Review your dietary habits, and reduce the number of between-meal sweet snacks that contain carbohydrates, especially sugar. Substitution by snacks rich in protein, such as cheese, will also help.
Brush twice daily with a new strong toothpaste, Colgate Prevident (5,000 parts per million fluoride). This paste is to be used twice daily in place of your regular toothpaste.
Rinse for one minute, once a day with special antibacterial mouth rinse that we will prescribe you. It is called Chlorhexidine Gluconate at 0:12 percent. You will use this once daily just before going to bed at night (10ml for one minute), but only for one week each month. You must use this at least one hour after brushing with the 5,000 ppm fluoride toothpaste.
Eliminate the dental decay you have now in a minimally invasive fashion. This might mean patch fillings on some teeth, provisional crowns on other teeth, and extractions if neither patch fillings nor provisional crowns can restore the teeth.
Suck xylitol candies or chew xylitol gum four times daily. We can help you obtain these if you cannot find them elsewhere at your pharmacy or grocery store.
Obtain a thorough professional cleaning and fluoride varnish of your teeth once every three months in the office of your dentist until no new cavities are evident.
Use a baking soda rinse four to six times a day. You can make this yourself by shaking two teaspoons of baking soda in an eight ounce bottle of water.
How to use custom fluoride carriers (Trays)
1. At bedtime, remove partial of full dentures from the mouth. Brush teeth thoroughly with soft toothbrush and regular toothpaste. Floss teeth by sliding the floss up and down between each side of each tooth. Note: it is very important to remove all food and plaque from between teeth before using fluoride. Food and plaque can prevent the fluoride from reaching the surface of the tooth.
2. Place a thin ribbon of the fluoride gel into each upper and lower fluoride tray so that each tooth space has some fluoride. Either 0.4 stannous fluoride (Gel Kam) or 1.1% sodium fluoride (Prevident) may be used. The fluoride can be spread into a thin film that coats the inside of the trays, by using cotton-tipped applicator, finger or toothbrush.
3. Seat the trays on the upper and lower teeth and let them remain in place for 5 minutes. Only a small amount of fluoride should come out of the use of the trays when they are placed, otherwise, there may be too much fluoride in the trays.
4. After 5 minutes, remove the trays and thoroughly expectorate (spit out) the residual fluoride. Very Important – do not rinse mouth, drink or eat for at least 30 minutes after fluoride use.
5. For head and neck radiation patients, begin using fluoride in the custom trays no longer than one week after radiotherapy is completed. Repeat daily for the rest of your life. Remember that tooth decay can occur in a matter of weeks if the fluoride is not used properly.