60번 주강욱 예방논문2 발표
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This article discusses caries risk assessment and management for prosthodontic patients. It outlines factors that increase or decrease caries risk and recommends a preventive treatment plan involving patient education, fluoride therapy, chlorhexidine, xylitol, and amorphous calcium phosphate to reduce caries risk. The goal is to involve patients in disease control and favor remineralization over demineralization for more successful long-term prosthodontic outcomes.
60번 주강욱 예방논문2 발표
- 1. CARIES RISK ASSESSMENT AND MANAGEMENT FOR THE PROSTHODONTIC PATIENT 5조 60. Kanguk Joo
- 2. Purpose of this article To review how caries risk assessment of the prosthodontic patient can result in meaningful caries management and a more favorable prosthodontic outcome. To outline considerations on caries risk assessment for improved caries management in the prosthodontic patient.
- 3. Risk factos for caries
- 4. Protective factors for caries
- 5. Preventive treatment plan Involve the patient in disease control The importance of a caries reduction program during and following prosthodontic treatment should be thoroughly discussed with the patient prior to initiating treatment. Fluoride in various forms In prosthodontic patients with gingival recession with other risk factors for caries, a fluoride varnish on root surfaces three times annually is warranted.
- 6. Preventive treatment plan Chlorhexidine Because of staining and impact on taste, chlorhexidine use should be limited to seven consecutive days a month. Recommended dosage is 10 ml of a 0.12% rinse for 1 minute at night at least 1 hour after brushing with fluoridated toothpaste and after removing any prosthesis.
- 7. Preventive treatment plan Xylitol Although the independent variables of unit dose, frequency of chewing, and time chewing have not been thoroughly evaluated, patients at high risk for caries should chew xylitol-containing gum twice daily for 15 minutes with a total xylitol dose of 7 to 10 g per day.
- 8. Preventive treatment plan Combination of xylitol and chlorhexidine Elderly partially and completely edentulous patients with caries and denture stomatitis and/or angular cheilitis would benefit from chewing gum containing both xylitol and chlorhexidine. Since the product studied by Simons et al is not currently available in the United States, the use of xylitol gum daily and 10 ml of a 0.12% rinse of chlorhexidine 1 day a week is a viable alternative.
- 9. Preventive treatment plan Amorphous calcium phosphate Although studies of CCP-ACP are somewhat controversial, there appears sufficient evidence of caries reduction potential to recommend its use, especially in patients with root exposure. Application follows the use of fluoridated toothpaste twice a day using a cotton swab, a finger, or a custom tray.
- 10. Preventive treatment plan Stimulation of salivary flow Patients with diminished saliva flow should be counseled managing the condition, including the advantages of a low-sugar diet and on possible relief provided by the products discussed above. Sipping frequently on water that contains two teaspoons of baking soda in 8 oz of water will help hydrate the mouth and neutralize bacterial acids generated in the plaque.
- 11. Conclusion Management of caries risk may include patient behavioral modification, chemical control of the biofilm, stimulation of salivary flow, and/or the supplement of constituents to favor remineralization over demineralization. Successful management of the patient’s caries risk will ultimately result in more enduring prosthodontic outcomes.