Not everybody has the same level of risk for developing dental caries; this is further complicated by the fact that the risk is dynamic and changes daily, as well as overtime. Therefore, assessing the degree of risk is crucial. And let's not forget that prevention includes determining both pathogenic and protective factors — both sides of the balance.
Modern dentistry is moving toward an approach to tooth decay management that is “evidence-based” from years of systematic, accumulated and valid scientific research. In other words, it allows individualized treatment based on current science that is customized to the patient's actual risk that he/she presents with, rather than a “one size fits all approach.”
Risk assessment allows preventive and treatment decisions to manage those in greatest jeopardy. This approach allows for “targeted” management appropriate for individuals whether in low, medium, high or extreme risk groups. Protocols have been recently established based on the Age One Visit (for infants and toddlers) as well as for children age 6 through adulthood.
You can see now that prevention doesn't simply mean brush and floss and don't eat sugar. It is a complicated topic with many implications. In fact, your dental office may offer some additional steps to measure your caries risk (salivary and bacterial analysis) and then recommend some products that specifically manage your risk level (sealants, antibacterial agents, topical fluoride, calcium and phosphate supplements, pH neutralizers, special toothpaste and rinses, and xylitol gum). These strategies are based on tipping the balance toward health by maximizing the protective side and minimizing or eliminating the pathogenic side. Prevention must be strategic since it affects planning on an individual and community level.