n Journal of Minimum Intervention in Dentistry - Standard and active preventive care




According to the patient susceptibility, two types of preventive care are available: standard and active preventive care. Preventive standard care is indicated for patient with low susceptibility for caries occurrence, in order to reduce the risk for recurrence of caries. This type of care could be compared to conventional maintenance therapy for patients who have not developed any new caries lesions in the past 2 or 3 years. For individuals highly susceptible to caries, active care is recommended. Active preventive care includes the standard care regime with addition of professional decontamination, remineralisation, management of aetiological factors and the use of fissure sealants. Decontamination is used to rebalance the oral microflora. Few actions of decontamination are available: professional mechanical tooth cleaning (PMTC), Chlorhexidine and stabilizing restorations. Remineralisation is indicated for incipient, non-cavitated lesions with a use of fluorides or more recently introduced casein derivates. When Casein Phosphopeptide-Amorphous Calcium Phosphate (CPP-ACP) or Casein Phosphopeptide-Amorphous Calcium Fluoride Phosphate (CPP-ACFP) is applied in the oral environment, it will bind to biofilms, plaque, bacteria, hydroxylapatite (tooth structure) and soft tissue localising bioavailable calcium, phosphate and fluoride ions. Therapy of aetiological factors can also be managed by some simple advice on oral hygiene, diet or saliva flow stimulation, to help rebalance the oral environment. Since dental caries is a bacteria-dependent, multifactorial disease, preventive measures such as sealants, can be implemented once patients susceptible to caries are identified. Sealants act as a barrier, protecting tooth enamel from plaque, bacteria and acid and preventing pit and fissure caries.


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