Advances in Dental Research, Vol 9, 106-109, Copyright © 1995 by International & American Associations for Dental Research
Can prevention eliminate caries?
D. O'Mullane
WHO Collaborating Centre for Oral Health Services Research, University Dental School, Ireland.
There are four main factors involved in the carious process: at-risk tooth
structure, plaque flora, fermentable carbohydrates, and time. Based on our
knowledge of the carious process, four main preventive strategies have been
developed over the years, namely, fluorides, fissure sealing, dietary
choice, and plaque control. Fluorides are having a major impact on
smooth-surface caries; hence, strategies combining fluorides and fissure
sealing are very effective. However, use of fissure sealing is still
problematic. Changing dietary practices with a view to reducing dental
caries seems to be having little impact on a global scale. Plaque control,
as practiced routinely by the majority of people, is not sufficient to
result in caries reductions. Deprivation and poverty are strongly
associated with high caries levels. Although the preventive strategies
currently available are likely to result in lower caries levels for many,
for logistical reasons and because of factors associated with deprivation
and poverty, caries is likely to remain a major public health problem in
most communities for the foreseeable future.
