Chris Salierno, DDS

I challenge you to prevent, not just treat

April 1, 2020
Do you have a caries management program that matches the comprehensiveness of your periodontal management program? DE’s Chief Editor Chris Salierno, DDS, says it’s time to develop one.
Chris Salierno, DDS, Chief Dental Officer, Tend

I’m willing to bet that your practice has a solid periodontal management program. When a patient presents with periodontal disease, you and your hygienist diagnose the severity, present in-office therapies such as scaling and root planing, recommend at-home preventive measures such as oral irrigators and rinses, and, when necessary, refer to a periodontist. The disease is treated, and a program is put into place to attempt to prevent its reoccurrence. But are we doing the same thing for tooth decay?

When a new patient presents with multiple carious lesions, or when a patient seems to get a new cavity at every recall, what do you do to educate the patient and prevent future disease? Do you have a caries management program that matches the comprehensiveness of your periodontal management program?

For years, I would perform the same song and dance about electric toothbrushes, flossing more, and cautionary tales about frequent sugar intake. You know, the usual boring dentist lectures that patients dread. I treated my pediatric patients differently, however. Kids and their parents would get extensive oral hygiene instructions and preventive measures such as topical fluoride and sealants. We talked about decay like the disease it really is, and we tried to figure out how to best manage it. But the adult patients? Just a shrug and a recitation of how many fillings and/or crowns we had to do.

I’d like to challenge us to develop a complete caries management program for adults. We can classify their disease severity, identify their specific contributing factors, and present preventive therapies to lower their caries risk. It’s not rocket science, of course, but it does take some effort to design a proper program. It requires that we familiarize ourselves with products such as fluoride varnishes and trays, silver diamine fluoride, sealants, and MI Paste. Which ones will you and your hygiene team recommend for patients? What will you say if their third-party payer won’t cover the service you’re providing? 

In this issue, Drs. Laura Picano, Erinne Kennedy, Adrien Theriot, and Gordon Christensen will discuss materials and methods aimed at reducing caries for our patients. These best practices can serve as a starting point for your new caries management program. And when you have it in place, brag about it. Let patients know in your marketing materials, on your website, and in person that you are taking extra steps to keep them healthy. 

On a related note, Michelle Strange, MSDH, RDH, writes about how your infection control systems should also be highlighted in your marketing. At the time of this writing, the coronavirus (COVID-19) continues to spread worldwide and is impacting almost every industry and profession. It will be a comfort to your patients to know that your office is making their safety a priority.


Chris Salierno, DDS

[email protected]

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