Modern strategies to prevent dental caries in children

Cilj terapije u dječjoj dobi jest usporiti propadanje zubnog tkiva i održati postojeće zube u čeljusti što je duže moguće, kako bi se omogućio normalan rast i razvoj obje čeljusti. Karijes je infektivna bolest koju uzrokuju bakterije. Dolazi do demineralizacije kristala koji izgrađuju caklinu i dentin uslijed bakterijskog metabolizma gdje nastaju kiseli nusprodukti. Napretkom tehnologije i razvojem znanosti omogućilo se bolje razumijevanje etiologije te se promijenio i način terapije karijesa. Dijagnosticiranje karijesa provodi se klasičnim i suvremenim metodama koje omogućuju dijagnozu lezije u njezinoj ranoj fazi, kada postoji inicijalna lezija bez formiranja kaviteta. U neinvazivne metode ubrajamo preventivne postupke kao što su kontrola plaka, primjena klorheksidina, pečaćenje fisura, korištenje oralnih antiseptika i umjetnih zaslađivača. U remineralizacijske postupke liječenja početne karijesne lezije ubrajamo primjenu fluorida, amorfnih kalcijevih fosfata (ACP), kazein fosfopeptid- amorfno kalcijevih fosfata (CPP ACP), kalcijev-natrijevog fosfosilikatnog – bioaktivnog stakla, ozona i lasera. Ovim metodama ubrzava se i poboljšava remineralizacija te se samim time zaustavlja ili zacijeljuje lezija. U slučaju da je došlo do kavitacije, lezija se mora kirurški tretirati i tada koristimo principe minimalno invazivne stomatologije. Štedi se zdravo tkivo, a uklanja samo bolesno, dok se defekt zatvara adhezivnim materijalima koji se vežu za tvrda zubna tkiva.The goal of the treatment in childhood is to slow the deterioration of a tooth structure, maintain the existing teeth in the jaw as long as possible, and to allow normal growth and the development of both jaws. Dental caries is an infectious disease caused by bacteria. There is a demineralization of crystals that make up the enamel and dentin due to bacterial metabolism which produce acid by-products. The advancement of technology and the development of science has led to a better understanding of the etiology, and has also changed the way of treatment of dental caries. To diagnose caries we use both traditional and modern methods, which allow the diagnosis of lesion in its early stage, when there is an initial lesion without formed cavities. The non-invasive methods include preventive procedures such as plaque control, the use of chlorhexidine, fissure sealing, oral antiseptics and artificial sweeteners. The remineralizing treatment of the initial caries lesions include the application of fluoride, amorphous calcium phosphate (ACP), casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), calcium sodium phosphosilicate bioactive glass, ozone and laser treatment. This method accelerates and enhances remineralization and thus stops or heals lesions. In the event that there is a cavity, lesions must be surgically treated by using the principles of minimally invasive dentistry. This way the healthy tissue is preserved and the diseased tissue is eliminated, while the defect is closed by adhesive materials bound to hard dental tissue