2.1 Goals of Prevention Strategies

The main goal of traditional dental caries prevention strategies has been to use fluoride to make tooth surfaces more resistant to acid attack or less conducive to plaque retention.1,2 Additional strategies, including behavior modification, especially in the areas of oral hygiene and dietary practices, have also been employed to prevent or reduce caries.

Within the last 20 years, dental sealants have been used to cover deep pits, fissures, and grooves to remove them as areas of plaque retention and to separate bacteria deep within the grooves from their food source. Sealants may also be placed in defective restoration margins without recurrent decay, extending the life of the restoration. Other prevention strategies include application of topical fluoride and use of anti-microbial agents.

Prevention strategies seek to influence the oral environment by:

• Reducing or eliminating odontopathic bacteria.
• Reducing the acid produced by bacterial colonies by decreasing dietary sugar.
• Increasing the mineral content of saliva, especially the calcium and fluoride content. Calcium and fluoride are most active in the remineralization process.

Preventive strategies should be customized based on the patient’s risk category (see the Caries Risk Classification Table), and modifying factors should be documented in the patient’s dental record.3 The patient’s age, dental history, and caries pattern should be assessed, along with the patient’s exposure to various preventive measures. The following sections describe available and recommended preventive strategies.

Oral health professionals are patients' partners in achieving and maintaining optimal oral health. Each plays an important role in the process of eliminating or controlling infection.

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