing fluoride into tooth enamel and thus increasing its resistance to caries, it is proposed to use fluoride-containing toothpastes. Their use ensures repeated and fairly long-term contact of fluoride with enamel. The results of observations are heterogeneous, but most authors note the anti-caries effect of this method of local fluoridation.
In addition to sodium fluoride, in a number of countries tin fluoride and sodium monofluorophosphate are used for local dental treatment. The mechanism of the preventive action of tin fluoride is associated with the formation of tin phosphate, calcium fluoride and tin hydroxyphosphate. At the same time, a decrease in the solubility of enamel in acids, a slowdown in the formation of dental plaque, and a deterioration in its fixation on the surface of the tooth crown are noted.
IN lately Organic fluorine compounds began to be used. According to a number of authors, amino fluorides have a great ability to be incorporated into the enamel: they increase its acid resistance; have a more pronounced inhibitory effect on the glycolysis of anaerobic bacteria and the formation of acid in the plaque.
It is promising to increase the resistance of dental tissues by treating them with remineralizing solutions, the main components of which are calcium and phosphorus. Application remineralizing therapy using a 10% solution of calcium gluconate in combination with a 2% solution of sodium fluoride has become widespread. First, the tooth surface is cleaned with a toothbrush and any hygienic toothpaste, and then washed with cotton swabs moistened with a solution of hydrogen peroxide. After this, the surface of the teeth isolated from saliva is dried with a stream of warm air and a tampon moistened with a 10% calcium gluconate solution is applied for 15-20 minutes. Then a swab moistened with a 2% sodium fluoride solution is applied for 1-2 minutes. This procedure carried out three times (every other day) every six months, reducing the increase in dental caries to 24% or more.
Preventive treatment with the Remodent composition is carried out according to the following method: teeth are cleaned with hygienic paste, the teeth are isolated from saliva and dried with a stream of air. After this, cotton swabs, generously moistened with a 2.5-3% Remodent solution, are placed in mouth guards made of plastic, and the mouth guards are applied to the teeth. This allows the solution to be applied to all surfaces of the tooth crowns. The duration of the procedure is 15-20 minutes, repeated treatment is carried out after 2-3 days. Three such courses are carried out per year. Clinical observations have shown that three years of use of the Remodent solution in applications reduces the incidence of caries by approximately 45%.
Remodent toothpaste has an anti-carious effect. The mechanism of action of this drug is seen in a decrease in the oral hygiene index and an increase in the acid resistance of human tooth enamel.
One of the ways to eliminate the cariogenic situation in the oral cavity is to avoid contact of food debris and microorganisms with the most caries-prone areas of the teeth. For this purpose, it has been proposed to use sealants with high adhesive ability to close fissures and blind pits. After drying the tooth and isolating it from saliva, the fissure is etched with phosphoric acid (found in the kit) for 1 minute filling material). Then equal parts of the liquid from two bottles are mixed on a mixing plate and the liquid mixture is applied to the enamel etching area. This mixture not only fills the fissures, but also diffuses into the interprismatic spaces of the enamel of the tooth crown, which determines the high adhesive properties of the sealant. Reliable closure of fissures is ensured in this way throughout the year. This method makes it possible to achieve a significant reduction in the incidence of dental fissures by caries.
