PhD, UK; Research Professor, Department of Cariology – Operative Dentistry & Dental Public Health, Indianapolis

More Than Meets the Eye – Why Caries Lesions Are Different and Why They Require Diverse Treatment Approaches

Dental caries is a continuum, involving many cycles of de-and remineralization, starting at an atomic level of mineral loss and long before the disease can be detected clinically as a white spot lesion – and ultimately culminates in cavitation. White spot lesions are extremely variable and change in their characteristics throughout their lifespan. Currently, lesion activity and severity are the only ‘lesion parameters’ that are being propagated to determine non-invasive treatment approaches, although these parameters can only be crudely determined in vivo. Yet, lesions also vary in other parameters that determine their responsiveness to interventions, such as fluoride. This talk will provide an overview of mechanistic aspects of caries lesion formation and reversal, while also highlighting how lesion parameters can affect the efficacy of interventions.

Prevention of Erosive Tooth Wear

Erosive tooth wear (ETW), a condition of growing concern and threating public health, is a largely irreversible process of tooth surface loss due to the potentiating interaction between chemical agents and mechanical forces. Many different factors have been identified in the development of ETW, with the frequent consumption of acidic beverages being the most reported etiological factor.While behavioral change interventions may appear to be the most prudent of preventive approaches, they require a high level of subject adherence over a long period of time, are resource-intensive; and thus have been largely unsuccessful in achieving clinically meaningful benefits. Hence, alternative preventive strategies requiring little to no compliance are currently being considered state-of-the-art. This talk will provide an overview of the current state of erosion prevention through modification of erosive beverages and the topical application of metal fluorides.