CAMBRA

Question 1

what is risk assessment?

Answer 1

Risk assessment is the first
step; this is the estimation of the likelihood that an event will occur in the future

Question 2

What is cambra aimed at?

Answer 2

prevention
(risk factors, caries disease indicators, protective factors)

Question 3

what is created as a result?

Answer 3

evidence-based care plan

Question 4

what is the highest inidicator for risk factor

Answer 4

no saliva

Question 5

dental caries is

Answer 5

• A transmissible
  bacterial infection
• Preventable
• Sometimes
  reversible
• Not self-limiting
• Not amenable to a
  course of antibiotics

Question 6

demineralization equation

Answer 6

cariogenic bacteria + fermentable carbohydrates
= organic acids

dental mineral + organic acids = demineralization

Question 7

what can help stop caries besides fillings?

Answer 7

SDF or spf?

Question 8

remineralization equation

Answer 8

calcium in saliva + phosphate in saliva = remineralization

(saliva ~ “tooth water”)

Question 9

saliva’s beneficial actions

Answer 9

• Provides calcium and phosphate for remineralization
• Carries topical fluoride around the mouth for
  remineralization
• Neutralizes organic acids produced in plaque biofilm
• Discourages the growth of bacteria, inhibiting infection
• Recycles ingested fluoride into the mouth
• Protects hard and soft tissues from drying
• Facilitates chewing and swallowing
• Speeds oral clearance of food

Question 10

what does the caries balance include?

Answer 10

pathological factors and protective factors

Question 11

Caries Risk Assessment

Answer 11

First step in CAMBRA
* Manages the disease process
* For ages 6 years or older

Question 12

2 phases of caries risk assessment

Answer 12

Phase 1: assess caries indicators, risk factors and protective factors

Phase 2: determine level of caries risk (low, mod, high/extreme)

Question 13

Four Caries Disease Indicators for Caries Risk
Assessment

Answer 13

• Teeth with frank cavitations or lesions that
  radiographically show penetration into dentin
• Approximal radiographic lesions confined to the enamel
  only
• Visual white spots on smooth surface
• Any restorations placed in the last 3 years

Question 14

caries risk factors

Answer 14

• Medium or high S. mutans
  and lactobacilli counts
• Visible heavy plaque
  biofilm on teeth
• Frequent snacking
  between meals
• Deep pits and fissures
• Recreational drug use
• Inadequate salivary flow
• Saliva-reducing factors
• Exposed roots
• Orthodontic appliances

Question 15

caries protective factors

Answer 15

 Lives, works, and attends school in fluoridated community
 Uses fluoride toothpaste at least once daily
 Uses fluoride toothpaste at least twice daily(additional +)
 Uses fluoride mouthrinse daily (0.05% NaF)
 Uses 5000 ppm fluoride toothpaste daily
 Had fluoride varnish applied in the last 6 months
 Had an office fluoride topical application in the last 6 months
 Used prescribed chlorhexidine daily for 1 week during each of
the last 6 months
 Used xylitol gum or lozenges four to five times daily for the last
6 months
 Used calcium and phosphate supplement paste during last 6
months
 Has adequate salivary flow

Question 16

Criteria for High Caries Risk: Ages 6 Years and Older to
Adult

Answer 16

One or more disease indicators:
* Cavities
* Radiographic lesions to dentin
* Recent restorations
* White spots

And/or

Multiple risk factors:
* Heavy plaque on teeth
* Frequent (greater than three times per day) between meal
snacks of sugars or cooked starch
* Appliances present (e.g. orthodontic brackets)
Coupled with little or no protective factors

Question 17

when should salivary flow rate test be conducted?

Answer 17

should be conducted if inadequate salivary flow is noticed or if the patient reports having a dry mouth

Question 18

if any one of the four disease indicators is present,

Answer 18

a bacterial culture should be taken

Question 19

results from bacterial culture can be used for what?

Answer 19

used to motivate
patient compliance with
recommended antibacterial
regimens

Question 20

comprehensive CAMBRA assessment for kids 0-5 yrs

Answer 20

• Parent interview
• Examination of the child
• Assignment of caries risk level
• Individualized treatment based
  on risk level
• If indicated, bacterial culture
  on parent or caregiver and
  child
• Sharing of bacterial results
  with parent or caregiver as the
  basis for treatment
  recommendations and to
  enhance motivation
• Individualized homecare
  recommendations
• Motivational interview of parent
  or caregiver for caries control
• Setting of self-management
  goals with parent and child
• Anticipatory guidance according
  to a specific age category
• Determination of the interval for
  periodic oral examination
• Collaboration with other
  healthcare professionals

Question 21

FACTORS FOR HIGH CARIES RISK FOR AGES
BIRTH TO 5 YEARS

Answer 21

• Mother or primary caregiver with active dental decay in the last 12
  months
• Sleeps with bottle or nurses on ad lib basis
• Bottle contains fluids other than milk or water
• Visible cavities, white spots, or obvious decalcification
• Recent dental restorations (<2 years)
• Bleeding gums or heavy plaque on teeth
• Frequent (more than three times) between-meal snacks of sugars or
  cooked starch
• Appliances present (e.g., space maintainers, obturators)Visually
  inadequate salivary flow
• Visually inadequate salivary flow
• Presence of saliva-reducing factors, as follows:
• Medications, such as for asthma or hyperactivity
• Medical reasons (cancer treatment) or genetic predisposition

Question 22

PROTECTIVE FACTORS FOR
AGES BIRTH TO 5 YEARS

Answer 22

• residence includes community fluoridated water
• mother/caregiver cleans child’s teeth 2x daily with fluoride toothpaste (small amount)
• dental exam for child combined with oral hygiene instruction for parent/caregiver
• visible adequate saliva flow
• caregiver uses xylitol gum/mints four to five times daily
• caregiver who has no caries activity