1. Dr.Shahzadi Tayyaba Hashmi

2. 1. Prevention 2. Stepwise excavation 3. Fissure sealants 4. Carisolv

3. 1. PREVENTION The most important preventive roles are improving plaque removal and reduction in frequency of sugar consumption Oral hygiene instructions should aim to improve plaque removal and produce a reduction in the bacterial load in the mouth Careful flossing techniques, although difficult to learn, are efficient at removing the cariogenic bacteria even from Interdental areas Efficient plaque removal reduces the bacterial load but without changes to the diet by reducing the frequency of sugar intake, neither will be effective on their own

5. 1. PREVENTION Dietary changes are difficult to achieve Educational messages such as reducing the frequency of sugar intake, particularly in drinks such as tea and coffee, can have significant impact The concept of hidden sugars are also important These sugars can be found in biscuits, crisps and other snack foods. Removing them from the diet can aid caries reduction

7. 2. STEPWISE EXCAVATION The knowledge that progression of caries is dependent upon a continual supply of substrate has been utilized in the concept of stepwise excavation If the supply of sugar substrate is stopped, the bacteria are no longer able to metabolize and their numbers reduce and the activity of the lesion slows This method involves sealing the carious lesion from the oral cavity with hard restorative materials The cavity is covered with restorative material and left alone for a few months. After that the material is removed and the cavity restored with a long term material such as composite or amalgam

8. 3. FISSURE SEALANTS The concept of separating the lesion from the oral bacteria has also been utilized with fissure sealants Provided the sealant remains intact and the diet of the individual improves, sealants have been shown to be effective in arresting the caries activity Materials should be sufficiently flowable to pass into the occlusal fissures

13. 4. CARISOLV Sodium hypochlorite dissolves organic material. This property is used in the formulation called carisolv The material is presented in a blue gel formulation and applied on to the surface of a carious dentine lesion The hypochlorite partially breaks down the organic material and kills the bacteria, rendering the lesions carious free The gel is placed over the carious lesion. After 10-20 minutes the gel is washed away and cavity can be restored with an adhesive material Studies have shown that the technique is successful in removing caries but it has not become a common clinical procedure in general practice It has perhaps a greater application for ART in underdeveloped third world countries because of the minimal requirement of rotary instruments