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Prediction and prevention of caries

29-03-2010
Prediction and prevention of caries
The younger the population and the lower the caries prevalence in the population, the
higher the percentage of caries-free subjects. In these populations, it is necessary to
focus on “high-risk strategy” and primary prevention, rather than secondary
prevention.
For practicing primary prevention according to the high-risk strategy, the etiologic
factors used for caries prediction must be as sensitive as possible, that is, optimizing
the percentage of true high-risk individuals for cost effectiveness. Because dental
caries is a multifactorial disease with a complicated etiology, it is necessary to
combine as many etiologic factors as possible to predict caries risk in children with
low caries prevalence, which is the situation among most children in the world.
In this approach high and very high plaque formers (PFRI scores 4 and 5,
respectively) with a high percentage of cariogenic bacteria such as S mutans would be
expected to develop significantly more new carious surfaces than would those with a
very low or low plaque formation rate (PFRI scores 1 and 2, respectively) and little or
no S mutans in the plaque.
There is a correlation between salivary S mutans counts and the number of tooth
surfaces colonized with S mutans. Therefore, the combination of salivary S mutans
counts and Plaque Formation Rate Index (PFRI scores 1 to 5) is recommended for
caries risk prediction, according to the following scale:
1. No caries risk: Streptococcus mutans-negative individual
2. Low caries risk: Streptococcus mutans-positive individual with a PFRI score of 1 or
2
3. Caries risk: Streptococcus mutans-positive individual with a PFRI score of 3
4. High caries risk: Individual with high S mutans counts and a PFRI score of 4 or 5
Views: 2730 | Comments: 11 Send reply
 
Comments
Ãîñòü:
Holy Toledo, so glad I ccliked on this site first!

Ãîñòü:
All of these articles have saved me a lot of hedacahes.

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Гость:
This couldn’t have came at a betetr time my 3rd child who is only 2 has 2 cavities. We just found out. Sadly the procedure to fix them seems so invasive. I need to be on top of my game now that I know he is cavity prone. My heart is so broken because I feel like I have don’t everything right and it still happened. I now know that some kids require a little more to keep their teeth healthy

Гость:
This is very interesting. My kids have their deatnl check up in two weeks and I am going to ask our dentist about this. My oldest has horrible teeth. I feel so bad because he has my teeth but soooooo much worse so anything I can do to help I am all for!

Гость:
Almost all my published cocnoltiels are available on my blogs and you are welcome to choose the poems that appeal to you. I think you will enjoy the variety of form and content in my poetry. All the bestR K

Гость:
Orit,While I understand why you may see my post as a liltte extreme, and although I do admit to indulging in sweets sometimes when they are offered me (they do not come into my house) I have to stick by my assertion that in many ways sugar is poison to our systems. I know that every time I indulge I am doing at least small amounts of damage damage that I do believe our bodies were created to be able to repair when the damage is relatively minor but damage nonetheless. I understand that most people (myself included) may indulge once in a while, but I think we all need a wake up call on how detrimental sugar is maybe then we will cut it down to a very occasional treat (the way it was a couple of hundred years ago) instead of treating it like a necessary part of our diet.I do have to disagree with you about sugar being the only food our brains use (if you are talking about sugars from the foods we eat). First of all, our muscles cells and most brain cells are designed to get energy from ketones (made from fatty acids) in the absence of glucose. While there are a few brain cell processes that require glucose exclusively, our livers are capable of making glucose from proteins and fats through a process called gluconeogenesis. So a case can be (and has been) made that an outside source of glucose is completely unnecessary. Indeed carbohydrates are the only macro-nutrients that do not seem to be essential for us to consume. Our bodies can make all the glucose they need from fats and proteins while both of those macro-nutrients do have forms that are essential for us to consume. Ultimately, I believe we need to cut out 95% of our sugar intake and reduce our complex carbohydrate intake by 50% or more. http://acfcyag.com [url=http://vvmvfwyn.com]vvmvfwyn[/url] [link=http://qvwqby.com]qvwqby[/link]

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Articles for theme “caries”:
29-03-2010
Rationale for combining salivary MS tests and PFRI for prediction of caries risk Like the inflammation induced in gingival soft tissues adjacent to dental plaque, carious lesions that develop on the individual enamel surface beneath bacterial plaque should be regarded as the net result of an extraordinarily complex interplay between harmless and harmful bacteria, antagonistic and synergistic bacterial species, their metabolic products, and their interaction with the many other external (fermentable carbohydrates etc) and internal (saliva and other host factors) modifying factors,which are discussed in more detail in chapters 2 and 3.
29-03-2010
Selection of caries-risk patientsInability of a sole salivary MS test to predict caries riskAs already mentioned in this chapter, numerous cross-sectional as well as longitudinalstudies have shown significant correlations between salivary MS levels and cariesprevalence and caries incidence (for review, see Bratthall, 1991; Bratthall andEricsson, 1994; Beighton et al, 1989). At the surface level, even more significantcorrelations between MS colonization and caries incidence have been found(Axelsson et al, 1987b; Kristoffersson et al, 1985).
29-03-2010
Accuracy ofrisk assessments in practiceA perfectrisk marker would have a sensitivity of 100% and a specificity of 100%, implying noerrors in risk assessment. Consequently, the false-positive and falsenegative rates wouldbe 0%, and positive and negative predictive values would be 100%.Having perfect accuracy means that the predicted high-risk group would consist ofonly true high-risk individuals and that only true low-risk individuals would be includedin the predicted low-risk group.
29-03-2010
Prediction of Caries RiskPrinciples of risk predictionSome basic principles have to be followed for successful and cost-effective cariesprediction, caries prevention, and caries control:1. The higher the risk of developing caries for most of the population, the moresignificant the effects of one single preventive measure and the stronger thecorrelations between one single etiologic or modifying risk factor and the risk forcaries development.2. In populations in which only a minority of the people will develop new cariouslesions, it is necessary to use accurate risk predictive measures to select at-riskindividuals and introduce needs-related combinations of caries-preventive measures,in other words, a “high-risk strategy.
29-03-2010
Cariogenicity of other bacteriaThere are overwhelming data from experimental and clinical studies in humans showing that S mutans and S sobrinus and lactobacilli are strongly correlated to caries etiology. However, the use of selective substrates in most of these studies may have introduced some bias. For example, Sansone et al (1993) found that plaque samples with and without MS and lactobacilli were equally acidogenic when cultured at low pH and in the presence of excess glucose.