Department of Social and Preventive Dentistry, School of Dentistry, Federal University of Rio Grande do Sul, Porto Alegre, RS, Brazil.
Braz Oral Res. 2010;24 Suppl 1:18-25. doi: 10.1590/s1806-83242010000500004.
The central idea of the Brazilian health system is to prevent the establishment of disease or detect it as early as possible. Prevention and treatment of dental caries are related to behavioral factors, including dietary and oral hygiene habits, which are related to many chronic diseases. Dental health promotion therefore should be fully integrated into broadly based health-promoting strategies and actions such as food and health policies, and general hygiene (including oral hygiene), among others. For decades, a linear relationship between sugar consumption and caries has been observed. Recent data has indicated that this relationship is not as strong as it used to be before the widespread use of fluoride. However, diet is still a key factor acting in the carious process. Oral hygiene is a major aspect when it comes to caries, since dental biofilm is its etiological factor. Oral hygiene procedures are effective in controlling dental caries, especially if plaque removal is performed adequately and associated with fluoride. An alternative to a more efficient biofilm control in occlusal areas is the use of dental sealants, which are only indicated for caries-active individuals. If a cavity is formed as a consequence of the metabolic activity of the biofilm, a restorative material or a sealant can be placed to block access of the biofilm to the oral environment in order to prevent caries progress. The prevention of dental caries based on common risk-factor strategies (diet and hygiene) should be supplemented by more disease-specific policies such as rational use of fluoride, and evidence-based dental health care.
巴西卫生系统的核心思想是预防疾病的发生或尽早发现疾病。龋齿的预防和治疗与行为因素有关，包括饮食和口腔卫生习惯，这些因素与许多慢性疾病有关。因此，口腔健康促进应该完全纳入广泛的健康促进策略和行动中，如食品和卫生政策，以及一般卫生（包括口腔卫生）等。几十年来，人们一直观察到糖的消耗与龋齿之间存在线性关系。最近的数据表明，这种关系不如氟化物广泛使用之前那么强。然而，饮食仍然是龋齿发生过程中的一个关键因素。口腔卫生是龋齿的一个主要方面，因为牙菌斑是其病因。口腔卫生措施在控制龋齿方面非常有效，特别是如果能够充分去除牙菌斑并与氟化物结合使用。在咬合面区域控制生物膜的另一种替代方法是使用牙面封闭剂，它仅适用于龋齿活跃的个体。如果由于生物膜的代谢活动形成了龋洞，可以放置修复材料或密封剂来阻止生物膜进入口腔环境，以防止龋齿的进展。基于常见风险因素策略（饮食和卫生）的龋齿预防应辅以更具针对性的疾病策略，如合理使用氟化物和基于证据的口腔保健。
