There are several therapeutic strategies that can be used to prevent and treat Dental Caries:
- pH strategies
Today we will discuss with Antimicrobials.
Antimicrobial Strategy- Sodium Hypochlorite
When discussing antimicrobial agents, Dr. Kutsch prefers sodium hypochlorite.
4 Key points about Sodium Hypochlorite
1. It is broad spectrum
Sodium Hypochlorite is safe, effective and has a broad spectrum of activity. It has been recommended for periodontal disease by Jorgensen Slots for years, and Dr. Kutsch has been using it for dental caries management for over a decade.
“0.1- 0.5% sodium hypochlorite for patient self care. These antiseptics have significantly broader spectra of antimicrobial action, are less likely to induce development of resistant bacteria and adverse host reactions, and are considerably less expensive than commercially available antibiotics in controlled release devises.”
Jorgensen MG, Aalam A, Slots J. Periodontal antimicrobials—finding the right solutions. Int Dent J February 2005. 55(1):3-12
In addition, a 3 year clinical trial in Queensland, Australia where two high-risk groups of school children were treated. One group treated with a placebo fluoride rinse and the other with the CariFree Treatment Rinse. The results?
2. Reduced caries index
“The placebo fluoride rinse reduced the mean caries index by 29%, and the Carifree Treatment Rinse reduced the caries index by 73% over a 3-year period. There was no additional benefit after 2 years of use.”
Hallett KB, O’Rourke PK. Oral biofilm activity, culture testing and caries experience in school 3-year double-blind randomized clinical trial. Queensland, Australia 2007-2010
Also, while this study was done looking at perio patients, the decrease in dental plaque cannot be overlooked.
3. Marked decrease in dental plaque levels
“A twice-weekly oral rinse with 0.25% sodium hypochlorite produced marked decreases in dental plaque level and bleeding on probing and may constitute a promising new approach to the management of periodontal disease. Long-term controlled studies on the effectiveness of sodium hypochlorite oral rinse are needed and encouraged.”
Galván M, Gonzalez S, Cohen CL, Alonaizan FA, Chen CT, Rich SK, Slots J. Periodontal effects of 0.25% sodium hypochlorite twice-weekly oral rinse. A pilot study. J Periodontal Res. 2013 Dec 14. 30PDD, 15/15,0,2wk, 3 mos, Subgingirrig
4. Dissolves biofilm
“Overall, 2.5% NaOCl dissolved and killed bacteria significantly more efficiently when used against polymicrobial mature biofilm on human dentine. Cetrimide improved the antimicrobial activity of chlorhexidine and alexidine.”
Ruiz-Linares M, Aguado-Pérez B, Baca P, Arias-Moliz MT, Ferrer-Luque CM. Efficacy of antimicrobial solutions against polymicrobial root canal biofilm. Int Endod J. 2015 Dec 13. doi: 10.1111/iej.12598
We have been using sodium hypocholorite during root canals for nearly 100 years. One of the greatest challenges to treating dental caries is penetrating the biofilm. To Dr. Kutsch, Sodium Hypochlorite is the best option to date.