An Examination of the Advances in Science and Technology of Prevention of Tooth Decay in Young Children Since the Surgeon General's Report on Oral Health

Abstract

This paper addresses a number of areas related to how effectively science and technology have met Healthy People 2010 goals for tooth decay prevention. In every area mentioned, it appears that science and technology are falling short of these goals. Earlier assessments identified water fluoridation as one of the greatest public health accomplishments of the last century. Yet, failure to complete needed clinical and translational research has shortchanged the caries prevention agenda that incomplete at a critical juncture.Science has firmly established the transmissible nature of tooth decay. However, there is evidence that tooth decay in young children is increasing although progress has been made in other age groups. Studies of risk assessment have not been translated into improved practice. Antiseptics, chlorhexidine varnish, and PVP-iodine may have value, but definitive trials are needed. Fluorides remain the most effective agents, but are not widely disseminated to the most needy. Fluoride varnish provides a relatively effective topical preventive for very young children, yet definitive trials have not been conducted. Silver diammine fluoride also has potential but requires study in the US. Data support effectiveness and safety of xylitol, but adoption is not widespread. Dental sealants remain a mainstay of public policy, yet after decades of research, widespread use has not occurred.We conclude that research has established the public health burden of tooth decay, but insufficient research addresses the problems identified in the Surgeon General's Report. Transfer of technology

Sugar alcohols—their role in the modern world of sweeteners: a review

“…Besides reducing the development of dental caries, it also plays a role in a decrease in plaque formation as it inhibits the growth and metabolism of Streptococcus mutans and Streptococcus sobrinus, which are responsible for caries and dental plaque acid production, respectively [96,[110][111][112][113]. There are results of several clinical studies which confirm that the daily usage of small amounts of xylitol significantly decreases the risk of dental caries [3,95,114]. It has been also reported that maternal xylitol consumption results in reduced occurrence of dental caries in children [115].…”

Saving One Smile at a Time: Oral Health Promotion in Pediatric Primary Care Practice

“…Fluoride varnish also provides additional benefits for those high-risk children who may have limited access to fluoridated water. Fluoride varnish is proven to be easy to use as well as safe and effective for infants and toddlers [28].…”

Targeted Antimicrobial Treatment to Re-establish a Healthy Microbial Flora for Long-term Protection

“…Consequently, there is no strong clinical evidence supporting the long-term prevention of re-infection of cariogenic bacteria and very few studies examining the impact on caries reduction (Milgrom et al, 2009;Vollmer et al, 2010;Young et al, 2010;Papas et al, 2012). The reason for the lack of long-term protection could be tied to the persistence of cariogenic bacteria within the dental plaque and the dynamic balance of the biofilm community between a healthy state and cariogenic state.…”

“…Fluoride has been successful in reducing the incidence and prevalence of dental caries and should remain an important part of any anti-caries regimen, but it has limited efficacy in killing cariogenic bacteria residing in dental plaque, even though there have been reports of its inhibitory effects on bacterial metabolism (Hamilton, 1990). This could be a factor contributing to the persistence of dental caries within populations, despite fluoride's well-documented clinical efficacy (Beighton, 2005;Anderson and Shi, 2006;Milgrom et al, 2009).…”