Operative dentistry aje qualtrough, jd satterthwaite la morrow, pa brunton

Caries prevention
A decision to intervene in the management of dental caries is pro-
bably one of the most important decisions a dentist will make. Early
restorative intervention should be avoided if possible as tooth prepa-
ration is irreversible and commits the tooth to the restorative cycle
8
.
All restorations fail at some time and require either repair/refurbish-
ment or replacement, resulting in yet another insult to the tooth 
tissues. This repeated insult can ultimately lead to the loss of the tooth.
A delayed start on this cycle is advised wherever possible, and there is
a resurge in providing early preventive and remineralisation treat-
ment and minimal intervention of carious lesions
8
.
Diet
Decreasing the frequency of fermentable carbohydrate consump-
tion and elimination or substitution is essential as this will result in
reduced periods of acid production and less risk of demineralisation
of the tooth tissue
9
.
Fluoride
Fluoride supplements can be either patient or dentist applied. The
effects of fluoride on caries in different sites are variable
10
. Fluoride
has produced the following reductions in caries:
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• 20% in occlusal caries
• 55% in interproximal caries
• 61% in smooth surface caries
It is clear that occlusal caries will still be a significant clinical 
problem. The topical and systemic effects of fluoride have, however,
made the clinical diagnosis of caries more difficult.
Oral hygiene
A well maintained oral hygiene regime helps to maintain the bacterial
balance within the oral cavity and can also help to deliver topical
fluoride on a regular basis.