1. prepared by: Dr. Ala'a Al-Otaibi
2. definition
   1. ‘‘a chemical dissolution of the dental hard tissues by acidic bacterial products from degradation of low molecular weight sugars’’
3. etiology
   1. Dental caries is a multifactorial infectious disease process.
      1. host factor
         1. Host factors that affect the caries process begin with the tooth itself.
            1. location
            2. in adolescent : interproximal
            3. morphology
            4. composition
            5. saliva
            6. buffering agent
            7. Subtopic 2
            8. Subtopic 3
            9. ultrastructure
      2. dietary
         1. Composition
         2. frequency
      3. bacterial
         1. Streptococcus
         2. Lactobacillus species
         3. Actinomyces isrealli
      4. socioeconomical factors
         1. The caries rate among individuals living below the poverty level is higher than the rate among those who are economically comfortable.
            1. limited income
            2. Lack of value placed on dental health
            3. lack of knowledge of oral care
            4. transportation limitations
      5. caries process
4. risk assessment
5. prevention strategies
   1. primary
      1. increased fluoride exposures
         1. community water fluoridation
         2. fluoride dentifrices,
         3. fluoride mouthwashes
         4. professionally applied topical fluoride
            1. topical flouride
            2. 1.23%acidulated phosphate fluorided
            3. applied topical application inhibits caries formation by reducing enamel solubility and improving remineralization
            4. no tartness or after taste
            5. 1-minute uptake
            6. 2.0%–2.2% sodium fluorided
            7. applied; reduces caries; most efective when a four-visit procedure is used
            8. no tartness or after- taste
            9. 4-minute uptake required
            10. 0.4% stannous fluoride
            11. daily application; brushed on at bedtime; re- duces caries
            12. slight metallic taste; may produce extrinsic stain
            13. 1.1% neutral sodium fluoride
            14. daily application; brushed on at bedtime or applied using a custom tray recommended for bulimic and xerostomic patients
         5. systemic fluoride supplementation
         6. use of flouride dentifrices in conjunction with water flouridation may be the only two flouride products necessary to prevent dental caries in the adolescent.
      2. enhanced diet education programs
         1. increase in poor food choices
         2. frequent snacks
         3. abundant consumption of sweetened
         4. acidulated carbonated & non carbonated beverages
      3. improved oral home care routines
         1. Brushing with ADA-approved dentifrices
         2. use of mouth rinses,
         3. dental floss
   2. secondary
      1. focus on the oral health care provider’s ability to assess adolescents most at risk, educate them on the carious process, inform them of their individual risk factors, and provide them with appropriate preventive therapies
         1. Examination
         2. Dental history
         3. Radiograph
         4. Adjunctive assessments
         5. Prophylaxis
         6. pit & fissure sealant
   3. behavior
      1. The success of any caries prevention program or any dental health promotion program depends on :
         1. the interest
         2. Motivation
         3. Cooperation of the patient.