Preventive and Interceptive Treatment of Hard Dental Tissue Diseases in Children

Karijes je kronična bolest koja može dovesti do destrukcije i gubitka zubnog tkiva. Nastaje zbog nakupljanja većeg broja bakterija na površini zuba koje fermentacijom ugljikohidrata iz plaka proizvode kiseline. Preventivna terapija uključuje postupke kojima se sprječava razvoj karijesne lezije. U slučaju nastanka inicijalne karijesne lezije, koja je reverzibilni oblik karijesa, pristupa se interceptivnom liječenju. I preventivna i interceptivna terapija zahtijeva suradnju djeteta i njegovog roditelja sa stomatologom jer u slučaju da se ne provode promjene navika prema zdravima, ishod terapije neće biti uspješan. U planiranju preventivne i interceptivne terapije bitno je provesti procjenu karijes rizika, obaviti dobar klinički pregled i dijagnostiku. Topikalna fluoridacija jedna je od najraširenijih preventivnih metoda. Najvažnije karijes protektivno djelovanje fluorida očituje se u remineralizaciji demineralizirane cakline. Fluoridi se primjenjuju u obliku zubnih pasti, tekućina za ispiranje usta, otopina, gelova, lakova, tableta za otapanje u ustima, žvakaćih guma, restaurativnih materijala koji otpuštaju fluor, naprava za otpuštanje fluorida. Od ostalih remineralizacijskih metoda prisutna je još terapija preparatima temeljenih na kalcijevom fosfatu i preparatima s nanohidroksilapatitom. Pečaćenje fisura primarno je preventivni zahvat, iako se koristi i u interceptivnom liječenju. Cilj terapije je zaštititi fisurni sustav i jamice zuba od pojave karijesa i pretvoriti ih iz fiziološki nečistih područja u mjesta dostupna čišćenju i samočišćenju. Antimikrobna sredstva su preventivna sredstva koja kemijskim putem kontroliraju količinu plaka i bakterija u usnoj šupljini. Najčešće primjenjivana sredstva su klorheksidin, koji pripada u oralne antiseptike, i ksilitol, koji je umjetni zaslađivač.Dental cavity is a chronic disease which can lead to tooth destruction and tooth loss. It happens due to increased number of cariogenic bacteria on tooth surface created by acids from metabolizing fermentable carbohydrates. Preventive therapy includes actions that decrease cavity activity. If an initial cavity lesion appears, which is a reversible cavity, interceptive treatment can be performed. Preventive treatment, as well as interceptive one, calls for collaboration between children and their parents with the dentist since the outcome of the therapy will not be successful if there are no changes in habits towards the healthy ones. While planning preventive and interceptive treatment, individual cavity risk assessment, clinical examination and diagnosis must be done. Topical fluoridation is one of the most commonly used preventive methods. The most important caries protective action of fluoride is the remineralization of demineralized enamel. Fluorides come in toothpastes, mouthrinses, solutions, gels, varnishes, pastils, chewing gums, and fluoride-releasing restorative materials. Other remineralizing materials are based on calcium phosphate and nanohydroxyapatite. Fissure and pit sealants are primarily preventive methods but can also be used in interceptive therapy. The aim of the therapy is to protect the fissure system and dentures from the appearance of caries and turn them from physiologically unclean areas into places prone to purification and self-purification. Antimicrobial agents are preventive agents that control the amount of plaque and bacteria in the oral cavity by chemical means. The most commonly used agents are chlorhexidine, which belongs to oral antiseptics, and xylitol, which is an artificial sweetener