Free sugars are the essential dietary factor in the development of tooth decay. Tooth decay, also known as dental caries, is a microbial foodborne disease that occurs when bacteria in the mouth metabolize sugars to produce acid that demineralizes the hard tissues of the teeth (enamel and dentin). This process takes place in the biofilm, which remains permanently active with each fluctuation in pH, and the lesion occurs in the hard tissues of the teeth. If tooth decay progresses to a moderate stage with loss of a specific tooth structure, the tooth must be filled and reconstructed.
Dentistry dates back to 5000 BC. C., when it was thought that the cause of tooth decay was a “dental worm”. However, today we know that free sugars are the key factor that relates to dental caries. Studies conducted in industrialized countries in recent decades have demonstrated a decrease in dental caries and an increase in the number of people without cavities and restorations.
Tooth decay must be differentiated from developmental injuries (hypoplasia, hypomineralization, dental fluorosis, amelogenesis and dentinogenesis imperfecta) and from mechanical and chemical trauma (tooth wear). The prognosis of tooth decay depends on the patient's health, the maintenance of oral hygiene, and the extent and severity of tooth decay. Therefore, it is important to have regular dental checkups and cleanings, even when your mouth is fine. Over time, the acids in dental plaque can demineralize the enamel and dentin in the fissures and smooth surfaces of the tooth.
Antimicrobial oral rinses with 0.12% chlorhexidine are also effective in controlling dental plaque bacteria that cause tooth decay. Among topical antibiotics, although both penicillin and tetracycline have karyostatic effects in animal models, the topical application of vancomycin has only been shown to reduce dental decay with a certain degree of success in humans. The risk of tooth decay includes factors such as high numbers of cariogenic bacteria, frequent sugar consumption, inadequate salivary flow, insufficient exposure to fluoride, poor oral hygiene, and poverty. Regular visits to the dentist and good brushing and flossing habits are the best protection against tooth decay and cavities.
Fluoride varnish is ideal for professional applications in preschool children because of its ease of use, even with non-dental health providers, and its safety thanks to single-dose dispensers.