Tooth decay is one of the most common dental disorders in Spain, affecting over 90% of the population. The recommendations offered at the dental clinic are fundamental to prevent the onset and to contribute to improving patients’ oral health. In this section, several dentists and hygienists share their tips to prevent tooth decay and its consequences.

Laura Argudo, dental hygienist (Valencia)

To prevent tooth decay, the first step is to have regular dental check-ups and, at least once a year, to have your teeth thoroughly cleaned at the dental clinic.

Second, it is essential to keep daily dental hygiene, for which I advise to:

• Use toothpaste from the pharmacy. All DENTAID toothpastes contain fluoride, but in my case I recommend the use of VITIS® anticaries as it is specifically formulated to prevent tooth decay.
  
• Apply mouthwashes with fluoride and other components that help prevent decay.
  
• Use interproximal brushes if you have wide interdental spaces, or dental floss or tape for narrower interdental spaces.
  

Lastly, it is important to brush your teeth after each meal, especially at night, as salivary flow decreases while we sleep, so there is less protection from saliva, increasing the risk of decay. You should also avoid eating sweets between meals, as well as having excessively sugary beverages like soft drinks. 

Dr. Paula Bousoño, paediatric dentist and special patients’ care provider (Oviedo)

Tooth decay is a common chronic, multifactor, complex disease that arises from the imbalance between risk and protective factors that interact simultaneously.

The progression of decay occurs when there is an imbalance between pathological factors (cariogenic bacteria, fermentable carbohydrates and salivary dysfunction) and protective factors (salivary flow, fluoride and antibacterial therapy); Cavitation is a late consequence of the disease.

A check for tooth decay should assess the patient’s oral hygiene (biofilm type and pH), eating habits, oral saliva (pH, buffer capacity, amount and quality of saliva) and microbiota.

A clinical examination should be made on plaque-free teeth with bitewing radiographs to assess interproximal caries. Depending on the study, the patient will be classified according to level of risk and the following guidelines will be recommended as appropriate:

• Check-ups whose frequency will vary according to individual risk.
  
• Teaching oral hygiene.
  
• In high-risk patients, begin antibacterial therapy.
  
• Perform fluoride therapy.
  
• Replace sugar with xylitol to modify bacterial flora and prevent development and formation of new lesions.
• Increase salivary flow.
• Remineralising therapy to incipient carious lesions (without cavities).
• Minimally invasive restorative therapy for cavitated lesions. 

Dr. José Manuel Redondo, dentist (Ibiza)

Tooth decay is, like periodontal disease, a bacterial pathology that causes deterioration and ultimately loss of multiple teeth. Its prevention therefore plays a fundamental role.

Daily use of anti-decay toothpaste and a mouthwash, as well as moderate consumption of sugar-rich foods, prevents the onset of incipient lesions.

The new VITIS® anticaries formula reduces the formation of dental biofilm, neutralising the acid pH of the mouth thanks to the high concentration of xylitol. The synergy between the fluoride and the hydroxyapatite nanoparticles not only repairs and strengthens the enamel, but also fosters the formation of fluorapatite, increasing resistance to erosion.

Together with regular check-ups, daily use of VITIS® anticaries mouthwash and toothpaste, especially indicated for patients with high susceptibility to tooth decay, prevents and averts the appearance of irreversible lesions. 

Dr. Ana Isabel Terán de Agustín, dentist (Madrid)

Usually, and regardless of the particular risk of each patient, we apply three measures to prevent tooth decay:

1. Mechanical control of dental plaque. We offer the patient recommendations on brushing teeth: technique, brush type, frequency, use of dental floss, etc.

2. Advice on diet. We perform a questionnaire on the patients' eating habits: what they eat, the amount of carbohydrates they consume, etc. This way we can determine if any changes need to be made to their eating habits to help prevent caries.

3. Annual check-up at the dental office, or twice a year for patients with a higher risk of decay.

All the advice we offer must be adapted to the risk level of each person. This risk is determined by the analysis of several factors specific to each patient: decay indicators, individual risk factors, eating habits, dental anatomy, protective factors, etc. According to all this, a balance is established and the patient is classified at a risk level, establishing more specific preventive measures.

With higher-risk patients, we recommend following brushing with a chlorhexidine mouthwash during one week a month, and following brushing with a fluoride mouthwash for the remaining three weeks.

To prevent tooth decay in children, in addition to the annual visit to the dentist, we advise the use of a children's paste and a mouthwash of fluoride from the age of six (by which time they will know how to rinse and not swallow the mouthwash). From the age of six we recommend brushing with fluoride toothpaste after dinner and a fluoride mouthwash just before bedtime. 

Marta Alba, dental hygienist (Seville)

We inform patients on three key points for prevention of tooth decay.

1. First, good dental hygiene, consisting of brushing at least three times a day with a quality toothpaste containing fluoride, with emphasis on brushing before going to bed. There are toothpastes with different concentrations of fluoride, since depending on age are differing requirements. There are also anticaries toothpastes on sale with new active ingredients that prevent decay.

Furthermore, daily interdental hygiene should be performed with dental floss, oral irrigation or interproximal brushes. You can also use mouthwashes, taking into account that these should never replace brushing. Although brushing your teeth after every meal is ideal, if you can’t because you are away from home, we recommend chewing sugar-free gum as it produces more salivation, and xylitol helps prevent decay as it encourages remineralisation.

As for children, it is very important to start brushing once the first teeth come out. When they are very young and do not yet know how to spit, toothpaste is not recommended, just brushing with water. From the age of three, they can brush with a children’s toothpaste.

2. It is also essential to maintain a good diet and not eat too much sugar, tooth decay’s number one [ally]. It is best not to eat or drink continuously because saliva needs time between meals to neutralise acids and repair teeth.

3. And lastly, visits to the dentist for fluoride application and, if necessary, dental cleaning, placement of sealants, etc. are fundamental. These dental check-ups should be done at least once a year in adults and every six months in children. It is very important that the dentist check if a good brushing technique is followed. If decay is detected at any of the check-ups, it is best to treat it as soon as possible, because if you wait too long it can go deeper and reach the nerve of the tooth, which would cause more pain and longer, more expensive treatment.