Preventing Tooth Decay: Evidence-Based Oral Hygiene & Diet Guide

Dental caries (cavities) is the most common chronic disease—largely preventable. The caries balance: pathological factors (bacteria, sugar, acid) vs. protective factors (saliva, fluoride, hygiene).

Core Prevention Pillars

1. Fluoride Toothpaste: 1000–1500 ppm. Brush 2x/day (last thing at night + one other). Spit, don't rinse. Pea-sized (3–6 yrs), smear (<3 yrs).
2. Interdental Cleaning: Floss daily once teeth touch. Removes plaque where brush can't reach.
3. Dietary Sugar Control:
   • Limit frequency: ≤4 eating/drinking occasions with free sugars/day.
   • Avoid sticky, slow-dissolving sugars.
   • Water/milk between meals.
4. Fluoridated Water: Community water fluoridation (0.7 ppm) reduces caries 25%. If not fluoridated, discuss supplements with dentist.
5. Regular Dental Visits: First visit by age 1 or first tooth. Then every 6 months. Early detection, fluoride varnish, sealants.
6. Sealants: Resin coating on molar pits/fissures. Reduces 80% of molar caries. Apply at 6 & 12 yr molar eruption.

Additional Protective Measures

• Xylitol gum/lozenges (5–10g/day) – inhibits S. mutans.
• Chlorhexidine varnish/rinse for high-risk.
• Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) paste (MI Paste®).
• Avoid saliva-sharing (utensils, cleaning pacifier with mouth) – delays S. mutans colonization in infants.

If Cavity Develops

• Early (white spot): fluoride, MI Paste, monitoring – may remineralize.
• Cavitated: filling (composite, glass ionomer).
• Deep: pulp therapy (pulpotomy, root canal) or extraction.

Consistency with basics (fluoride, hygiene, diet, dental visits) prevents most decay. Start early, involve whole family.