Caries Risk Assessment

Saliva provides protective factors to promote remineralization:

• ? and helps rid?

• Supplies?

healthy buffers acid and helps rid mouth of bacteria food debris

minerals to replace lost caclium and phosphate

Fluoride 3 main ways of protective factor

• inhibits demineralization

• enhances remineralization

• inhibits bacteria growth

caries paradigm shift:

From what ?

Goals (3)

• drill and fill

• early detection of caries and disease indicators

• identification of caries risk factors (modifiable and nonmodifiable)

• treatment planning focused on prevention and management

Risk factor vs risk indicator

Indicator is influencing vs factor is casual (increases probability)

critical pH of enamel

5.5

early stages bacteria (2)

later stages: (2)

early: streptococcus mutans and bifidobacteria

late: lactobacillus and actinomyces

Caries risk has 4 main components

environmental indicators, biologic biochemical factors, behavioral indicators, protective factors

3 environmental: indicator or risk

indicators: socio-economic, epidemiologic, general health

Biologic / Biochemical factors (3) all are ?

immediately involved in caries process: risk factors

bad bacteria, absence of saliva, dietary habits

fructose vs sucrose

fructose has moderate cariogenicity

sucrose high enamel mineral loss

cooked starch: contributes to formation of ?

When combined with ___, cariogenic potential increases

glucans, s mutans uses to adhere

sucrose, cariogenic potential increases

4 behavioral components: indicator or risk factor?

indicators: inadequate oral hygiene, infrequent dental visits, cariogenic diet, ortho and removable

5 protective factors

saliva, sealants, anti-bacterials, fluroide history, dietary habits

what does cambra stand for?

caries management by risk assessment

ADA caries risk assessment:

what age/range?

what scores?

0-6, 6-adult

low, moderate, high

AAPD risk assessment (CAT)

age ranges:

risks?

0-3 nondental, 0-5 dental, 6-adolscent

low and high risk for non-dental providers

low, moderate, high risk for dental providers

cariogram

all ages

bacteria, diet, susceptibility circumstances

pie chart illustration

Cambra clinical examination (5): tells us?

obvious white spots, decalcifications, decay

restorations within 2 years

plaque, BOP

dental or orthodontic appliances

inadequate saliva flow

presence (NOT about cause)

cambra criteria protective factors (6)

fluroridated water supply, fluoride supplements, fluor toothpaste at min 1x /day, caries activity in mother of child, xylitol gum or lozenge, dental home

cambra risk assessment non common sense (5)

continued bottle use, sleeps with bottle, nursing on demand, low SES, deep pits and fissures

risk determines?

management protocol

MUSOD caries risk assessment

• adapted from?

• based on?

• student makes ?

• patient takes ?

ADA and cambra, calculated result, non-surgical preventative recommendations, handout with recommendations

Cambra risk assessment:

high risk if one of these: (2)

high risk if two of these: (3)

white spots, decalcifications, decay

restorations within 2 years

plaque, BOP

dental or otho appliance

inadequate saliva flow