From the Guidelines
The most effective treatment for dental caries is the use of fluoride to prevent and control the disease.
Treatment Options
- Fluoride toothpaste: brushing with a fluoride toothpaste twice daily to minimize dental caries by inhibiting demineralization of tooth enamel and facilitating tooth remineralization 1
- Drinking water with optimal fluoride concentration: frequent exposure to small amounts of fluoride through drinking water to prevent dental caries 1
- High-Concentration Fluoride Products: applying high-concentration fluoride products to persons at high risk for dental caries 1
Patient Risk Assessment
It is essential to assess the patient's risk for dental caries to determine the most effective treatment approach.
- High-risk patients: fluoride modalities are most cost-effective for persons at high risk for dental caries 1
- Low-risk patients: limited benefit is gained by adding caries-preventive modalities to water fluoridation and fluoride toothpaste 1 The use of fluoride has been a major factor in the decline in the prevalence and severity of dental caries in the United States and other economically developed countries 1.
From the Research
Treatment Approaches for Dental Caries
The treatment for dental caries involves a combination of diagnosis, risk assessment, and management of the disease process. According to 2, caries is a diagnosis of a person, and people can be diagnosed as caries active, caries balanced, or caries undetermined. The treatment plan is based on the diagnosis and risk assessment, which leads to five treatment groups, each with an appropriate protocol for managing the disease process.
Non-Restorative Caries Treatment
Non-restorative caries treatment options have been emphasized in recent decades to avoid or delay the restorative spiral of the tooth. As reported in 3, sealants and fluoride gels and varnishes are effective strategies to prevent the onset of caries lesions and to arrest them in the early stages. Resin infiltration has also been shown to have high caries arresting rates in non-cavitated proximal lesions.
Restorative Therapy and Disease Management
Restorative therapy plans treat the holes, while disease management plans treat the disease, as stated in 2. Surgical treatment does not manage the disease, and the goal is to prevent and manage the caries disease process using patient-centered, risk-based interventions, as discussed in 4.
Emerging Technologies for Caries Treatment
New technological approaches, such as liquid crystalline systems, polymer-based nanoparticles, lipid-based nanoparticles, and inorganic nanoparticles, have demonstrated great potential for preventing and treating dental caries, as reviewed in 5. These systems have antimicrobial and remineralization properties or can deliver drugs to remove oral biofilms and remineralize dental enamel.
Key Considerations for Caries Management
- Caries risk assessment and carious lesion activity are crucial in determining the treatment plan, as mentioned in 6.
- Patient-centered and personalized treatment planning is necessary to regain oral microecological balance, control caries progression, and restore the structure and function of the carious teeth, as discussed in 6.
- Follow-up visits are essential for personalized caries management, as stated in 6.