Yes, patient education and awareness are very important, but because there are a multitude of risk factors each of them needing specific tool for assesment and measurement, in addition to plan a specific strategy for prevention and the importance of financial suppmmust, all must be taken in consideration.

Dietary habits is the main reason for prevalence of caries. Fluoride is a weak remineralizing agent and if used frequently can be a useful agent for increasing acid resistance of enamel.

Financial support

Some dental professionals followed two philosophy or schools, one group satisfied that it is important to increase the resistance of dental enamel against acid attack by the use of fluoride, and/or calcium and phosphate, while the other group satisfied by dietary control including sugar restriction with the use of anticariogenic enzymes such as casin in order to get rid of dental fluorosis.

Well, dental caries (and also the progression of periodontal disease) are multifactorial. Although fluoride measures have been done in most countries, it is only one of the approaches to preventing dental caries. We should also take into consideration regional factors differences. One factor in one region may not be the factor in another region. Thus, preventing dental caries is not a one size fits all approach. We still have a lot to know and more factors to explore. It may not only be on increasing resistance of enamel against acid and dietary control, there might be more to that (e.g., bacterial make-up and interaction, possible associated risk variants, and salivary make-up). These are some of what we need to explore further.

There are lots of factors that we should explore to understand the complex nature of caries however, diet is the key factor that controls and either accelerate or slows down the caries process. Unfortunately sucrose sources is deeply embedded in most popular types of food regardless of cultures or social backgrounds.

Dear Lord, yes this is right, we must look at the problem from society's point of view, and consider the population as a patient rather than individual taking in consideration the etiological and predisposing factors, this will give attention to make efforts to apply preventive treatments and programs along with conservative treatment.

Dear ahmed, yes diet is an important factor that play a negative and positive roles in dental caries and periodontal disease status, negative through the formation of dental plaque and the role of sucrose and positive role through nutrition by the important role of minerals, this will make us to consentrate about the use of ulternatives such as xylitol and other at community level.

concentrate

Yes i agree. Since its a multifactorial disease...relying fluoride to put an end would be mission impossible. Other things should follow such as the restriction of cariogenic diets and good oral habit

CAMBRA seems to be a tool worth trying to fight caries :)

Thankyou Paulina you are right, will you pleace briefly explain CAMBRA

As mentioned above, caries is a multifactorial disease and several risk factors not just genetics (as the quality of saliva) but also enviromental, cultural and behaviour riskfactors must be considered. Caries is not caused by the absence of fluoride or fluoride toothpaste, as in many developing countries. Both at population level but mostly at individual level the causative risk factors of the desease must be indentified. In many cases is our life-style changes, behaviour risk factors are the cause. We are not seeing, unfortunately, a decrease in sugar intake for example (as it increases in every country). We see in increases incidence in caries amongst children here in Sweden.

Periodontal disease, the incidence is rather stabile among the population.

In both cases, these diseases are preventable, and for me as a health practitioner the most important is to teach people, individuals how to achieve a healthy lifestyle, helping them to adapt and practice healthy behaviours, change poor habits but also monitor and support those at high risk of the disease.

Working daily with health promotion my goal is for the individual to develope healthy habits early in life (but as we know is never to late to make a change), and maintain them to old age.

Thankyou for a nice explanation, when we think about the community, achieving a healthy lifestyle, practicing healthy behaviors and changing poor or bad non healthy habits into good healthy habits may need to concentrate on oral and dental health education and promotion, this will achieve by press and media activities to send messages to increase knowlege and gaining correct health habits because people are affected easily by such media

Yes Raad, I agree with You. The media is a strong "influencer" and people are easily persuaded by them. But our patients strongly believe in us, dental health professionals , therefore it is important that we teach/educate and promote healthy habits and stress the importants of health behaviour change.

I agree with dr Olga but how to make the voice of dentists reach to the huge population of the world??

Well Dr Ahmed, that is a good question and a great challenge for us dentists of the world. But foremost we, Dental Health Professionals, must agree on the How!

Sincerely Olga

It is important that each dentists educate and promot his patient in the dental clinic side by side with his conservative treatment but dentist- patient communication even it succeeded in reaching preventive message but still restricted to a specific group of people which later on will reaffected by dental diseases

There is evidence supporting that continued development of caries in certain individuals is a sign of chronic disease. As both caries and periodontal diseases are chronical diseases, the importance of continued support and monitor of patients, their self-care is essential and a life long task of Dental Health Professionals. Just as patients with chronic diabetes are for Public Health Care.

Good interpretation that is wright,

We can say that now caries and periodontitis are unusual chronic diseases. Caries and periodontitis are permanent diseases. The period of onset of reversible symptoms of periodontitis and caries is very short, about 10 days at any age. Further, irreversible changes are gradually formed. Caries and periodontitis are permanent diseases with a very short period of reversible symptoms. Now among dentists, there is no understanding of the cause and mechanism of caries development. Therefore, the consequence of this is the permanent need for observation by the dentist to eliminate the constantly occurring symptoms of caries and periodontitis.

Dear colleagues, some concluded that the reason was due to worldwide growth of people and increased retention of the teeth so these two diseases have grown and because the dental biofilm was considered as a major etiological factor that share in their development, this is true, because it is related to, if they are not performing good oral hygiene measures with the use of fluoride measures, but if other important cause is added which is related to the nutritional status, the picture will become clear, this is from population point of view, who are (the population) affected by dietary (related to high sugar intake), geographical, medical (including systemic diseases and drugs use), environmental, bacteriological factors, in addition to other factors such as genetic factor, all these factors make seeking and searching for the solutions is more complicated.