Innovations in Preventive Dentistry

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Prevention is better than healing … or treatment. Thus, preventive dentistry is a cross-sectional challenge for all fields in dentistry, and one that has already achieved great success, as shown by the caries decline in many countries. The walls between prevention and treatment have recently fallen in caries and periodontal disease, as well as in orthodontics, where guidance of function and space maintenance are a combination of prevention and treatment.
This book discusses new developments and innovations in preventive dentistry, from primary «real» prevention to secondary prevention by inactivating initial lesions, and on to tertiary prevention to avoid subsequent progression and
complications of manifest oral disease. This evidence base is then translated into clinical dental practice.
The book addresses everyone interested or involved in dentistry, including students, the whole dental practice team, educators, health scientists, and policy makers, who want to gain insight into these up-to-date clinical practices and future developments. It intends to make an impact on teaching and all fields of clinical dentistry – not by giving cookbook recipes, but by pointing out the rationale behind the changes in our routines.
Presented by an international group of recognized specialists in their fields, the topics include the new understanding and management of caries and periodontal disease, prevention of orthodontic problems, diagnostic approaches, the role of diet and according recommendations for oral health, routes to better oral hygiene, changes in oral disease patterns and their consequences, non- and minimally invasive caries treatment, current fluoride guidelines including the use of silver fluorides, risk management, a common risk-factor approach, facilitating behavior changes, sealants, and probiotics. This broad spectrum is elucidated for the most relevant dental problems from early childhood to seniors to implement preventively oriented dental practice.

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ACPA, anti-citrullinated protein antibody

AD, Alzheimer disease

ART, atraumatic restorative therapy

BL, bone loss

BMI, body mass index

BOP, bleeding on probing

CAL, clinical attachment level

CHALO, Child Health Action to Lower Oral Health and Obesity

CI, confidence interval

CPP, casein phosphopeptide

CRFA, Common Risk Factor Approach

CRP, C-reactive protein

DIFOTI, digital imaging fiber-optic transillumination

DHSW, Dental Health Support Worker

DM, diabetes mellitus

dmfs, decayed, missing, or filled surfaces

DMFT, decayed, missing, or filled teeth

EADPH, European Association of Dental Public Health

ECC, early childhood caries

EHCP, Essential Health Care Program

EPS, extracellular polymeric substances

FOTI, fiber-optic transillumination

GA, general anesthesia

GBR, guided bone regeneration

GER, guided enamel regeneration

GTR, guided tissue regeneration

GWAS, genome-wide association studies

HA, hydroxyapatite

IADR, International Association for Dental Research

ICDAS, International Caries Detection and Assessment System

IgA, immunoglobulin A

IL, interleukin

MFP, monofluorophosphate

MI, motivational interviewing

MIH, molar incisor hypomineralization

NCD, noncommunicable disease

NHS, National Health Service

NNT, number needed to treat

NOCTP, nonoperative caries treatment program

NRCC, nonrestorative cavity control

NSF, nano silver fluoride

OHI, oral hygiene instruction

OHRQoL, oral health-related quality of life

OR, odds ratio

ORCA, European Organisation for Caries Research

OSAS, obstructive sleep apnea syndrome

PAD, peptidylarginine deiminase

PD, probing depth

PISA, periodontal inflamed surface area

PMPR, professional mechanical plaque removal

PSI, Periodontal Screening Index

QLF, quantitative light-induced fluorescence

RME, rapid maxillary expansion

RR, relative risk

RRR, relative risk reduction

SaC, Specific affected Caries Index

SAPM, self-assembling peptide matrix

SDF, silver diammine fluoride

SDG, Sustainable Development Goal

S-ECC, severe early childhood caries

SES, socioeconomic status

SCT, social cognitive theory

SiC, Significant Caries Index

SMART, silver modified atraumatic restorative technique

SNP, single nucleotide polymorphism

SPT, supportive periodontal therapy

SSB, sugar-sweetened beverages

TMD, temporomandibular disorders

TNF, tumor necrosis factor

VAS, visual analog scale

WASH, water, sanitation, and hygiene

WHO, World Health Organization

WIC, Women, Infants, and Children program

Contents

Preface

Editor

Contributors

Abbreviations

Chapter 1 – Understanding caries

Christian H. Splieth, Mhd Said Mourad, Mohammad Alkilzy, Julian Schmoeckel, Ruth M. Santamaría

Caries epidemiology and its consequences

Early childhood caries

Caries diagnostics

Clinical examination

Caries activity

Further diagnostics

Current concepts and treatment approaches in caries management

References

Chapter 2 – Understanding periodontitis

Daniela Hoedke, Henrik Dommisch

Epidemiology

Etiopathogenesis of periodontitis

Periodontitis in relation to systemic diseases

Clinical features and diagnosis

Prevention and therapy of periodontal diseases

Oral hygiene

Preventive and therapeutic aspects in relation to general health

References

Chapter 3 – Fluoride: How much is needed?

Livia M.A. Tenuta, Line Staun Larsen, Branca Heloisa Oliveira, Ana Paula P. Santos, Carlos González-Cabezas

Fluoride: the mode of action and why it is needed

Fluoride toothpaste: how much fluoride is enough?

Professional fluoride use: mechanism and evidence

Using as much fluoride as needed

References

Chapter 4 – Nutrition and caries: Sugar is the enemy, but what solutions are offered by preventive dentistry?

Cor van Loveren

Shape of the dose-response association between sugar intake and caries

Influence of fluoridated toothpaste

Frequency or amount of sugar

Reduction of sugar content in products

Selective taxation for unhealthy and healthy products

Personal advice

References

Chapter 5 – Healthy life, healthy mouth? Interdisciplinary and common risk factor interventions

Denise Duijster, J. H. (Erik) Vermaire

Determinants of childhood dental caries

The rationale for the Common Risk Factor Approach and interdisciplinary action

Interventions using interdisciplinary partnerships for the prevention of dental caries

Integrated interventions to prevent childhood dental caries and obesity

Integrated interventions to prevent childhood dental caries- and hygiene-related diseases

References

Chapter 6 – Oral hygiene: The best route to a healthy mouth?

Elena Figuero, Irene Dige, Vita Mačiulskienė

Definition of the dental biofilm

Nature of the dental biofilm

How to interfere with the dental biofilm

Clinical effect of biofilm control on dental caries

The role of fluoride

The effect of supervised versus individually performed tooth cleaning

Clinical effect of biofilm removal on periodontal and peri-implant diseases

Self-performed mechanical biofilm control

Chemical biofilm control

References

Chapter 7 – Interdental oral hygiene: To floss, or not to floss?

Falk Schwendicke, Christian H. Splieth

The evidence for flossing

The evidence for interdental brushes

Clinical considerations

References

Chapter 8 – Tooth brushing: Myth and science

Stefan Zimmer

Classic criteria of a manual toothbrush

Production of toothbrushes

Evidence-based criteria for manual toothbrushes

Manual toothbrushes for children

Tooth brushing technique

Tooth brushing time

References

Chapter 9 – Guidance for healthy dental and oral behavior: Multilevel prevention of early childhood caries

Julian Schmoeckel

How do we learn: different theories

Ethical considerations in modern patient-doctor relationships

Health literacy and belief in self-efficacy

Evidence of different aspects in counseling for preventing ECC

Access to children: prevention on individual, group, and collective level

References

Chapter 10 – Fissure sealing: Still to be recommended?

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