Preventing caries – from Brazil to Bern

In order to achieve the best caries prevention, he believes it is very important prevent dental decay from an early age and pass on good oral care habits from adults to children. Caries prevention from Colgate: we have launched an educational campaign to better the prevention and management of caries and provide guidance to patients on keeping their caries risk low.

Champion of caries prevention Thiago Carvalho gets a kick out of seeing patients smile because he knows they are both confident about showing off their healthy teeth and proud of the effort they have put in to keep them that way.

Long before his PhD from São Paulo Dental School in 2011, Brazilian-born Carvalho took part in an epidemiological study of fluorosis in 12-15 year olds in the deprived city of Joao Pessoa in North East Brazil, which inspired his passion for caries prevention. Shocked at how bad the oral health of these teenagers was, simply through lack of access to guidance and knowledge, the student decided prevention was his career direction.

What inspired Thiago’s passion for caries prevention? At first he was shocked at how bad the oral health of the teenagers was in areas of Brazil. However, with time he saw their brushing technique improved so much they could get away with only an annual check-up.
Some children’s brushing technique improved so much they only needed annual reviews.

Now both a researcher and lecturer at Bern University, Switzerland, Dr. Carvalho says those images of mouth after mouth of blackened and missing teeth, and youngsters afraid to smile, motivated his career in changing that depressing picture.

In prevention clinics in Brazil, he saw dramatic results – children whose oral health was so bad that they required an examination once a week – their brushing technique subsequently improved so much they only needed annual reviews.

He says: “That’s when I became convinced that we needed to prevent dental decay from an early age, so that adults will maintain good oral care and pass on good habits to their children. Of course the situation in Europe is different from Brazil. Nevertheless, in almost all European countries more progress is needed in preventing caries in children from disadvantaged groups.”

Dr. Carvalho believes that the biggest barrier to adopting preventive techniques is the sheer number of cavities which need restoring, thus diverting attention away from progress on general oral health. “We also need to get better at maintaining effective caries prevention and management into adulthood and throughout patients’ whole lives,” he added. “I want to see every dentist embracing a preventive approach – but it needs to be easy-to-implement during a short check-up.”

Colgate has recently launched an educational campaign called ‘Caries? We Care!’, which aims to improve the prevention and management of caries. The ‘Caries? We Care!’ Action Pack is designed help dental professionals implement the ICCMS™¹* guidelines, by allowing them to quickly assess a patient’s caries risk-level and then recommend simple but effective steps to manage that risk.

The Action Pack also includes educational materials for patients on how to keep their caries risk low. Bright and easy-to-follow patient materials are essential in Dr. Carvalho’s view, needed to set up a collaborative relationship in which the patient feels motivated and can track their progress.
Dr. Carvalho considers himself lucky as his dental studies began in a prevention clinic. Not every dentist has been so lucky, and at certain points in his studies even he was told to put aside all he had learned, by lecturers who favoured a more restorative course of action. Traditional attitudes will be difficult to change, he says, but will be influenced by results. He welcomes a project like ‘Caries? We Care!’, which gives dentists the confidence to adapt their practice, in the knowledge that their methods are backed up by strong evidence.

Seeing patients happy as well as healthy is a reward he can promise his students in Bern University’s preventive clinics. “It’s very satisfying for us, when we see how patients’ quality of life has improved alongside their oral health,” says Dr. Carvalho. “Because the patients just smile.”

¹Pitts NB et al. ICCMS™ Guide for Practitioners and Educators. December 2014.
*ICCMS™ stands for International Caries Classification and Management System.



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The #ColgateDialogue team