> If she decides to keep her teeth, improve oral hygiene,

(I recommend sonic brushes -e.g. Sonicare)

watch for dietary acids,

(Some people have way too many acid exposures on a daily basis e.g. Coke is pH

2.1, -lemonade, orange juice, grapefruit juice all contain citric acid, then

there's acetic acid (vinigar) which can also cause erosion)

>neutralize the acids with baking soda toothpaste

(I recommend Arm and Hammer Dental Care since it contains 60% sodium

bicarbonate, which really increases the pH of dental plaque when it is exposed

to sugar) and chewing gum,

(Arm and Hammer and Trident now market chewing gum with baking soda- also

chewing gum really stimulates saliva)

> swish with soda water after snacking,

(again to neutralize the acids)

and continue using fluoridated

> products (like Prevident),

(Prevident by Colgate has 5000 ppm fluoride- a really high concentration. Use

only for high risk patients since a lot of the fluoride ends up systemically

absorbed, either due to swallowing or due to direct absorption through the

mucous membrane, especially under the tongue- if the patient complains of

nausea, they are getting fluoride poisoning and should stop using it)

you might consider alternating professional fluoride applications

> (I prefer Duraphat or Duraflor varnish)

(fluoride varnish -Duraphat- is now available for professional application in

the US- it has 22,600 ppm fluoride - check out Colgate's website on this

product at

http://www.colgateprofessional.com/cp/ColPro.class/jsp/products/productHome.jsp?prodcode=011400100

with a professional application of 2% chlorhexidine gluconate (applied like a topical fluoride gel) as often

as she is willing to come in for (e.g. every two weeks).

(Unfortunately, you have to make this stuff up through your local pharmacist if

you don't want to make it up yourself since there is no commercial product

available yet in the US- it's being studied in Iowa, though- check out

http://www.ihcf.org/publi/chxcaries.html for a whole bunch of chlorhexidine

articles).

If you monitor the bacterial counts

(One US company DOES make bacterial testing. Ivoclar sells a caries risk test

kit. You can look it up at http://www.ivoclarna.com/Secure30/ivoclar.jsp?

xml=ivoclar:data/product.xml&xsl=ivoclarsheets:/sheets/product.xsl&id=prd_com_a_

90_20_10&language=EN&encoding=iso-8859-

1&portal=us&hm_0=menu1,item_0_1&hm_1=a_a_0,item_1_10&hm_2=a_a_90,item_2_2&hm_3=a

_a_90_20,item_3_1&

(or if you don't want to copy that URL, go to Ivoclar's wesbsite

(www.ivoclarna.com) and look up 'clinical', then 'diagnostic' from the menu.)

Hope that's helped.

Keep smiling.

Hardy