Caries prevention through life course approach

Recent epidemiological analyses showed that caries risk continues throughout all age groups. Moreover, it seems that there are trajectories of oral health. Individuals seem to enter such a trajectory at an early age and it shows to be difficult to escape to another trajectory with better health perspectives. Therefore it is important to start caries prevention even before birth in order to ensure that children start in a favorable trajectory. Also health depends on social, environmental, and economic determinants which are conceptually summarized in the life course theory. For oral health, this implies that primary health-care providers integrate oral health into their routine examinations with oral health screenings, preventive education, and prophylactic fluoride applications. The main message for each age group is the twice daily toothbrushing with a fluoridated toothpaste individually supplemented with other oral hygiene techniques. If the oral hygiene technique fails, improvement can be achieved through composing self-care management goals. This method stimulates patients to formulate self-management goals, action and coping planning, and control. Patient’s adherence to his own goals is strengthened by the oral care provider who alerts the patient (and parents, caregivers, or voluntary aids) continuously about their own decisive influence on the control of caries in his own mouth. This requires tailored recall intervals for monitoring, motivation, and stimulation. The self-management goals are the take-home message towards creating a stronger and healthier dental atmosphere at home and are a vital facet to preventing caries for all age groups.