CARIOLOGY (DENTAL CARIES) OUTLINE 2005

   Dental Caries Treatment as an Infectious Disease

Dr Steven Steinberg
Clinical Consultant, Skokie, IL

Dr. Arnold D. Steinberg
University of Illinois
College of Dentistry

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IIntroduction
A. Overview.
B. A review of concepts associated with the epidemiology of infectious diseases.

C. Basic premise.
 
D. Previous restorative philosophies and preventive strategies.
E. Sequela of previous preventive strategies. 
F. Strategies to follow for caries control using the current medical model.
G. Treatment of the smooth surface carious lesion using  previous restorative philosophies.
H. Treatment of the smooth surface carious lesion using current infectious disease model philosophies.
I.  Treatment of the pit and fissure carious lesion using previous restorative philosophies.
J.
Treatment of the pit and fissure carious lesion using current infectious disease model philosophies.
K. Using the current infectious disease model should treatment consist of remineralization or sealing pit and fissures?
 

II. The Epidemiology of Dental Caries
 

 

III. Principles of Prevention of Dental Caries


 

IV. The White Spot Lesion-D3 Class 2004


 
V. Treatment protocol using the specific plaque hypothesis.
                   A.  Overview     Medical model summation
 
                   B.  Patient's chart
 
                   C.  Factors in dental caries risk assessment -Obtaining the information.
1. Diet assessment
2. Host risk factors
a. Medical history
b. Dental caries status
c. Fluoride intake
d. Salivary assessment
i.  Salivary flow rate
ii. Salivary buffer test  
               3. Bacterial assessment
a. S. Mutans test
b. Lactobacilli test

D. Classify patient by risk potential-Applying the information.

1. Low risk

2. Moderate risk

3. High risk

4. Treatment goals

5. Overview of treatment

E.    Treatment modalities for the various risk classification patients.

                    1.   Treatment of the low risk patient
        Proactive treatment
        a.  Control S. Mutans
        b.  Methods of suppression
                        i.   Dietary methods, replacements and additives
                       ii.   Plaque control
                      iii.   In child, prevent transmission  
                           
        2.  Treatment of the moderate risk patient.
               -Caries active moderate risk.
Arrest of initial lesions-after lesion starts.
a.   Caries activity tests      
b.   Enhancing the remineralization process
                       i.   Pharmaceuticals to be used
                       ii.   Dietary factors
 
                      3.  Treatment of the high risk patient.
              -Caries inactive high risk.
              -Caries active high risk. 
                     Arrest of cavitated lesions.                   
                     a.  Caries control with F containing materials to limit extent and penetration.
                     b.  Caries activity tests to monitor infection control.
                     c.   Dietary factors.

VI.  Preventive Measures

A. Enamel healing
B. Fluoride use in enamel healing
C. Use of Xylitol gum

 VII.  Dr. Steven Steinberg Lecture Outline


VIII. The Pedodontic Patient.
IX. The  Xerostomic Patient.
 


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Copyright -Dr. A. D. Steinberg 2005