Featherstone. (2000)
宮下裕志（JDPIC研究会）
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J Am Dent Assoc 2000 Jul;131(7):887-99 |
Comment in:
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J
Am Dent Assoc. 2000 Dec;131(12):1674, 1676, 1678.
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J
Am Dent Assoc. 2000 Dec;131(12):1678, 1680, 1682.
The
science and practice of caries prevention.
Featherstone JD.
Department of Preventive and Restorative Dental Sciences,
BACKGROUND AND OVERVIEW: Dental caries is a bacterially based disease. When it
progresses, acid produced by bacterial action on dietary fermentable
carbohydrates diffuses into the tooth and dissolves the carbonated hydroxyapatite mineral--a process called demineralization.
Pathological factors including acidogenic bacteria (mutans streptococci and lactobacilli), salivary
dysfunction, and dietary carbohydrates are related to caries progression.
Protective factors--which include salivary calcium, phosphate and proteins,
salivary flow, fluoride in saliva, and antibacterial components or agents--can
balance, prevent or reverse dental caries. CONCLUSIONS: Caries progression or
reversal is determined by the balance between protective and pathological
factors. Fluoride, the key agent in battling caries, works primarily via
topical mechanisms: inhibition of demineralization, enhancement of remineralization and inhibition of bacterial enzymes.
CLINICAL IMPLICATIONS: Fluoride in drinking water and in fluoride-containing
products reduces caries via these topical mechanisms. Antibacterial therapy
must be used to combat a high bacterial challenge. For practical caries
management and prevention or reversal of dental caries, the sum of the
preventive factors must outweigh the pathological factors.
Publication Types:
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Review
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Review, Tutorial
キーワード
う蝕予防の科学
Copyrights(c) 2001 Hiroshi Miyashita DDS.