National Academy of Medicine

Dental Caries Management in Children and Adults

By Rebecca L. Slayton, Margherita Fontana, Douglas Young, Norman Tinanoff, Brian Nový, Ruth D. Lipman, and Lindsey Robinson
September 14, 2016 | Discussion Paper

From our perspective, dental caries continues to be one of the most common chronic diseases in the United States and globally, with individuals living in poverty and minorities being affected more than their more affluent peers. Dental caries (commonly referred to as “cavities”) is a complex multifactorial disease mediated by factors that protect teeth (fluoride, salivary flow, buffering capacity, and host immunity) and patient-specific factors that put teeth at increased risk (frequent exposure to dietary carbohydrates, poor oral hygiene, and a cariogenic biofilm containing bacteria capable of fermenting carbohydrates and producing a decrease in pH). As Fontana and Wolff (2011) note, it is critical to develop effective tools for prevention and management that are risk based and patient centered.

Investing in effective nonsurgical (medical) management of dental caries will pay off by reducing the need for dental surgery to remove some or all of the tooth structure. Effective nonsurgical (medical) management of dental caries, including disease prevention and interventions in its earlier stages, requires early assessment to identify individuals at risk prior to visual indications of disease occurrence (dental cavities) combined with person- and/or family–centered education about the importance of oral health and its link to overall health. We believe a person’s health literacy is especially important to consider because their understanding of the factors related to the promotion of oral health and prevention of disease will impact their ability to take action and incorporate appropriate home care as a standard routine. Health literacy as practiced is a shared responsibility of the health care provider, clinical setting, and patient/caregiver. The dental team can enhance a patient’s self-efficacy by incorporating basic health literacy principles, such as the use of clear language and the use of the “teach back” method in clinical practice.

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Disclaimer: The views expressed in this paper are those of the authors and not necessarily of the authors’ organizations, the National Academy of Medicine (NAM), or the National Academies of Sciences, Engineering, and Medicine (the National Academies). The paper is intended to help inform and stimulate discussion. It is not a report of the NAM or the National Academies. Copyright by the National Academy of Sciences. All rights reserved.