Caries prevention
Caries prevention
Dental caries is not inevitable and can be prevented. Several effective evidence-based caries preventive interventions exist, some delivered at home and some in the dental setting. Toothbrushing with a fluoride-containing toothpaste is the fundamental home-based self-care intervention and members of the dental team are well placed to deliver knowledge, give advice and instruction about toothbrushing as well as skill training on how to brush children’s teeth effectively. Similarly, the dental team can provide information about limiting sugar in the diet – the major cause of dental caries and support behaviour change to achieve any goals that are agreed. Professionally delivered preventive interventions include fluoride varnish application for children of all ages and placement of fissure sealants on permanent teeth.
Bringing infants to attend the dental practice will assist the child’s acclimatisation to the practice environment and enable preventive advice to be given to the parent/carer at an early stage.
As every child is at risk of developing caries, preventive interventions are required for all children. In Toothbrushing, Dietary advice and Professionally-delivered interventions, Standard Prevention actions for all children are presented under amber headings. For children considered to be at increased risk of developing caries, additional preventive interventions are recommended and are presented under red Enhanced Prevention headings.
Encourage parents/carers to register their child with a dentist as early as possible, before or as soon as the first tooth appears, and to attend regularly.
- The BSPD Dental Check by One campaign aims to ensure all children see a dentist as their teeth come through, or by their first birthday, at the latest.
Ensure that all children receive Standard Prevention appropriate to their age.
If the child is at increased risk of developing caries, in addition to Standard Prevention, ensure they receive Enhanced Prevention, unless there is valid reason not to. In this case, ensure this is documented in the patient’s notes.
When giving preventive advice, ensure that both the child and the parent/carer who is responsible for supervision are included in the discussion.
After relief of any pain, carry out preventive interventions for permanent teeth before treatment of the primary teeth (e.g. fissure seal first permanent molars before managing carious primary teeth).
In addition to the crucial preventive interventions provided by the dental team, the Childsmile programme in Scotland also promotes multidisciplinary prevention and oral health care for children in other settings. Young children who attend nursery or school within the most deprived areas are targeted to receive specific additional preventive interventions through Childsmile.55 Dental teams can also refer families who require additional support to local Childsmile dental health support workers.
The preventive interventions described in this section can also be employed as part of a strategy for the management of certain carious lesions, as discussed in Caries management in primary teeth, Caries management in permanent teeth and Dental techniques.