Specific Oral Microflora:

It has been established that dental caries is an infectious disease and is transmissible.

 

This bacterial infection is mainly due to mutans streptococcus and in the later stages to lactobacillus.

Since caries is caused by specific plaque bacteria, certain consequences will follow:
    1.  Some patients will be at low risk since they have a limited number of the pathogenic bacteria.
    2.  Some patients will be at moderate risk since they have a sufficient number of bacteria to activate the disease.
    3.  Some patients will be at high risk since they have cavitated lesions indicating very high numbers of the pathogenic bacteria.

Preventive measures:

As in any infectious disease control the infectious agent. 

 

How do we do this?

1.  Control the bacteria as in any other infectious disease by the use of antimicrobials such as chlorhexidine, fluoride and Xylitol.

 

2. Monitor to see if the infectious agent is under control.

3.  If prevention has failed and a cavitated lesion is present, a restoration must be placed prior to reinstituting preventive measures. The logic behind this is similar to that of "incision and drainage" of an abscess.  The bacterial load is diminished extensively by this local, mechanical, surgical procedure. This is followed by systemic, non-local, antibacterial therapy.  Similarly, by placing a restoration first the bacterial, the local bacterial load is diminished.  This allows for better control of the mouth-wide disease process when treated chemotheraputically.

Dental Caries Vaccine.

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