August 09 2022

Recommendations for preventing childhood caries

Prevention is better     

Help keep your child's teeth healthy before it appears caries. As is known, dental tissue, once destroyed does not have any ability to recover by itself.

If your child has tooth decay in deciduous teeth, consider this more accurately predicts future risk of decay that the first permanent teeth caries.

General and local factors in caries     

The food is a determining factor in dental health. Local effects of food are more important than its general influences, despite adequate food, with the best possible intake of fluoride are very important for healthy teeth. Protective enamel layer only suffers general influences during the previous years before teething.

Throughout the life of the person, the tooth will be exposed to attacks that may occur as a result of eating and dental hygiene.

The sugar component is determinant of the risk of caries. A normal average child takes seven meals a day, including snacks between hours and other foods.

The factors associated with the diet are:

1. Amount of carbohydrate susceptible of fermentation
2. Concentration of sugars in food
3. Physical state of carbohydrate
4. Intervals between meals

5. Time during which the teeth are exposed
6. Number of meals
7. Frequency of meals

The food     

The fundamental fact in the development of caries is that increasing exposure to sugar increases the risk of caries.

The conditions for the formation of carious lesions are:

1. The massive proliferation in the oral cavity of bacteria on tooth surfaces, aided by the availability of food remains, especially sugar, leading to the formation of a mass strongly adherent to the tooth surface (plaque formation).

2. Sugar consumption with a sufficiently high frequency and concentration.

The decay occurs as a result of the transformation in acids of most of the sugars deposited in the plaque, which contains mouth bacteria. This phenomenon occurs massively when the sugar content of food is greater than 10%. Those foods with reduced sugar content are far less dangerous as inducers of caries.

After each intake of sugary foods is observed on the plaque a fleeting but intense increase in acidity, which lasts about 30 minutes, producing enamel demineralization.

This period of aggression against the tooth can be shortened by toothbrushing. After this time, the tooth is remineralized when the acidity caused by sugary food disappears. The tooth is prepared to endure two hours of acidity, provided it has 22 hours of repair and remineralization.

Therefore, it is crucial in the development of caries the number of times your child takes sugary foods because after each of these intakes will be produced a transformation of sugars in acids and also a period of half an hour of acid aggression to teeth.

In the classic study from Vipeholm it was observed that the ingestion of large amounts of sugar during the meal did not produce a greater number of cavities than relatively modest amounts, whereas if small amounts of sugars between meals were ingested increased considerably number of cavities, which highlights the influence of the number of intakes of sugary foods on caries.

Brushing teeth     

The elimination of dental plaque combat one of the most important factors in the development of caries. Toothpaste containing 1000-2800 parts per million of fluoride are effective in children 6 to 16 years. Brushing twice a day prevents more that brushing it less frequently.

Teeth should be brushed at least twice a day with a toothpaste containing at least 1000 ppm fluorine. Note that rinsing of the teeth with a glass of water after brushing reduces protection of brushing with fluoride toothpaste. The child should be taught (even children under seven years) to spitting paste left after brushing teeth. avoiding the ingestion of any amount of toothpaste with fluoride.

If plaque is not regularly removed can cause the onset of chronic gingivitis, even at a very young age. From the standpoint of the prevention of dental caries, the toothbrushing has only a limited effectiveness since the anatomical characteristics sometimes hinder access of the bristles.

Dietary changes     

Should be limited ingestion of refined sugars in food and beverages.

However, it is also crucial to limit the number of times your child eats sugary foods. According to Vipeholm's researches, eat more candy immediately after an ordinary meal is less cariogenic than eating a single treat between meals.

Starchy foods without added sugar, like bread, potatoes or rice, are not too cariogenic since the giant starch molecules do not penetrate deep into the plaque, resulting in its degradation oral to a small amount of maltose.

If you can, replace sugar with xylitol as a sweetener. This reduces the incidence of caries.

The child should use preferably sugarless chewing gum, and if possible, with xylitol.

Preferably, use sugar-free medicines. Consult your doctor and/or pharmacist about this point and ask his opinion about the drugs you use regularly for your child , including those obtained without a prescription.

In infants and young children, who eat food more often than older children, even breast milk lactose can cause the appearance of significant decay of the deciduous teeth in cases of prolonged breastfeeding. Take into account that natural sugars are also cariogenic.

Fluoride supplements     

Fluoride supplements are not routinely recommended for prevention of tooth decay in children living in areas with low fluoride content in drinking water. However, this possibility can be taken into account in children with a high caries risk. If it is expected that the child receives regular fluoride, these supplements could be a complementary measure.

In the cases where your doctor or dentist has considered administering fluoride supplements to your child, brushing teeth and taking fluoride tablets should happen at different times, to get that fluoride from both sources is as long as possible in contact with the teeth.

Aplicaciones tópicas     

Topical application of fluoride:

The topical application of fluoride gel twice a year is appropriate for children at high risk of caries. A higher frequency of local application of this substance does not improve prevention and it is unnecessary.

Topical application of chlorhexidine:

Topical application reduces the risk and incidence of caries and can achieve a 46% reduction in the incidence and level of risk of caries, regardless of the form and method applied (mouthwashes, gels, creams, etc.). It is a useful alternative for caries prevention.

Your dentist     

In addition to the advice that the dentist can give you or your child, this healthcare professional will proceed to establish an excellent barrier to prevent tooth decay by sealing dental fissures.

  

For most children at risk for tooth decay, sealing the permanent molars it is a sufficient measure. However, in patients at high risk should be sealed all fissures

The role of the dentist is not limited to performing the tasks of diagnosis and treatment of established caries, as well as the sealing of molars. His advice produces effective and positive changes in the behavior of children and adolescents.