Presentation on theme: "Dr. Derango & Dr. Mueller’s CARIES PROTOCOL"— Presentation transcript:
1 Dr. Derango & Dr. Mueller’s CARIES PROTOCOL The answers to your questions.Jenna R. Derango R.D.H.
2 Past Methods of Treatment Drill- remove all cariesFill- place restorations3. To cut is to cure- removing decay and placing a restoration solved the problem
3 Present Method for Treatment Bacterial controlReduce risk levelRepair active decayContinued care
4 Bacterial Control Reduce number of caries causing bacteria METHODS: Plaque Removal: brushing and flossingAnti-bacterial Mouth RinseXylitol Gum / Mints
5 Reduce Risk Level Decrease exposure to sugary / starchy snacks Increase repair or remineralization processMETHODS:Diet counselingEliminate food sharingFluoride application to strengthen weakened areasCalcium Phosphate application to strengthen teeth
6 Repair Active DecayProvide fluoride, calcium, and phosphate to repair enamelRemove caries and replace with restorationsMETHODS:Prescription strength Fluoride toothpasteCalcium and Phosphate pasteFillings for small cariesCrowns for teeth with large caries
7 Continuous Care At home and in office METHODS: Review plaque removal and diet control6 month cleaning appointments with fluoride and x-rays
8 CARIES PROTOCOLUsing x-rays and an oral exam, it has been determined you have dental caries.You are a HIGH RISK patient who not only needs treatment, but a method of prevention for the future.
9 What are Dental Caries?Caries is also known as: cavities or tooth decay.Caries, if stopped early enough, can be reversible.Caries is a bacterial infection caused by specific bacteria.Caries is transmissible, or can be transferred from person to person, and from tooth to tooth in a patient’s mouth.
10 Caries as a Reversible Process Different forms of CariesInactive decay- When a tooth has a surface lesion but is not rough upon examination.- Inactive decay can be in a state of remineralization or repair. The tooth, with help from fluoride, calcium, and phosphate is trying to repair itself.Active decay- When a tooth is breaking down and leading towards becoming a complete irreversible cavity. It appears as a white chalky lesion that is rough upon examination.Active decay is also known as demineralization or decalcification the loss of calcium and minerals from the teeth .There are periods of remineralization and demineralization of the teeth depending on risk factors.
11 Factors in the Caries Process Negative FactorsBacteria (already living in your mouth)+ Sugar (candy, soda, etc.)AcidAcid (Soda, fruit juice, etc)+ ToothCariesPositive factorsSaliva (Calcium & Phosphate)+ FluorideDecrease of caries
12 Our Caries Management Program Caries Protocol is designed to:Decrease bacteria levels that cause cariesIncrease the repair (remineralization) processReduce the risk of future dental cariesContinually monitor patient status and progress
14 Plaque Removal by Brushing Brush time from beginning to end should be around2 minuets. 30 seconds spent in each section of themouth (upper right and left, lower right and left).1. Using a soft bristled brush place the toothbrush ata 45-degree angle toward the gum line. Use gentle, shortstrokes, moving the brush back and forth against the teethand gums along the outside and insides of your teeth.2. To clean the chewing surfaces of your teeth hold thebrush flat across the surface and use a scrubbing motionfront to back.3. To clean the inner front tooth surfaces, hold the brushupright and use gentle up-and-down strokes with the tipof the brush.Pictures courtesy of Oral B (Proctor & Gamble
15 Plaque Removal by Electric Toothbrush Direct the brush head along the gum line guiding thebrush head slowly from tooth to tooth, following the curveof the gum and the shape of each tooth.Hold the brush head in place for a fewseconds before moving on to the next tooth.It isn't necessary to press hard or scrub. Simplylet the brush do all the work.Don't forget to reach all areas, includingthe inner and chewing surfaces, and behindyour back teeth.It is also important to brush your tongue usinga forward sweeping motion.Courtesy of Oral B (Proctor & Gamble
16 Plaque Removal by Flossing 1. Remove an arms length of floss from the holder andwrap around your middle fingers. You will use your indexfinger and thumb to guide the floss between your teeth.Make sure to have only a small area, about one inch offloss between your finger tips at a time to allow for bettercontrol.2. Ease floss between teeth, being careful not to snap itroughly against your gums. Pull the floss tight to hugone side of your tooth gently moving up and downunderneath your gums as far as the floss will go. Liftup slightly, just enough to move over the tip of the gumsbut staying in between the same two teeth, move the flosstowards the other side of the tooth and repeat.3. As you move to the next area unwind your floss and use aclean piece. Repeat the above process.4. Floss between all teeth and behind the last teeth as well.Pictures courtesy of HIVdent
17 Plaque Removal with braces When brushing braces it is important to use aprescription fluoride toothpaste.In order to clean around brackets first place your brush withthe bristles angled down away from your gums towards your brackets.Vibrate brush back and forth gently until all areas are clean.2. Next take your brush facing towards your gums but placed nearthe ends of your teeth. Gently vibrate and continue till all areas arecleaned.3. Hold your toothbrush straight on with your brackets and gentlyscrub to remove any plaque or food from your brackets. Use this samemethod to clean the backside and chewing surfaces of your teeth.4. Finally, tilt your brush vertically to clean behind your front teeth.Photos courtesy of &
18 Plaque Removal with braces 1. To floss between brackets use a floss threader orspecially designed floss with a stiff end.2. Place floss through large loop in threader.Use the straight end of the flosser to enter behindyour wire between two teeth.3. Once the flosser is completely pulled throughteeth separate floss so that an end is on each sideof the wire.4. Use floss as you normally would gently taking flossbelow the gum line following the contour of the teeth.Remove and repeat until all areas are complete. Anyareas with out brackets or wires should be flossed as normalas well as behind the very back teeth.Photos courtesy of & GUM® Eez-Thru® Floss Threaders
19 Other methods of plaque removal Some patients especially thosewith braces can greatly benefit fromwater picks. Water picks are used toclean underneath your gum line andbetween teeth.Proxy brushes are also great waysto clean braces or between teeth withlarge spaces.
20 DIET Eating sugary or starchy snacks increase the risk of caries. The sugar mixes with your bacteria to create acid. The acid then eats away at the tooth to create caries.Reduce the number of sugary / starchy snacks, food, or drink between meals.Reduce the frequency of sugary / starchy snacks.
21 Battery Acid, Hydrofluoric Acid Battery Acid, Hydrofluoric Acid1Hydrochloric acid secreted by stomach lining2Lemon Juice, Gastric Acid, Vinegar3Grape fruit, Orange Juice, Soda4Tomato Juice, Acid rain5Soft drinking water, Black Coffee6Urine, Saliva“Pure” water7Sea water8Baking soda9Great Salt Lake, Milk of Magnesia10Ammonia solution11Soapy water12Bleaches, Oven cleaner13Liquid drain cleaner14
23 Saliva Neutralizes acid to protect teeth. Brushing or chewing sugar free gum can increase saliva to help buffer more acid.Patients with little saliva should drink several glasses of water throughout the day.
24 RestorationsFirst step in the caries elimination process after diagnoses.Placed after removal of caries.Replaces diseased tooth structure with whatever dental material is necessary.
25 Antibacterial Mouth Rinse Reduce number of bacteriathat cause tooth decay.Proven to reduce bacteria formonths after use.Must be used in addition to thorough plaque removal and regular cleanings.
26 Chlorhexidine Suggested Protocol: Rinse with 10 ml of the mouth rinse in the morning after normal brushingand flossing for 1 minuet. Use fortwo weeks or as prescribed by yourdentist.
27 Xylitol Gum / Mints Sugar substitute with anti-bacterial affect Studies show not only decrease in caries risk of patient but decrease risk in transfer of caries from mother to child.
28 Xylitol Gum & Mints Suggested Protocol: Chew or dissolve two pieces three to five times daily. Useuntil the product is gone.
29 FluoridesHelp strengthen teeth from being dissolved by bacterial acids.Many sources of fluoride: prescription toothpaste and varnish most effective in preventing and caries and repairing (remineralizing) teeth.
30 Fluorides Suggested Protocol for Pastes: Brush nightly without water. Do noteat or drink for 30 minuets.Suggested Protocol for Varnishes:Three full mouth applications within a 10 dayperiod.
31 MI PasteCalcium and Phosphate combination used to strengthen teeth and assist in the absorption of fluoride.
32 MI PasteSuggested Protocol: Apply pea sized amount to your finger rub on the surface of your teeth then use your tongue to rub around to all surfaces. Use a minimum of twice daily after brushing and flossing
33 3 Month Recall3 month cleanings are recommended to eliminate plaque, provide fluoride, and re-examine your teeth.We will evaluate your home care and answer any questions that you may have.
34 Protocol ResultsAgain, we want to stress that you have been diagnosed as a HIGH RISK caries patient. We know that by reducing decay causing bacteria, we can significantly decrease your risk for future dental caries.Our goal for all of our patients is not only to fix teeth, but to lower your dental risk factors. By working together with this recommended program, we can and will achieve this goal!