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Cottonwood Dental Group’s High Risk Dental Decay Protocol Highlands Ranch dentist

This protocol was taken in part from the California Dental Associations November 2007 report on caries risk assessment. Dr. James DeLapp and Dr. H. Candace DeLapp, Highlands Ranch Dentists, have seen rampant decay that has occured over a few months and has been most frustrating for the dentist and the dental patients. Most of the literature in the past has not had such a good protocols as this. Certainly, home fluoride and diet control have been the mainstay in the past but now we are turning up the heat and adding significantly more therapies Until rampant decay can be shown to be under control "complex" dental treatment is not recommended. Once the environment shows a low caries (decay) risk then complex dental treatment can proceed. Ultimately if not controlled you can lose you teeth!

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Cottonwood Dental Group P.C. has begun using the assessment tools listed below and are working with our patients to reduce their caries risk. Our example is listed below:

Our assessment reveals you are at Extreme risk of having new dental decay (cavities) in the near future because you have several significant risks factors listed below:

1. Medical history
2. Low salivary flow
3. Age related
4. Prescription related
5. Visible decay/root decay
6. Radiographic decay/restorations
7. Periodontal disease
8. Diet (simple sugars etc)
9. Sodas
10. Brushing
11. Flossing
12. Other

We want to help you to move towards avoiding/decreasing new decay (cavities) if at all possible. We strongly recommend the following:

1. A saliva flow measurement to check for dry mouth (xerostomia). Dry mouth promotes rampant decay. Please read “Dry Mouth Destruction” for further information.

2. If you smoke… please consider stopping. This contributes to decay and gum disease. It also helps your general health.

3. Review your dietary and oral hygiene habits and master what you have learned.

4. Fruit roll-ups and sticky candies are like sugar “napalm” and contribute to rampant decay. Eat “colored” foods! High glycemic index foods promote decay … wheat bread has a lower glycemic index than white bread as an example.

5. Reduce the number of between meal sweet snacks that contain carbohydrates especially sugar. Sodas with high sugar and high caffeine are particularly destructive and promote decay.

6. Use Xylitol gum or candies four (4) times daily
.
7. Brush twice daily with high fluoride toothpaste either Control RX or Prevident Plus toothpaste or similar product with around 5,000 parts per million fluoride.

8. Use atongue scraper once or twice per day to reduce the numbers of bacteria in your mouth.

9. Rinse your mouth for one (1) minute once a day with a prescription antibacterial mouth rinse with chlorohexidine (Peridex or Perioguard). You should use this once daily before bedtime but for only one week per month after brushing before bedtime.

10. Rinse with Listerine after brushing for two (2) min (it can be tough) for the other Three (3) weeks in the month before bedtime.

11. We “may” have you follow up with an oral irrigating device like a water pick or similar oral irrigating device with “Closis”.

12. Use a special paste that contains calcium and phosphate (e.g. MI paste). Apply it two (2) or more times daily to your teeth.

13. Use a baking soda “rinse” four (4) to six (6) times daily during the day. You can make this by shaking up two (2) teaspoons of baking soda in an eight (8) ounce bottle. Alternatively you can use a baking soda gum. This neutralizes the acids formed by the bacteria.

14. Have necessary restorative work done likedental fillings or crowns as needed in a minimally invasive fashion.

15. If appropriate, have dental sealants applied to all biting surfaces of your back teeth to reduce the bacteria that may infect your teeth and cause decay.

16. Return when requested for a caries recall exam in two (2) to four (4) months to re-evaluate current caries risk.

17. Get new bitewing radiographs (x-rays) about every 3-18 months to check for cavities.

18. Getf luoride varnish treatment for all of your teeth every three (3) to every four (4) months.

19. Rinse your mouth frequently during the day with water from a drinking fountain (has fluoride in it).

20. Reduce bottled water intake. Bottled water is highly filtered and likely contains no fluoride, which protects your teeth (tap water contains fluoride).

We understand that this is a lot of things to do and to remember. We strongly recommend you follow this protocol to reduce/stop the rapid destruction of your teeth. Ultimately, it is up to you to put in the time and effort. Our mutual goal is for you to improve the health of your mouth, gums and teeth and reduce the risk of tooth loss.

If you have questions about high risk dental decay please feel free to contact Cottonwood Dental Group P.C. at (303) 694-9740. Cottonwood Dental Group P.C. serves Dental Patients living in Highlands Ranch, Parker, Lone Tree and the Greater Denver area.

Dental Decay high risk Highlands Ranch Dentist