Overview

Dental caries is one of the most common diseases in the world. It is a bacterial disease that results in a continuing loss of mineral ions from the tooth structure due to the presence of acid-producing oral bacteria and is the process that leads to tooth decay.

Tooth decay is the cause of cavities, pain, tooth loss and infection. It is the main reason why people seek dental treatment such as fillings, root canal treatment, extractions and other costly complicated dental procedures.

In the early stage of the disease, a white spot starts to form on the tooth surface. At this stage, the decay process is reversible as the tooth surface is still intact. If the caries disease is not treated, the continued loss of tooth minerals from the tooth results in the formation of a cavity, and the process then becomes irreversible. In severe cases, the caries can spread to the dental pulp causing pulpal infection.

Causes

1. Poor oral hygiene
2. Consumption of sugary foods and drinks
3. Frequent snacks between meals
4. Inadequate saliva flow and function

At the National Dental Centre Singapore we not only treat the effects of the caries disease, i.e. cavities, pulp death, infection, etc, we also help you to identify the risk factors contributing to the progress of your disease. We are then able to customise a caries management programme to help you control the disease more effectively.

Caries disease is a totally preventable disease, and with correct intervention, early caries can be reversed. A simple Caries Assessment Test (CAT) can be carried out to assess your risk for caries disease. Prevention is better than cure and in the case of dental caries, prevention is certainly more cost-effective, less time-consuming and best of all, pain-free!

What does the Caries Assessment Test comprise?

In order for us to prevent dental caries, we must first understand that it arises from a complex interaction of bacteria and sugar on our teeth over a period of time. Sugar may come from various food sources, and not just sweets. In addition, caries formation is affected by numerous factors such as saliva, diet, oral hygiene habits and even lifestyle.

Every individual will have a different predisposition towards dental caries. Once a basic dental examination is done, our dentists can carry out the CAT by providing you with:

• Comprehensive education on the process of tooth decay
• Clinical and radiographic assessment of the caries activity level of each tooth in your mouth
• Diet analysis
• Saliva analysis to assess whether your saliva is healthy and able to adequately protect your teeth
• Plaque analysis to determine its bacteria and acidity levels

These tests are quick and painless and will help in identifying the factors predisposing you to caries disease.

With these results, a preventive strategy tailored to your needs will be designed. The strategy will include:

• Modification to lifestyle and/or prescription of safe therapeutics for home use
• Introducing a tooth brushing method tailor-made for you
• Incorporating calcium- and fluoride-based remineralisation therapies, such as putting concentrated fluoride on your teeth to control or reverse early caries lesions
• Starting painless, minimally invasive treatment such as sealing the deep grooves on the chewing surfaces of teeth, if necessary

Am I a suitable candidate for the CAT?

• Do you have a past history of fillings, extractions and complex dental work?
• Do you have new cavities detected or existing fillings that need to be replaced at each recall visit?
• Do you regularly consume soft drinks and sweets?
• Are you wearing braces or partial dentures?
• Do you have a history of or are currently undergoing radiation therapy?
• Have you been diagnosed with gum disease or are being treated for the condition?
• Does your mouth feel dry?

If you experience any of the above, understanding your risk for caries is half the battle won. The best results are achieved when patients are committed to following the prevention strategies drawn up between the dentists and themselves. Caries can recur at any stage in your life, even after this test.

However, partnering responsibly with your dentist improves tremendously the chances of it NOT becoming an irreversible disease in your life.

1. Early decay can be REVERSED.
2. Understand your risk for caries.
3. Ask your dentist for more information on the Caries Assessment Test (CAT).