In my journey as a dental hygienist, I've always strived for a proactive approach to oral health, veering away from the traditional, disease-chasing paradigm that has historically dominated dentistry. By emphasizing minimally invasive therapies, I’ve found effective ways to treat and prevent oral health issues in both private practice and public health settings.
This topic and way of practicing are honestly new to me. I "grew up" in the world of periodontics. I started my career as a dental hygienist in periodontal practices and then shifted to public health settings. Perio has always been the area of dentistry in which I felt the most comfortable. From treating active disease to secondary prevention and maintenance, I always felt very confident in this area of dentistry. In the past five years, I have been learning and growing in the space of minimally invasive therapies and ways to prevent the loss of tooth structure, aka cavities. Here are some of the products and procedures that I will be using in 2024.
The Crucial Role of Saliva in Oral Health
A fundamental aspect of my approach is understanding the oral environment, primarily through salivary analysis. Just to clarify, I am not analyzing the bacteria, but the pH and consistency of the saliva. I find this to be a very low-cost procedure. I do like the idea and have used bacteria analysis of the saliva, but there is a higher cost for this. By utilizing products like GC America's Saliva Check and litmus papers from Amazon, I can accurately gauge the acidity levels and consistency of saliva. This is pivotal, as saliva is the first line of defense against tooth decay and gum disease, neutralizing harmful acids and providing essential minerals to repair tooth enamel.
Saliva pH and Preventive Strategies
Educating patients about maintaining a balanced oral pH is vital. This includes recommending pH-neutral products such as specific mouth rinses and kinds of toothpaste containing fluoride and hydroxyapatite. These products are essential in strengthening tooth enamel and enhancing its resistance to acid attacks, a topic I delve deeper into in my post on How to Reverse Tooth Decay and Early Cavities, or read my thoughts on Brilliant or Bulls*t: Putting Baking Soda in Toothpaste.
Introducing GC America's TriPlaque ID Gel
A recent addition to my practice is the GC America TriPlaque ID Gel. This innovative product reveals areas of acidic bacteria, which are a major concern in the prevention of tooth structure loss. By visually identifying these areas, I can target specific sites for intensive care and prevention. Learn more about this product GC Tri Plaque ID Gel™. Explored my discussion on the importance of Using Disclosing Solutions on Every Patient. This diagnostic solution helps guide me to my next steps in the treatment plan and allows me to provide the best care possible for my patients.
The Effectiveness of Xylitol and Arginine
In the realm of preventive dental care, the role of dietary components like xylitol and arginine cannot be overstated. Xylitol, a natural sugar alcohol found in various fruits and vegetables, has been a revolutionary addition to the world of oral health. When used in sugar-free candies, mints, and gums, it offers a dual benefit. Firstly, it reduces the levels of Streptococcus mutans, a primary bacterium responsible for tooth decay, in the mouth. This happens because these bacteria cannot metabolize xylitol for energy, unlike regular sugar, leading to their reduced growth and adhesion to the tooth surface. Secondly, xylitol helps reduce the acidity of saliva. A more neutral pH in the mouth is less conducive to enamel demineralization, thereby reducing the risk of cavities.
Arginine, an essential amino acid, works synergistically with xylitol. Certain oral bacteria metabolize it to produce ammonia, which aids in balancing oral pH. This increased alkalinity in the mouth fosters an environment that favors remineralization over demineralization. By aiding in the rebuilding of minerals in the teeth, arginine plays a critical role in combating the early stages of tooth decay and preventing its progression.
Pioneers in Decay Prevention: Silver Diamine Fluoride and Curodont
In addressing early signs of dental decay, I turn to groundbreaking solutions like silver diamine fluoride (SDF) and Curodont. SDF, a powerful agent in the fight against tooth decay, combines two key components: antimicrobial silver and remineralizing fluoride. The silver component provides a strong antimicrobial action, effectively halting the progression of cavities by killing the bacteria that cause decay. Fluoride, a well-known dental care ingredient, aids in the remineralization process by helping to harden the acid-softened tooth enamel. This dual action makes SDF an exceptional choice for stopping decay in its tracks, particularly in situations where traditional drilling and filling are not viable or desired.
Curodont, another innovative dental product, takes a different approach to preventing tooth decay. It utilizes a peptide-based technology that stimulates the natural repair process of tooth enamel. By promoting the growth of new enamel minerals, Curodont helps to strengthen and protect teeth from further decay. This innovative solution offers an alternative option for individuals looking for non-invasive methods to address tooth decay. This approach not only halts the progression of decay but also promotes the natural healing of the tooth structure, preserving the integrity of the tooth and reducing the need for more invasive treatments.
Glass Ionomer Sealants: A Protective Barrier
Glass ionomer sealants are a tried-and-true but underutilized material in preventive dentistry. These sealants are unique in their composition and function. When applied to the chewing surfaces of teeth, they form a robust barrier against the common culprits of tooth decay: acids and bacteria. What sets glass ionomer apart from other sealant materials is its ability to release fluoride over time, AND it is so easy to use, especially on children or anyone where isolating saliva is an issue or can't sit through the etching process. This sustained fluoride release provides ongoing protection against decay, continuously fortifying the enamel and helping to prevent the onset of cavities.
The fluoride release from glass ionomer sealants is particularly beneficial in high-risk areas, such as the grooves and fissures of molars, which are often more challenging to clean and thus more susceptible to decay. As I mentioned, these sealants are also less technique-sensitive compared to their resin-based counterparts, making them a more practical choice in various clinical situations, including those involving young children or patients with special needs.
By incorporating these innovative products and practices, such as xylitol and arginine-based products, silver diamine fluoride, Curodont, and glass ionomer sealants, into my preventive care regimen, I can offer my patients a comprehensive and minimally invasive approach to dental care. This approach not only addresses current dental issues but also lays the foundation for long-term oral health, staying true to my commitment to proactive and preventive dentistry.
This is just a starting point for me, as I know some of you reading this are like:
What about nutrition?
What about lip seal and mouth breathing?
What about home care?
Yes, those are other areas that I identify and discuss, but those have been a part of my routine in dentistry. The areas I have discussed here are new to my routine.
This is the expansion of my dental care philosophy, which is anchored in prevention rather than cure. Through the use of minimally invasive techniques and innovative products, my goal is to treat and prevent oral health issues effectively. This proactive stance is key to transforming the narrative of dentistry from disease chasing to disease prevention. As a dental hygienist, my commitment is to educate and empower my patients to take control of their oral health with these advanced preventive measures.