Sprečavanje nastanka karijesa

Karijes je najčešće oboljenje današnjice. Ukratko, to je progresivno uništavanje zuba kiselinom koju proizvode bakterije koje se nalaze u dentalnom (zubnom) plaku.

Prevencija

Preventiva počinje odgovarajućim održavanjem oralne higijene. Fokus održavanja oralne higijene je uklanjanje i sprečavanje nastanka pomenutog zubnog plaka, koji je ustvari lepljiva materija koja sadrži bakterije, a nalazi se na površini zuba.

Danas postoje mnoga sredstva koja nam to olakšavaju, ali najvažnije je ipak redovno pranje zuba četkicom i pastom za zube (najmanje dva puta dnevno, ujutru i uveče).

Pogledajte demonstracione video klipove za prevenciju karijesa na engleskom jeziku:

Problem je što se četkica za zube može koristiti za uklanjanje plaka na pristupačnim površinama, ali ne i među zubima ili unutar jama i pukotina na površinama koje koristimo pri žvakanju.

Tu pomaže zubni konac koji, ukoliko se pravilno koristi,uklanja plak iz područja u kojima bi moglo doći do razvoja udaljenijeg karijesa.

Pogledajte demonstracioni video sa prikazom pravilnog korišćenja zubnog konca  na engleskom jeziku:

Sva druga sredstva – preparati fluora, tečnosti za ispiranje, tuševa za zube (water pick), žvakaćih guma bez šećera do deterdžentne hrane (npr. jabuke) – dodatno smanjuju stvaranje zubnih naslaga što naravno utiče na smanjenje oboljenja od karijesa.

Takođe, žvakanje vlakana poput celera pomaže prevenciji karijesa. To se dešava iz razloga što razređuje i razgrađuje ugljene hidrate (šećere), neutrališe kiseline i reminerališe demineralisani zub.

Promena načina ishrane

Učestalost uzimanja šećera je važnija od količine unetog šećera. Naime, u prisustvu šećera i drugih ugljenih hidrata, bakterije u ustima proizvode kiseline koje demineralizuju (rastvaraju se minerali iz gleđi). Što su češće zubi izloženi takvom okruženju, to je veća verovatnoća da će nastati karijes.

Što se tiče dece, Američka Asocijacija Stomatologa (ADA) i Evropska Akademija Pedijatrijske Stomatologije (EAPD) preporučuju ograničavanje učestalosti konzumiranja pića sa šećerom, kao i prestanak davanja  flašica novorođenčadima za vreme spavanja.

Majkama se takođe preporučuje izbegavanje deljenja pribora za jelo i čaša s njihovom decomkako bi se sprečilo prenošenje bakterija iz usta majke.

Takođe, xylitol žvake (xylitol je ustvari alkoholni šećer) se koriste za zaštitu zuba u nekim zemljama. Efekat xylitola utiče na smanjenje plaka i to najverovatnije zbog nemogućnosti bakterija da ga iskoriste kao druge šećere.

Žvakanje i stimulacija receptora ukusa na jeziku dovode do povećavanja proizvodnje i ispuštanja tečnosti (pljuvačke), koja sadrži prirodna zaštitna sredstva za sprečavanje karijesa tj. sprečavanja spuštanja pH faktora u ustima do vrednosti na kojoj gleđ može da se demineralizuje.

Uz sve navedene mere, treba uključiti stomatologa koji će kontrolisati i unapređivati vaše oralno zdravlje. Redovne šestomesečne, a za decu i tromesečne kontrole, stomatologu pružaju potpuni uvid u vaš zubni status, što mu daje prostora i vremena za planiranje terapije.

Stomatolozima stoje na raspolaganju mnoga sredstva i znanja važna u prevenciji karijesa – premazivanje zaštitnim lakovima, preparatima fluora, zalivanje fisura, odabiranje odgovarajuće četkice, paste i načina četkanja. Ako na kraju i dođe do zubnog kvara, na redovnim kontrolama, on se pravovremeno dijagnostikuje i sanira jednostavnim zahvatom.

Ali kada zub zaboli i otekne stvari se zakomplikuju.

Zbog toga treba staviti naglasak na važnost oralne higijene i stomatološke kontrole uz druge preventivne postupke.

Možda Vam budu interesantne informacije do kojih se stiglo istraživanjem prevencije karijesa. Naime, nedavna istraživanja pokazuju da nizak intenzitet laserskog zračenja jonima argona (hemijski element sa oznakom Ar) mogu da spreče osetljivost na karijes. Osim toga, bakterije koja su glavni uzročnici karijesa, trenutno se nalaze u fazi istraživanja u cilju pronalaženja vakcine za karijes. Takva vakcina uspešno je testirana na životinjama 2004. godine,a u fazi kliničkog testiranja na ljudima nalazi se od maja 2006. godine.

Izvori:

American Dental Association

European Academy of Pediatric Dentistry

Simple Steps to Dental Health

 Today, caries remains one of the most common diseases throughout the world. Also known as tooth decay or cavity, dental caries is a disease where bacterial processes damage hard tooth structure (enamel, dentin and cementum).

Prevention

Personal hygiene care consists of proper brushing and flossing daily. The purpose of oral hygiene is to minimize any etiologic agents of disease in the mouth. The primary focus of brushing and flossing is to remove and prevent the formation of plaque.


Plaque consists mostly of bacteria. As the amount of bacterial plaque increases, the tooth is more vulnerable to dental caries when carbohydrates in the food are left on teeth after every meal or snack.

A toothbrush can be used to remove plaque on accessible surfaces, but not between teeth or inside pits and fissures on chewing surfaces.

Dental floss demo video:

When used correctly, dental floss removes plaque from areas which could otherwise develop proximal caries. Other adjunct hygiene aids include interdental brushes, water picks, and mouthwashes.

However oral hygiene is probably more effective at preventing gum disease than tooth decay. The brush and fluoride toothpaste have no access inside pits and fissures, where chewing forces food to be trapped. It is here that resident plaque bacteria change any carbohydrate to acid that demineralises teeth inside pits and fissures, causing over 80% of cavities. (Occlusal caries accounts for between 80 and 90 percent of caries in children). The teeth at highest risk for carious lesions are the first and second permanent molars.

Dental caries prevention demo videos:

Chewing fibre like celery after eating forces saliva inside pits and fissures to dilute any carbohydrate like sugar in trapped food, neutralise acid and remineralise demineralised tooth and should be part of every day personal tooth care to prevent tooth decay.

Professional hygiene care consists of regular dental examinations and cleanings. Sometimes, complete plaque removal is difficult, and a dentist or dental hygienist may be needed. Along with oral hygiene, radiographs may be taken at dental visits to detect possible dental caries development in high risk areas of the mouth.

Dietary modification

For dental health, frequency of sugar intake is more important than the amount of sugar consumed. In the presence of sugar and other carbohydrates, bacteria in the mouth produce acids which can demineralize enamel, dentin, and cementum.

The more frequently teeth are exposed to this environment, the more likely dental caries are to occur. Therefore, minimizing snacking is recommended, since snacking creates a continual supply of nutrition for acid-creating bacteria in the mouth. Also, chewy and sticky foods (such as dried fruit or candy) tend to adhere to teeth longer, and consequently are best eaten as part of a meal. Brushing the teeth after meals is recommended.

For children, the American Dental Association and the European Academy of Paediatric Dentistry recommend limiting the frequency of consumption of drinks with sugar, and not giving baby bottles to infants during sleep. Mothers are also recommended to avoid sharing utensils and cups with their infants to prevent transferring bacteria from the mother’s mouth.

It has been found that milk and certain kinds of cheese like cheddar can help counter tooth decay if eaten soon after the consumption of foods potentially harmful to teeth. Also, chewing gum containing xylitol (a sugar alcohol) is widely used to protect teeth in some countries. Xylitol’s effect on reducing plaque is probably due to bacteria’s inability to utilize it like other sugars. Chewing and stimulation of flavour receptors on the tongue are also known to increase the production and release of saliva, which contains natural buffers to prevent the lowering of pH in the mouth to the point where enamel may become demineralised.


However chewing gum does not absorb saliva and is not able to effectively force saliva and any dental agents inside pits and fissures in chewing surfaces where over 80% of cavities occur. Chewing raw vegetable fibre like celery after eating forces saliva inside pits and fissures to dilute carbohydrate like sugar, neutralise acid and remineralise deminealised tooth.

Other preventive measures

The use of dental sealants is a means of prevention. A sealant is a thin plastic-like coating applied to the chewing surfaces of the molars. This coating prevents food being trapped inside pits and fissures in grooves under chewing pressure ao resident plaque bacteria are deprived of carbohydrate that they change to acid demineralisation and thus prevents the formation of pit and fissure caries, the most common form of dental caries. Sealants are usually applied on the teeth of children, shortly after the molars erupt. Older people may also benefit from the use of tooth sealants, but their dental history and likelihood of caries formation are usually taken into consideration.

Fluoride therapy is often recommended to protect against dental caries. It has been demonstrated that water fluoridation and fluoride supplements decrease the incidence of dental caries. Fluoride helps prevent decay of a tooth by binding to the hydroxyapatite crystals in enamel. The incorporated fluoride makes enamel more resistant to demineralization and, thus, resistant to decay.Topical fluoride is also recommended to protect the surface of the teeth. This may include a fluoride toothpaste or mouthwash. Many dentists include application of topical fluoride solutions as part of routine visits.

Furthermore, recent research shows that low intensity laser radiation of argon ion lasers may prevent the susceptibility for enamel caries and white spot lesions. Also, as bacteria are a major factor contributing to poor oral health, there is currently research to find a vaccine for dental caries. As of 2004, such a vaccine has been successfully tested on animals, and is in clinical trials for humans as of May 2006.

Sources:

American Dental Association

European Academy of Pediatric Dentistry

Simple Steps to Dental Health

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2017-11-25T18:26:36+00:00

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