Introduction

Cariology in the New World Order: Moving From Restoration Toward Prevention, Part II

John D.B. Featherstone, MSc, PhD, and Jon R. Roth, CAE

Contributing Editors

John D.B. Featherstone, MSc, PhD, is professor and chair of the Department of Preventive and Restorative Dental Sciences at the University of California at San Francisco. He is the Leland and Gladys Barber distinguished professor of dentistry at UCSF.

Jon R. Roth, CAE, is executive director of the California Dental Association Foundation.

Copyright 2003 Journal of the California Dental Association.

Last month, we reviewed the biological mechanisms of dental caries, looked at the current problems in California, and suggested ways to begin dealing with the problems of caries in the home, dental practice, and community setting.

In Part II of this series, we will explore new hands-on applications, review clinical interventions, and provide sample risk assessment forms for use in your practice that incorporate the research described throughout this two-part series.

* Heather Lynch, MD, and Peter Milgrom, DDS, will begin by sharing an overview and clinical applications of xylitol, a naturally occurring, low-calorie sugar substitute with anti-cariogenic properties.

* Maxwell Anderson, DDS, MS, MEd, will continue by reviewing the efficacy of chlorhexidine on dental caries and the caries infection. Dr. Anderson will review the literature for chlorhexidine’s caries reduction potential as well as the microbiologic reduction of the pathogens associated with dental caries.

* Kevin Donly, DDS, MS, will look at the increasing use of fluoride varnishes, which have been approved for use as a cavity preparation lining varnish and as a tooth desensitizing agent.

* Steven Adair, DDS, MS, explores new findings with another dental caries prevention strategy, pit and fissure sealants. Dr. Adair will explore the latest interventions using sealants that have developed as the epidemiology of caries has become better-understood.

* John Hicks, DDS, PhD, MD; Franklin Garcia-Godoy, DDS, MS; Kevin Donly, DDS, MS; and Catherine Flaitz, DDS, MS, review the efficacy of fluoride-releasing restorative materials and secondary caries. Fluoride-releasing dental materials provide for improved resistance against primary and secondary caries in coronal and root surfaces and plaque as well as elevate salivary fluoride levels to a point that facilitates remineralization.

* Ray Stewart, DMD, MS, and Kevin Hale, DDS, present an overview of methods in a practice setting where dental professionals can apply new intervention methods.

* William Bird, DDS, DrPH, brings the discussion full circle with information on consumer compliance as a measure of success for any caries control or caries protocol program. Dr. Bird will suggest an outline of six key global areas to be considered in compliance.

* The final item is a consensus paper prepared as a result of the conference held in April 2002 and the science reviewed at that meeting and published in the February and March issues of this Journal. It presents a caries management by risk assessment tool for dental and medical professionals to put to use in their practices and in community settings. This document can be reproduced from this Journal.

Our overall goal is to provide the basis for a cross-disciplinary approach from among medicine, dentistry, nursing, and other agencies to positively affect dental health and ultimately result in the reduction and eradication of dental caries in children in every county, community and culture in California by the year 2010. It is through this collaborative approach that we will seek to end the suffering of millions of children, their caregivers, and the elderly who live daily with the constant pain resulting from dental caries.