Caries Management By Risk Assessment

Question 1

What does CAMBRA stand for?

Answer 1

Caries Management By Risk Assessment

Question 2

What is CAMBRA?

Answer 2

an evidence-based disease management protocol aimed at the prevention of dental caries.

Question 3

What is the first step in the CAMBRA protocol?

Answer 3

Risk assessment.

Question 4

What are the 4 components of the CAMBRA risk assessment?

Answer 4

Risk factors
Caries disease indicators
Protective factors
An evidence-based care plan is created

Question 5

Dental caries is:

Answer 5

1. Multifactorial disease
2. A transmissible bacterial infection
3. Preventable
4. Sometimes reversible
5. Not self-limiting
6. Not amenable to a course of antibiotics

Question 6

What is the pH scale range?

Answer 6

The pH scale ranges from 0 (acidic) to 14 (alkaline).

Question 7

what is a neutral pH?

Answer 7

pH of 7

Question 8

What is demineralization?

Answer 8

the net loss of minerals from the tooth surface, which occurs when the pH drops below 5.5.

Question 9

What groups of bacteria are primarily responsible for causing dental caries?

Answer 9

1. Mutans streptococci
2. Lactobacillus species

Question 10

How does the pH level in plaque biofilm change when fermentable carbohydrates are ingested?

Answer 10

the pH of plaque biofilm rapidly drops, becoming acidic

Question 11

What happens to the pH level in plaque biofilm after the ingestion of fermentable carbohydrates stops?

Answer 11

The pH level gradually returns to neutral within 30-60 minutes, if salivary flow is adequate

Question 12

What is remineralization?

Answer 12

Remineralization is the deposition of minerals into areas of tooth structure that have been demineralized.

Question 13

What role does fluoride play in remineralization?

Answer 13

by enhancing the deposition of minerals into demineralized areas and protecting carious lesions.

Question 14

What is a white spot lesion?

Answer 14

A white spot lesion is a demineralized area of enamel that usually has an intact surface remaining over the body of an early carious lesion.

Question 15

What happens to the enamel surface in a white spot lesion?

Answer 15

The enamel surface typically remains intact, but the demineralized area underneath appears white.

Question 16

What causes a white spot lesion?

Answer 16

A white spot lesion is caused by a net loss of minerals in the subsurface zone of enamel.

Question 17

What role does saliva play in remineralization?

Answer 17

Saliva provides calcium and phosphate for remineralization and carries topical fluoride around the mouth to support this process.

Question 18

How does saliva neutralize acids?

Answer 18

Saliva neutralizes organic acids produced in plaque biofilm, helping to maintain a balanced pH in the mouth.

Question 19

How does saliva discourage bacterial growth?

Answer 19

Saliva discourages the growth of bacteria, inhibiting infections in the mouth.

Question 20

What is the role of saliva in fluoride recycling?

Answer 20

Saliva recycles ingested fluoride, bringing it back into the mouth for further use in remineralization.

Question 21

How does saliva protect tissues in the mouth?

Answer 21

Saliva protects both hard and soft tissues from drying, ensuring they stay hydrated.

Question 22

What functions does saliva have in digestion?

Answer 22

Saliva facilitates chewing and swallowing, and speeds up the oral clearance of food.

Question 23

What are the four clinical observations that indicate caries history and past activity?

Answer 23

1. Teeth with frank cavitations or lesions that show penetration into dentin on radiographs
2. Approximal radiographic lesions confined to enamel only
3. Visual white spots on smooth surfaces
4. Any restorations placed in the last 3 years for a new patient or in the last 12 months for a patient of record

Question 24

what are some Caries RISK Factors?

Answer 24

1. Medium or high S. mutans and lactobacilli counts
2. Visible heavy plaque biofilm on teeth
3. Frequent snacking between meals
4. Deep pits and fissures
5. Recreational drug use
6. Inadequate salivary flow
7. Saliva-reducing factors
8. Exposed roots
9. Oral appliances

Question 25

what are some Caries PROTECTIVE Factors?

Answer 25

1. Lives, works, attends school in fluoridated community
2. Uses fluoride toothpaste at least once daily
3. Uses fluoride toothpaste at least twice daily
4. Uses fluoride mouthrinse daily
5. Uses 5000 ppm fluoride toothpaste daily
6. Had fluoride varnish applied in the last 6 months
7. Used prescribed chlorhexidine daily for 1 week during each of the last 6 months
8. Used xylitol gum or lozenges four to five times daily for the last 6 months
9. Used calcium and phosphate supplement paste during last 6 months
10. Has adequate salivary flow

Question 26

What are the criteria for high caries risk in patients aged 6 years and older?

Answer 26

One or more of the following disease indicators:

1. Cavities
2. Radiographic lesions to dentin and beyond
3. Radiographic lesions in enamel
4. Recent restorations
5. White spot lesions on smooth surfaces
6. Multiple caries risk factors

Question 27

What should be considered if you cannot determine whether a patient is at high or low risk for caries?

Answer 27

the patient should be considered to be at moderate risk for caries.

Question 28

What is Silver Diamine Fluoride (SDF)?

Answer 28

SDF is a noninvasive dental caries treatment that has been shown to arrest and remineralize caries lesions.

Question 29

How is Silver Diamine Fluoride applied?

Answer 29

SDF is applied directly to the affected (decayed) area of the tooth dropwise, following the manufacturer’s instructions.

Question 30

What does the SDF panel recommend for cavitated caries lesions?

Answer 30

The SDF panel supports the use of 38% Silver Diamine Fluoride for arresting cavitated caries lesions in children, adolescents, or individuals with special healthcare needs.