Methods on the Horizon to Prevent Dental Decay

Dental caries, commonly known as tooth decay or cavities, contributes to so many health issues, especially since upwards of 17.5% of children and 27.4% of adults go untreated. A lot of research has been directed towards efforts to develop methods of preventing dental decay, which have ranged from simple to highly sophisticated techniques. These current approaches are still under trial, and are based on three strategies:

• Combating decay inducing microbes within the oral cavity
• Increasing tooth resistance to acid attack by strengthening enamel
• Modifying decay-causing diet ingredients to improve the quality of the oral cavity’s pH balance and bacterial count

1. Antiplaque Agents
The role of plaque in the formation of dental decay is well documented. Thus, anti-bacterial and anti-adherence agents are being tested as plaque blockers.

 
2. Altering surface morphology and Increasing tooth resistance
‘Surface active agents for surface adhesive binding’ have been developed by Bowen et al [1995] comprising of application in two stages for increasing tooth resistance to dental decay. Tooth resistance is improved using a two-step procedure, by enhancing the fluoride uptake in enamel. A two component system can be used as a professional topical application or self-applied mouth rinse; or alternately, using chewing gum containing calcium and toothpaste containing fluoride.

 
3. Lasers
Carbon dioxide lasers can be used to alter the enamel of the tooth surface, and make it less prone to decay. However, concern exists, regarding the depth control and optimum irradiation conditions. Pit and fissure, and root surfaces may be the areas targeted by the lasers.

 
4. Benign Microorganisms / Replacement Therapy
Using the ‘use a thorn to draw a thorn’ philosophy, an approach would be to supersede the decay causing bacteria by applying more benign ones. The dominant acid [lactic acid] produced by dominant bacteria found in the decay is controlled by a gene, which can be mutated. Genetic engineering provides a better alternative, producing inactivated forms and then cloning them.

 
5. SAP ( self assembling polypeptides)
Preliminary reports have suggested the use of these agents [Strafford et al 1999] for increasing host resistance. These may be useful in promoting enamel remineralisation. These protective agents are used as pacifiers for young children, to help modify the bacterial flora against baby bottle decay. These peptides have also been used in mouth rinses and tooth pastes.

 
6. Chewing Gums
A novel technique involves the use of chewing gums, after meals, in order to counter the pH drop that occurs with the intake of sugars. Various sugar free gums have been tried out.

7. Tooth friendly Sweets
Use of non-decay causing sweeteners has proved to be excellent measures in the control of decay. There have been seven of them approved by the FDA: aspartame, stevia, acesulfame potassium, neotame, saccharin, luo han guo (monk) fruit extract, and sucralose.

8. Microdentistry
Here treatment begins before condition arises. It enables the use of a microscope to detect conditions invisible to the naked eye. This can again be used as an educational and motivational tool, by helping you observe your own oral conditions. For example, letting you see the microorganisms in the plaque.

 
9. Teledentistry
This is the provision of dental care where the patient and provider are not physically in the same location. This is a relatively new field of study, which can also be used as an adjunct in providing preventative home care suggestions.

 
10. Indigenous products
Recently a lot of emphasis has been placed on the utilization of the rich natural resources. In this context, studies have been conducted on the use of various products such as mango leaf, neem, and tea. These have been found to have anti-plaque and anti-decay causing potential.

 

11. Caries vaccine
The concept of a vaccine can be visualized primarily with the recognition of Mutans Streptococci as the key microorganism in the development of caries.

 

Prevention Via Excellent Oral Care

While numbers on dental decay seem to be improving, there are still many cases out there. Proper oral hygiene and regular dental visits also can prevent dental decay from forming in the oral cavity. Those that come through our office make us wish we had a magic wand that could take away the suffering and set the mouth right again. All we can do is encourage you to understand the importance of keeping your mouth healthy and offer our exam and oral services. Feel free to make an appointment to have your mouth examined in our Fort Worth office so we can keep decay away or deal with any that has started before it progresses too far. We can discuss the above options in more detail to maintain caries-free, high level oral health now and into the future.