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The Cavity Prevention Program
The cavity prevention program
is an advanced preventive program designed to eliminate tooth decay.
"Why do I keep getting
cavities? I see the dentist regularly."
For years dentistry treated
tooth decay as a problem to be repaired. Often patients would get
fillings done, only to return with more cavities the next time. We now
see tooth decay as a disease, and cavities are a symptom. It is not
enough to treat only the symptoms. We now try to identify and eliminate
the disease, making cavities a thing of the past.
Steps in the Cavity
Prevention Program:
Step
1. Testing:
We perform a cavity index rating (Link
will open in a new window). This involves a score for various factors
related to decay risk, such as plaque and oral hygiene, existing
cavities, type and number of former cavities, diet issues, etc.. We
screen all our patients this way. This lets us tell whether existing
borderline lesions could progress, or whether they happened in the past
and are not active now.
New for
2007- We now have a special
computerized cavity screening test
that takes 15 seconds. This
can help us see if the patient is still at risk for decay. See photo at
left.
We base many of our decisions
on the cavity risk, such as:
Frequency of recare visits needed
Whether fluoride treatments are
necessary
Whether to watch older fillings or replace them
Whether to treat or observe micro-cavities and pits
We test people with larger
cavities once the cavities have been repaired, to make sure the decay
has been stopped.
Step
2. Analysis and Reduction of Tooth Decay Risk:
"Billy brushes his teeth
well. Why does he still get decay?" Many people believe that if they
brush well, they shouldn’t get cavities. This is simply not true. We
have seen many patients with good oral hygiene who get lots of decay
,and some with poor oral hygiene and no decay.
Everybody has some
plaque- decay is caused by plaque made up of harmful bacteria.
If a person tests at medium or high risk for decay, we then try to find
the cause and eliminate it:
We analyze the diet: In most cases,
careful professional analysis of the diet will reveal the cause of
decay- a diet that allows harmful bacteria to rule. This is very
important, because subtle differences in diet can
have huge effects on decay for people at risk. We work with the patient
to develop a diet which will reduce
decay risk.
We review
oral hygiene at this time. People at risk need to
take extra home care, using the latest techniques.
We set up a custom fluoride
program, with both home and
professionally applied fluoride
We may set up a special program
for dry
mouth problems
- New for
2006- We
start the patient on Xylitol gum. Xylitol is one of the safest
artificial sweeteners that not only does not cause decay but can
acutally reduce decay if you chew 3 pieces a day. 2 brands are
Xylichew and Spry- see photo at left.
Once we believe we have found
the cause of tooth decay and eliminated it, we will give the patient a
follow-up saliva test after a few weeks.

Most patients are no longer
at risk at this point, and will not need the next steps of the Cavity
Prevention Program.
Step
3. Advanced Cavity Prevention:
"I'm doing everything I can,
but I'm still getting tooth decay"
At this point, if a patient
is still at risk, we proceed with the following treatments:
We eliminate the spots that can
easily decay. We treat small cavities,
replace older poorly fitting fillings and seal deep pits and grooves in
the teeth.
We will have the patient keep a diet diary (Printable sample
will open in a new
window), and will perform computer analysis.
We place the patient on a special high-strength
fluoride program as well. We will schedule 3-month fluoride
treatments, diet and oral hyginene reviews. We can apply fluoride
varnish to areas prone to decay. We also make custom home fluoride
trays.
New
for 2003- We can place
special fluoride-containing sealants (Fuji Triage), that slow-release
fluoride exactly where they are needed in the grooves of the
teeth. They are available in pink or white. See photo at left.
New for
2007- We
now have a special anti-cavity
mouth rinse system that changes the entire environment of the mouth
so "bad" bacteria cannot grow and "good" normal bacteria can take over.
There is an extra strong 2-part rinse to "shock" the bad bacteria,
which is used for 1 minute a day for 2 weeks.
There is also a maintenance fluoride rinse that helps keep the bad
bacteria down.
A
note about insurance: We feel that prevention is
the most important and cost
effective treatment that we offer.
The Cavity Prevention Program
is very advanced dentistry, and insurance companies do not always keep
up with the latest techniques. They may not cover all parts of the
Cavity Prevention Program. Unfortunately, they will often pay large
amounts to have patients undergo repeated fillings, but will not fully
cover elimination of the cause. If you like, we will be glad to submit
an estimate to your insurance company to see in advance what portion of
the Cavity Prevention Program costs they will help to cover.
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