Preventing Caries: Essential Tools for Children and Adults
In the fight against caries and disease-causing biofilm, start with 2 proven preventive tools: fluoride varnishes and sealants
There are many factors to consider in the ongoing fight against caries, and 2 of the most important preventive tools in the hygienist's arsenal are sealants and fluoride varnishes. While children benefit significantly from these treatments for their still-developing teeth, it’s also important to recommend preventive care for adults—especially those with high caries risk.
“Fluoride protects the smooth tooth surfaces from demineralization, sensitivity, and bacteria, while sealants are helpful for preventing pit and fissure carious lesions,” said Katelin Johnson, RDH, who practices in Lindenhurst, NY.
“Adults also can benefit from topical treatments, and they should certainly get sealants on their ‘virgin’ molars and premolars if no decay is present.”
- Katelin Johnson, RDH
According to Johnson, children whose teeth are developing should also receive an oral fluoride supplement— depending on whether their hometown has fluoride in the public water system. “Fluoride mouthwashes are typically recommended to children, while adults often require more perio-focused care," Johnson said. "Adults also can benefit from topical treatments, and they should certainly get sealants on their ‘virgin’ molars and premolars if no decay is present.”
Diet education is another home care consideration when it comes to preventing caries. “I let my patients know that sugar, carbohydrates, and acidic beverages and foods should be consumed in moderation,” explained Johnson. “They should also limit alcohol and ideally not use drugs or tobacco.”
Sometimes, patients may think that their at-home dental routine suffices, but it turns out that they are not doing nearly enough to clean and protect their teeth. To help combat this, Johnson has a list of tools that she suggests patients use on a regular basis during home care. “I’ve found that recommending xylitol, a water flosser, electric brushes, and Sensodyne is effective for most of my patients.”
Next, explore a variety of varnishes and sealants that can help you win the fight against caries.
VARNISHES
Ultradent's Enamelast Fluoride Varnish, available in 5 flavors and a new flavor-free option, is a xylitolsweetened, 5% sodium fluoride in a resin carrier that produces a mechanical/chemical occlusion of the dentinal tubules in the treatment of hypersensitivity. Its adhesion-promoting formula enhances retention, providing superior fluoride release and uptake.
3M Vanish 5% Sodium Fluoride White Varnish provides an extended release of fluoride, calcium, and phosphate for up to 24 hours. It is formulated to stay in contact with the teeth longer for advanced protection, depositing acid-resistant minerals on tooth surfaces, including dentin tubules, to relieve hypersensitivity.
Profluorid Varnish from VOCO is a thin, great tasting, white transparent 5% sodium fluoride varnish that offers an easy, non-messy SingleDose delivery system, low film thickness, light taste, and enjoyable flavors. Profluorid Varnish is available in 6 flavors:
caramel, melon, cherry, mint, bubblegum, and cola lime.
Centrix's FluoroDose has been upgraded with a new, patented hygienic package, ergonomic design, and a smooth, easy peel. Each unit contains one dose (0.3 mL) of FluoroDose and a Benda Brush applicator. Simply peel back the cover, dip in the brush, mix, and apply. The varnish dries in seconds upon contact with saliva and comes in 5 flavors.
Uniquely formulated with amorphous calcium phosphate, Premier’s Enamel Pro Varnish delivers high fluoride uptake in addition to
tooth-building calcium and phosphate ions. Available in 3 flavors, it is indicated for treating dentinal hypersensitivity and postoperative sensitivity. A unique 5% sodium fluoride varnish that releases fluoride and tricalcium phosphate (TCP) to boost enamel protection and promote acid resistance, FluoroCal from BISCO penetrates and seals dentin tubules to provide immediate relief to sensitive teeth. The white varnish blends easily with natural tooth color and offers a pleasant spearmint flavor sweetened with xylitol.
Uniquely formulated to minimize clumping, dripping, or stringing, Dentsply Sirona’s Nupro White Varnish goes on white so it’s easy to see during application, and then sets to a clear finish. Flexible packaging allows hygienists to choose how to hold the unit dose: snap it on the prophy grip, hold it between their fingers, or rest it on the dental tray. ACCLEAN One Step from Henry Schein is a 5% sodium fluoride varnish that comes in 0.4-mL unit-dose packaging with an application brush. It delivers the highest fluoride concentration available and offers smooth and even application in 5 patient-pleasing flavors: caramel, bubblegum, cherry, mint, and raspberry.
Patterson Dental’s 5% Sodium Fluoride White Varnish offers a smooth consistency for fast and easy application of a thin, even layer on the tooth surface. The white varnish completely hardens within 10 seconds of contact with saliva or moisture and dries to a natural shade.
SEALANTS
VOCO’s Grandio Seal is the first nano-fissure sealant that enables longterm sealing. With low shrinkage and a drip- and bubble-free placement, it comes in one radiopaque shade for optimum visibility.
Pulpdent’s Embrace WetBond is a pit and fissure sealant that bonds to moist tooth structure. Research shows it has a remarkable sealing ability, good adaptation to tooth structure, and long-term success.
A low-viscosity resin system, Natural Elegance Pit & Fissure Sealant from Henry Schein has a white opaque color to help identify retention at recall appointments. The material cures quickly and comes in a direct-delivery syringe, providing a quick and easy
application.
Patterson Pit & Fissure Sealant protects against caries by sealing occlusal surfaces and inhibiting acid conditions caused by oral bacteria and dietary carbohydrates. The fluoridereleasing, radiopaque sealant offers a pearlescent color that is easily seen
For pit and fissure protection, Ultradent's Ultraseal XT Plus and Ultraseal XT Hydro are fluoride-releasing, BPA-free, radiopaque, and thixotropic. The Hydro version is hydrophilic and fluoresces under a blacklight to check margins over time.
Using a moisture-tolerant chemistry, Champ from Centrix is packaged in a convenient, single-dose LolliPack for greater infection
control. The single, brush-on application requires just 1 sweep from cusp to cusp, and the resulting margin-free seal prevents any pitting, chipping, or staining.
Formulated with amorphous calcium phosphate, Keystone’s Aegis Pit & Fissure Sealant can be used with any light-curing device and offers the added convenience of dispensing via syringe tips. Forming a chemical and thermal barrier, the material features controlled flowability that keeps the
sealant on the tooth while completely filling the pits and fissures.
