Karieshemmende

Karieshemmende refers to substances or materials that inhibit the development of dental caries. The term is most commonly used in dental literature in Dutch‑speaking regions, where it denotes products or substances that actively reduce the activity of cariogenic bacteria, lower acid production, or promote remineralisation of tooth enamel.

Fluoride is the most widely studied karieshemmende agent. By forming fluorapatite in enamel, it raises the threshold of pH at which demineralisation occurs. Everyday use of fluoride toothpaste, fluoridated water, and professional fluoride varnish or gel applications have been shown to significantly reduce caries incidence. Another group of karieshemmende compounds includes silver diamine fluoride (SDF) and sodium fluoride/shielding solutions; these not only provide high fluoride concentrations but also mechanically arrest active lesions.

Immunomodulatory and antibacterial agents such as chlorhexidine digluconate are also considered karieshemmende when used as mouth rinses or incorporated into dental materials. Chlorhexidine binds plasma proteins and planktonic bacteria, reducing the population of Streptococcus mutans and Lactobacilli that are implicated in caries formation. However, long‑term use can colour teeth and alter taste perception.

Emerging options involve arginine‑containing gels or mouthwashes. Arginine serves as a substrate for deiminases produced by certain oral bacteria, which elevates the local pH and counters acidogenic effects. Clinical trials report reduced surface microhardness loss in high‑risk patients.

In restorative dentistry, incorporating fluoridated glass ionomer cements and resin composites with milder fluoride release adds an intrinsic karieshemmende property to the restoration.

Dental practitioners combine the above agents into personalised caries‑control programmes. The choice depends on patient risk, age, habits, and tolerance. Evidence from systematic reviews consistently shows that a multi‑modal approach—fluoride, mechanical plaque removal, dietary counselling, and selective use of antibacterial products—yields the best prophylactic outcomes.