Moving prevention forward

The role of preventive restoratives and innovative screening technologies in caries risk management in SEARHC dental clinics

Oral health encompasses the stability of, and absence of diseases in, all structures in the mouth—from the teeth to gingival tissues, tongue to the hard palate, and other buccal and lingual tissues. Among the most preventable and reversible diseases that dental professionals see are caries and periodontal diseases.1,2 Regular visits to oral health-care professionals, combined with good hygiene that begins at a very young age, can prevent and curtail tooth decay and gum disease.

Unfortunately, several factors can increase an individual’s caries risk.3,4 These include genetic predisposition to caries and periodontal diseases, different strains of caries active bacteria that can be transmitted from person to person and which may be localized to specific geographic areas and populations, difficulty accessing inexpensive fresh fruits and vegetables and healthy foods, and lack of running water. An inability to access dental care in geographically dispersed locations also contributes to caries disease risk. Combined, these factors create barriers to good oral health.

The SEARHC caries risk program

In Southeast Alaska, however, dentists, dental hygienists, and primary dental health aides and therapists (levels 1 and 2) affiliated with the Southeast Alaska Regional Health Consortium (SEARHC) dental clinics have incorporated a multilevel approach for preventing, arresting, and treating caries disease.5 Even before CAMBRA (Caries Management by Risk Assessment) was established as the standard for caries risk assessment through disease indicators, protective protocol, and clinical interventions,6 SEARHC dental professionals began addressing the caries disease problem differently after realizing we weren’t winning the fight against cavities by drilling and filling. Rather than treat cavities according to a surgical model, we sought to treat caries disease according to a medical model, and spent considerable time researching and exploring available caries preventative and therapeutic products.